Surgical Specialties

Gynecologic Surgery

A woman is likely to undergo one or more surgical procedures relating to the care of her reproductive system. Most are routine elements of obstetrical and gynecological care.

Several surgical procedures – including hysterectomy, tubal ligation dilatation and curettage – have been common to gynecological care for decades, though they have been greatly refined over the years.

About one in four or five births is done by caesarean section, in which the baby is delivered through a surgical incision made through the abdomen. Caesarean sections are done to manage complications that make vaginal delivery problematic.

Laparoscopy offers an alternative to open surgery for conditions such as endometriosis and pelvic inflammatory disease. Hysteroscopy, a procedure that uses a fiberoptic instrument to view the inner body, can be used for a number of surgical applications.

A woman is likely to undergo one or more surgical procedures relating to the care of her reproductive system. Most are routine elements of obstetrical and gynecological care.

The late Theodore Sanford, M.D., who practiced at Central Maine Medical Center, introduced laparoscopy –the passing of a fiberoptic scope with a camera attached through tiny incisions in the abdomen – to Maine in 1969. (At the time, laparoscopies weren't being done even in Boston hospitals.) Laparoscopy offered an alternative to open surgery and was first used diagnostically.

New instrumentation made it possible for gynecologists to perform surgery through the same incisions that allow laparoscopic examinations. Two common conditions now treated through laparoscopy are endometriosis and pelvic inflammatory disease.

Hysteroscopy, a procedure that uses a fiberoptic instrument to view the uterine lining for abnormalities, was first done at CMMC in 1970 by Dr. Sanford. (At the time, this procedure was done nowhere else in New England.) A hysteroscope is inserted through a woman's cervix.

The hysteroscope is used with other instruments to perform biopsies or remove the endometrial lining in a process called endometrial ablation. When Michael Drouin, M.D., and John Woodward, M.D., a gynecologist from Dallas, performed laser ablation on an Auburn woman, it marked the first time that the procedure was used in Maine to alleviate severe menstrual bleeding and pain.

The hysteroscope can also be used with a laser to remove an abnormal septum dividing a uterus, a surgical advance that now allows women who become pregnant after the surgery to deliver vaginally.

Several surgical procedures have been common to gynecological care for decades, though they have been greatly refined over the years.

Hysterectomy, or removal of the uterus, is often performed if a woman has severe fibroids, endometriosis, cancer or other abnormal cervical or uterine growths, or if she has a history of heavy menstrual bleeding or pain. Often hysterectomies are done using a vaginal approach, which eliminates the need for an abdominal incision.

Tubal ligation is an outpatient procedure that prevents pregnancy by cauterizing or applying clips or rings to the fallopian tubes to block the passage of eggs along the tube. Tubes can sometimes be “untied” to restore fertility.

Dilatation and curettage, called a D & C for short is usually performed to determine the cause of abnormal bleeding, remove tissue left after a miscarriage, or remove fibroids or polyps. In a D & C, the cervix is gradually opened (dilatation) and the endometrial lining of the uterus scraped (curettage.)

About one in four or five births is done by caesarean section, in which the baby is delivered through a surgical incision made through the abdomen. Caesarean sections are done to manage complications that make vaginal delivery problematic.

A surgical suite within Special Delivery, CMMC's birthing center allows women who require a caesarean section to have the procedure without leaving the maternity unit. Unexpected complications happen infrequently, but when they do, having surgical services nearby can be advantageous for both mother and baby.