News & Information
Scarless Gynecologic Surgery – A New Frontier In Procedures For Women
Dec 01, 2009
Contact: Michael Schwartzberg, GBMC Media Relations Manager (O): 443-849-2126/Cell: 410-258-3465

Scarless Gynecologic Surgery – A New Frontier In Procedures For Women

BALTIMORE, Md. – December 1, 2009 – Groundbreaking treatment – offering dramatically quicker recovery and potentially fewer complications – is now being offered at Greater Baltimore Medical Center for women with various gynecologic diseases.

“We’re providing a comprehensive array of some of the most innovative minimally invasive surgical treatment options, including vaginal and robotic surgery, single incision laparoscopy and sentinel lymph node surgery, for women with benign or cancerous gynecologic conditions,” said Amanda Nickles Fader, M.D., a gynecologic oncologist and minimally invasive surgeon with GBMC’s Women’s Oncology Center.

Using state-of-the-art technology, GBMC physicians are performing major abdominal surgery through tiny often “scarless” incisions. One of the most recent surgical innovations, single incision laparoscopic surgery (known as laparoendoscopic single-site surgery or “LESS”) is an advanced minimally-invasive approach for treating a variety of conditions including fibroids, ovarian cysts or masses, endometriosis and even early-stage gynecologic cancers. GBMC is one of the only hospitals in the nation offering LESS procedures for the treatment of both benign and cancerous female diseases.

More than 600,000 hysterectomies are performed annually in the United States, and although studies demonstrate that many women benefit from having these surgeries performed through small incisions and a minimally invasive approach, in excess of 60 percent are done through large incisions that require longer hospital stays and recovery times. “We believe that ‘smaller is better’ when it comes to surgical incisions,” Dr. Fader said.

Rather than operating through a large abdominal incision or the traditional three to five small incisions used for traditional laparoscopy, during LESS procedures, the surgeon operates almost exclusively through a single entry point, typically the patient’s navel. All surgical instruments are placed through this small incision. Advantages of the LESS procedure include better cosmetic results from a hidden scar (“scarless surgery” because patients can’t see the incision at the base of the belly button), the potential for less pain, and quicker recovery from fewer incisions.

Judith Schagrin of Pikesville has benefitted from GBMC’s advanced surgical procedures. Schagrin, 55, was diagnosed in October 2009 with an early stage of endometrial cancer, the most common gynecologic cancer in the United States, and underwent a hysterectomy and staging procedure via a LESS procedure that same month. Schagrin experienced very little blood loss and pain and went home the day after surgery, with only a tiny scar at the base of her navel. “A diagnosis of cancer is never good but curing it with a minimally invasive procedure minimized the impact on me and my family,” she said. “After just a few days of discomfort, I had a rapid recovery and within two weeks was able to resume my normal schedule of walking my dogs, working eight to nine hours a day and being a mother and a wife.”

Elizabeth Handy of Severna Park went home less than two hours after a six-centimeter complex ovarian mass was removed using single incision surgery. Handy, 54, used only Motrin for pain and didn’t need the prescribed narcotics. She was able to walk three miles the day after surgery, was swimming four days later and back at work within a week. “I can’t see my scar and I feel great—it’s almost like I never had surgery,” said Handy.

LESS surgery appears to be safe for older patients as well. Dorothy LaRue Allenwalt of Timonium, an 84-year-old breast cancer survivor, has a genetic mutation which increases the risk of both breast and ovarian cancer. In early November 2009, Allenwalt underwent a single incision laparoscopic removal of both her fallopian tubes and ovaries – a move designed to decrease her risk of ovarian cancer - and went home the next day. She was soon back to her normal routine of walking, exercising, driving and playing bridge.

A specialist in treating precancerous and cancerous female diseases, Dr. Fader is one of only a handful of gynecologic surgeons in the country trained in LESS procedures. She recently completed a fellowship at the Cleveland Clinic and has co-authored some of the first published studies on the use of single incision laparoscopic surgery used to treat gynecologic conditions including fibroids, endometriosis, ovarian cysts, pelvic masses and select early-stage gynecologic cancers.

“The diagnosis of a gynecologic cancer can be scary and disruptive for women and their families,” said Dr. Fader. “Our goal is to make cancer treatment as gentle and as least disruptive as possible so our patients can get back to their lives more quickly without a significant interruption in their quality of life. Performing cancer staging surgeries through a minimally invasive approach helps tremendously in this regard.”

Although LESS offers many benefits including improved cosmetic outcomes, less pain and low complication rates, not every woman will be a candidate for this procedure. “LESS is an emerging surgical technique and our study results are exciting but still preliminary,” Dr. Fader said. “We hope in the next year to confirm our initial findings in larger, multi-institutional trials.”

GBMC has a long tradition of caring for women that began in 1822 when one of its parent hospitals, The Hospital for the Women of Maryland, in Baltimore City, opened as the second women's hospital in the country. That tradition continues today through a comprehensive offering of women's health services. GBMC’s Department of Gynecology is a regional leader in laparoscopic surgery and was one of the first in Maryland to perform these surgeries, its surgeons performed the first da Vinci robot-assisted gynecologic surgery (2006) at a community (non-academic) hospital in the Mid-Atlantic region, and the hospital has a dedicated inpatient unit for the comfort of GYN patients.

Editor’s Note: Dr. Fader and patients who have undergone these advanced gynecologic surgical procedures can be available for interviews. Please contact Michael Schwartzberg to make arrangements.


About GBMC
GBMC HealthCare includes Greater Baltimore Medical Center, a 300-bed acute care not-for-profit hospital which opened in 1965 and provides Health, Healing and Hope; Greater Baltimore Medical Associates, a group of more than 40 multi-specialty physician practices on the hospital’s Towson campus and in satellite locations across the region; Gilchrist Hospice Care, Maryland’s largest hospice organization offering both in-home care as well as a 24-bed inpatient unit; and the GBMC Foundation, which raises funds to support the organization’s mission. For more information, visit www.gbmc.org

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