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Women Have Options: Gynecologic Laparoscopic Surgery

Charles Koh, M.D., Reproductive Surgeon, Co-founder of Columbia St. Mary’s Milwaukee Institute of Minimally Invasive Surgery

Posted: May 1, 2007

Charles Koh, M.D., Reproductive Endocrinologist, Co-founder of Columbia St. Mary’s Milwaukee Institute of Minimally Invasive Surgery

Minimally invasive surgery for women has undergone rapid advances in the last few years, fuelled by technological innovations and the establishment of centers of excellence. Many procedures once thought too difficult or impossible by laparoscopy are now routinely done successfully.

At the Columbia St. Mary’s Milwaukee Institute of Minimally Invasive Surgery, we use laparoscopic surgery to successfully treat women with fibroids, prolapse, infertility, endometriosis and other gynecologic conditions, including many women who previously were told they would not be good candidates for minimally invasive procedures.

Any woman considering gynecologic surgery should carefully review all her options, including getting a second opinion to determine if the surgery is necessary in the first place, and to discuss the availability of minimally invasive procedures.

A woman who has minimally invasive surgery will experience less pain and recover faster compared with a patient who has traditional surgery, often going home the same day. The smaller incisions used to perform laparoscopic surgery cause less trauma to the body, so healing time is shortened. There also is less chance of infection.

When researching the surgery, it is important to consider a center’s experience, which includes the number of procedures of that kind that have been done the last year, the complication rates, and the conversion rate for the procedure, which is the percentage of cases that began as laparoscopic surgery but were converted to open surgery during the operation. A lower percentage is a good indication of the surgeon’s expertise with the laparoscopic procedure.

For example, at the Milwaukee Institute of Minimally Invasive Surgery, our conversion rate for laparoscopic hysterectomies is less than one percent, and a uterus up to the size of a seven-month pregnancy (like a honeydew melon) has been successfully removed.

Women who have been considered ineligible for laparoscopic surgery by other surgeons because they were told that the uterus is too big, there are too many adhesions, or because of too many previous abdominal surgeries, regularly come to Milwaukee for their surgeries.

Our group was the first in the world to perform laparoscopic surgery for the rejoining of sterilized fallopian tubes, called tubal anastomosis, in 1992. Today we have an 80 percent pregnancy rate with this procedure, far exceeding the result of one IVF cycle.

Pelvic reconstruction surgery done laparoscopically at our center also has demonstrated good long-term results for prolapse, which is the sliding of the uterus out of its normal position into the vaginal canal. We specialize in treating women who have had recurrence of prolapse after receiving other treatment methods that failed.

We are one of very few centers nationwide with experience in the laparoscopic treatment for endometriosis of the bladder, ureter, bowel and thorax. The endometriosis resection procedure has resulted in lower recurrence rates, and additional surgeries are not needed.

The Milwaukee Institute of Minimally Invasive Surgery was founded in 1992 with the goal of bringing together physicians in a variety of specialties to provide the most innovative surgical care and treatment for patients. As leaders of advanced laparoscopic surgery, our physicians teach and lecture worldwide. Our patients come from throughout Wisconsin, across the country and around the world.

When facing gynecologic surgery, it’s important to check all options. Getting the information you need to make a good decision is an important step to a successful outcome.


Charles Koh, M.D.
Milwaukee Institute of Minimally Invasive Surgery
Columbia St. Mary’s
414-326-1745

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