Minimally Invasive Gynecologic Surgery (MIGS)

Gynecologic surgery is surgery in the female pelvis involving organs of the reproductive tract, such as the ovaries or uterus. UPMC doctors use minimally invasive surgery for most gynecological surgeries.

With minimally invasive gynecological surgery, doctors make small cuts or no cuts during surgery. This reduces pain and helps you heal faster.

What Is Minimally Invasive Gynecologic Surgery?

Doctors define minimally invasive surgery as surgery that involves no incision or smaller cuts than traditional surgery. It often uses small tools and tiny cameras and is linked to faster recoveries and fewer complications.

Doctors use minimally invasive gynecological surgery (MIGS) to treat issues that affect the:

• Fallopian tubes.
• Ovaries.
• Uterus and cervix
• Vulva and vagina

Compared to traditional surgery, the benefits of MIGS include:

• Smaller incisions.
• Faster recovery.
• Fewer complications like infection or large blood loss.
• Less pain.
• Less scar tissue at the surgery area.

What types of minimally invasive gynecologic surgery do you offer?

UPMC's doctors perform two types of minimally invasive gynecologic surgeries:

• Hysteroscopic — No incision. Instead, doctors enter the uterus through the cervix and vagina.
• Laparoscopic/robotic — Doctors complete your surgery with only a few small cuts in the pelvic area.

The most common gynecological surgery is hysterectomy, which is when doctors remove your uterus; sometimes, other organs, such as your tubes or ovaries, may be removed at the same time. As opposed to traditional surgery, a minimally invasive hysterectomy requires a shorter hospital stay and recovery, along with other benefits. That’s why doctors use minimally invasive surgery to perform most hysterectomies.

UPMC also offers minimally invasive surgery for:

• Diagnostic laparoscopy.
• Endometrial ablation.
• Endometriosis excision.
• Diagnostic hysteroscopy.
• Myomectomy.
• Ovarian cystectomy.
• Pelvic organ prolapse repair (suspension surgery).
• Presacral neurectomy.
• Suspension surgery (pelvic organ prolapse repair).
• Tubal ligation.

Why Would I Need Minimally Invasive Gynecologic Surgery?

Doctors use MIGS to treat existing problems, but in some cases, minimally invasive gynecologic surgery can help diagnose problems and prevent future issues. Your doctor will tell you why you’re a good candidate for MIGS.

What conditions do you treat with minimally invasive gynecologic surgery?

At UPMC, our doctors use MIGS to treat:

• Adenomyosis — A benign (noncancerous) condition in which the lining of the uterus grows into the muscular layer of the uterine wall.
• Endometriosis — When cells from the uterus grow in other parts of the belly (abdomen) or pelvic area.
• Fibroids — Benign (noncancerous) tumors that grow in the wall of the uterus.
• Abnormal uterine bleeding — Heavy bleeding caused by fibroids, endometriosis, or other conditions.
• Infertility — When couples have trouble getting pregnant, doctors may use MIGS to diagnose and treat health problems that cause infertility, like endometriosis.
• Ovarian cysts — Fluid-filled sacs that form on or inside an ovary.
• Pelvic organ prolapse (POP) — When your bladder, uterus, or rectum “falls” out of place.
• Pelvic pain — Caused by health issues like endometriosis, ovarian cysts, fibroids, and prolapse.
• Urinary incontinence — When you have trouble controlling your bladder and leak urine.

What Are the Risks and Complications of MIGS?

All surgeries come with some degree of risk. The most common complication after any gynecological surgery is infection and fever.

Other risks of MIGS include:

• Bleeding.
• Injury to other organs in the abdominal or pelvic area.
• Thromboembolism — blood clots in your veins.

Your age, the extent of your condition, and your health history can impact your risk.

Your doctor and care team will talk to you about how to reduce your odds of complications.

What Should I Expect from Minimally Invasive Gynecologic Surgery?

Before your surgery

Your doctor will tell you how to prepare for your upcoming minimally invasive gynecological surgery.

Bring a list of questions to your presurgery (preop) appointment. Consider bringing a trusted friend or family member to your presurgery appointment, too. Having someone else take notes can help you focus on your conversation with your doctor. 

During your minimally invasive gynecologic surgery

Doctors use two different types of anesthesia during minimally invasive surgery:

• Sedation — Also known as deep intravenous (IV) sedation, this is when doctors use medication that makes you sleep through the procedure, meaning you won’t be fully conscious or remember the surgery. With sedation, your muscles aren’t completely relaxed, so you can breathe without a machine. Doctors may use a small nasal cannula (a device that sits under your nose) to help you breathe even easier.
• General anesthesia — When doctors use medication that affects your whole body. You're not awake during surgery, and your muscles relax, too, so doctors will give you a special airway device to help you breathe. Side effects like nausea and drowsiness can last longer compared to sedation. 

Your doctor will talk to you about which type of anesthesia you’ll receive for your surgery.

After your MIGS procedure

You might feel tired and uncomfortable after surgery, but you shouldn’t have a lot of pain. Most people can return to their regular routine after a few days or weeks.

Your doctor may recommend you wait until you’re fully healed to:

• Exercise.
• Have sex.
• Put anything in your vagina, including tampons.
• Lift heavy objects.

Your doctor or nurse will give you specific instructions on what you can and can’t do after surgery. Be sure to go to your follow-up appointment.

How long does it take to recover after minimally invasive gynecologic surgery?

Your recovery time will depend on several things, including:

• The procedure your doctor performed.
• The extent of your health issue.
• Your age and health history.  

At UPMC, our goal is for you to feel better and resume your normal lifestyle as soon as possible after your surgery.

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Last reviewed by Gretchen E. H. Makai, MD on 2024-09-05.