MIGS surgery

Minimally Invasive Gynecologic Surgery Center

The Minimally Invasive Gynecologic Surgery (MIGS) Center at Massachusetts General Hospital delivers innovative, multidisciplinary care for a full range of gynecologic conditions including endometriosis, fibroids, abnormal uterine bleeding, ovarian cysts/masses, pelvic pain, urinary incontinence and gynecologic cancers.

Overview

The Minimally Invasive Gynecologic Surgery (MIGS) Center at Massachusetts General Hospital brings together nationally recognized surgeons from every gynecologic discipline, including the Mass General Cancer Center. Each member of our team is dedicated to providing individualized, minimally invasive surgery options to diagnose and treat the full range of gynecologic conditions and improve our patients’ quality of life.

MIGS at Mass General

A Collaborative Approach to Care

Dr. Douglas N. Brown is director and chief of the MIGS Center at Mass General. The MIGS Center provides individualized, minimally invasive options to diagnose and treat the full range of gynecologic conditions.

Watch video to learn more

Minimally Invasive, Personalized Treatment

Minimally invasive surgical procedures are associated with significantly less blood loss during surgery, less scarring, less postoperative pain and faster recovery than traditional open surgery. This allows patients to recover faster and return to their lives and daily activities with improved quality of life. Read our Frequently Asked Questions to learn more about minimally invasive surgical procedures.

Depending on your personal history and symptoms, our expert physicians may recommend one or a combination of minimally invasive treatments to address your individual condition. See a list of minimally invasive procedures performed at the MIGS Center.

A Collaborative Approach to Care

A Collaborative Approach to Care

The multidisciplinary MIGS Center at Mass General includes specialists from reproductive endocrine, urogynecology, oncology, benign OBGYN and specialized MIGS fellows. Our surgeons take a collaborative approach to patient care to determine the best procedure for every patient.

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Treating the Full Range of Conditions

The MIGS Center team treats gynecologic conditions including:

What to Expect

New patients at the Mass General MIGS Center will be paired with a multidisciplinary team of physicians and surgeons. Our consultation process involves a thorough discussion of treatment options, both innovative and traditional, that are uniquely suited to address individual conditions and medical history. Our patients are integral members of their care teams. Patients work directly with their physicians to develop an optimal treatment plan. Patient questions and feedback are an important part of each visit.

We also welcome patients and physicians who are seeking a second opinion on treatment options for any gynecologic condition.

FAQ

Frequently Asked Questions About Minimally Invasive Gynecologic Surgery (MIGS)

Douglas Brown, MD
Douglas Brown, MD, Chief of Minimally Invasive Gynecologic Surgery

Douglas Brown, MD, chief of Mass General's MIGS Center, answers common questions about our unique approach to gynecologic surgery.

Questions about minimally invasive surgery

What is minimally invasive surgery?

Minimally invasive surgery limits the size of incisions made for surgery, which sets it apart from traditional “open surgery”.  There are three main types of minimally invasive surgery:

  • Hysteroscopic procedures: a long, thin telescope-like instrument (called a hysteroscope) with a small video camera attached to the end is inserted through the vagina and cervix. This gives the doctor a magnified view of the uterus on a video monitor. Small surgical instruments can also be inserted through the hysteroscope to perform the procedure
  • Laparoscopic procedures: video-guided surgery. Instead of making a large incision through the skin and underlying muscles, a laparoscopic procedure requires three to four small incisions: one for a long, narrow telescope with a camera attached, and two or three others for the instruments needed to perform a procedure.
  • Robotic procedures: video-guided surgery using a tool called the da Vinci Surgical System. It is similar to a traditional laparoscopic procedure in that the surgeon makes three to four small incisions: one for a magnified, high-definition 3-D camera that guides the surgeon during the procedure, and two or three others for the robotic instruments that allow the surgeon maximum range of motion and surgical precision. It differs from a traditional laparoscopic procedure in that the surgeon controls the instruments and the camera from a console located next to the patient in the operating room

Do your surgeons perform robotic surgery?

Yes. This type of surgery has been performed at Mass General since 2008. Your physician will determine based on your specific needs whether a robotic-assisted approach may be useful in your care.

What are the advantages of minimally invasive surgery?

There are many benefits to choosing minimally invasive surgery over traditional surgery. Because it requires only tiny incisions, minimally invasive surgery results in less trauma to the body and faster recovery compared to a large open incision. In fact, the method of choice for surgeons and patients has shifted from traditional “open surgery” to less invasive means.

This is good news for patients and surgeons as it often means that patients who choose minimally invasive surgery recover faster and frequently experience:

  • Shorter hospital stays
  • Less pain after surgery
  • Less scarring
  • Faster return to work and normal activities
  • Reduced costs for patients

How many incisions will there be from my surgery?

The exact number of incisions will depend on the specifics of your surgery. Generally, there are anywhere from three to five small incisions (usually around 5mm across).

Questions about recovery

What will my recovery be like?

While the time and experience of recovery is different for every patient, in general recovery from minimally invasive surgery is much smoother than open surgery.

Most patients find that they have minimal pain. You likely won’t be able to exercise for a few weeks, but many patients are able to resume their normal activities around two weeks post-surgery.

Will I have to stay in the hospital after my surgery?

Recovery varies from patient to patient, but most patients are able to go home a few hours after their surgery is completed.

Questions about your initial appointment

How do I get ready for my initial appointment?

It’s important to come prepared for your appointment to get the most out of it.

  • Gather your records: bringing all the records related to the care you have received in the past will help your doctor understand you and your condition. You can bring hard copies or have these sent to Mass General beforehand
    NOTE: It is important to bring any imaging studies or lab results with you or have them sent before your visit so they can be reviewed by the physician before your appointment.
  • Make a list of questions: your initial consult can be a little overwhelming, so take time beforehand to think about what questions you’d like to ask the doctor about your condition, surgery and recovery
  • Consider bringing a trusted friend or family member: it can be difficult to take in all the information shared in a consult and ask all of your questions. Bringing another person who can serve as a second set of ears and take notes can be helpful, since it lets you focus on your conversation with the doctor

How can I make an appointment?

Call 855-MIGS-MGH to speak make an appointment for a consultation.

NOTE: If you have not previously seen a doctor at Mass General or within the Partners HealthCare Network, please call the Mass General Registration & Referral Center at 866-211-6588 to register before calling to make your appointment.

Questions about MIGS at Mass General

What is unique about the Minimally Invasive Gynecologic Surgery Center at Mass General?

The MIGS Center at Mass General takes a multidisciplinary approach to patient care. Our expert team of surgeons collaborates to identify the best procedure for each patient and provide the best surgical care for each patient’s unique health concerns.

Who will take care of me during my time at Mass General?

Your care team at Mass General will include physicians, nurses, social workers and other clinical staff. One advantage of receiving care at Mass General is you’ll also have access to the full resources of the hospital treatment programs in addition to your physician and surgical team.

Are your surgeons certified to perform minimally invasive surgery?

All of our surgeons are certified in obstetrics and gynecology, along their respective subspecialties, and have advanced training. Douglas N. Brown, MD, Chief of the Minimally Invasive Gynecologic Surgery Center, completed advanced surgical training through a specialized two-year fellowship in Minimally Invasive Gynecologic Surgery sponsored by the American Association of Gynecologic Laparoscopists (AAGL). Several other surgeons are specially certified to perform laparoscopic procedures by a national program called  Fundamentals of Laparoscopic Surgery (FLS).

Learn more about minimally invasive surgery from AAGL's MIS for Women site.

Video

  • Minimally Invasive Gynecologic Surgery (MIGS) Center

    Minimally Invasive Gynecologic Surgery (MIGS) Center

    The Minimally Invasive Gynecologic Surgery (MIGS) Center at Massachusetts General Hospital provides individualized, minimally invasive options to diagnose and treat the full range of gynecologic conditions, including endometriosis, fibroids, abnormal uterine bleeding, ovarian cysts/masses, pelvic pain, urinary incontinence and gynecologic cancers.

  • Minimally Invasive Gynecologic Surgery at Mass General

    The Collaborative Approach to Minimally Invasive Gynecologic Surgery (MIGS) at Mass General

    The multidisciplinary Minimally Invasive Gynecologic Surgery (MIGS) Center includes specialized surgeons, fellows and a variety of other specialists. Our surgeons take a collaborative approach to patient care to determine the best procedure for each patient. Meet members of the MIGS team and hear one patient's story in this video by the American Congress of Obstetricians and Gynecologists (ACOG).

Procedures

Depending on your personal history and symptoms, your multidisciplinary team of physicians and surgeons may recommend one or a combination of the following minimally invasive treatments to address your individual condition.

Hysteroscopic procedures

Hysteroscopy is a technique for visually examining the inside of the uterus and treating a variety of intra-uterine conditions without making incisions. A long, thin telescope-like instrument (called a hysteroscope) is inserted through the vagina and cervix. A small video camera attached to the end of the telescope gives the doctor a magnified view on a video monitor. Specific procedures include:

  • Endometrial ablation
  • Dilation and curettage
  • Lysis of adhesions
  • Myomectomy
  • Polypectomy
  • Tubal occlusion

Laparoscopic procedures

Laparoscopic surgery is a minimally invasive, video-guided technique. Instead of making a large incision through the skin and underlying muscles (called laparotomy), a laparoscopic procedure requires three to four small incisions: one for a long, narrow telescope with a camera attached, and two or three others for the instruments needed to perform a procedure. Laparoscopic procedures include:

  • Excision, ablation or removal of endometriosis, endometriomas, endometrial implants
  • Lysis of adhesions
  • Myomectomy
  • Ovarian cystectomy
  • Presacral neurectomy
  • Salpingo-oophorectomy
  • Supra-cervical hysterectomy
  • Total hysterectomy
  • Trachelectomy

Robotic procedures

Robotic surgery is a type of laparoscopic surgery. The surgeon makes three to four small incisions: one for a magnified, high-definition 3-D camera that guides the surgeon during the procedure, and two or three others for the robotic instruments that allow the surgeon maximum range of motion and surgical precision. The surgeon controls the instruments and the camera from a console located next to the patient in the operating room. Procedures that can be performed with this method include:

  • Excision, ablation or removal of endometriosis, endometriomas, endometrial implants
  • Lysis of adhesions
  • Myomectomy
  • Ovarian cystectomy
  • Presacral neurectomy
  • Salpingo-oophorectomy
  • Supra-cervical hysterectomy
  • Total hysterectomy
  • Trachelectomy

Single-incision surgery

Procedures that can be performed with one incision include:

  • Hysterectomy
  • Ovarian cystectomy
  • Salpingo-oophorectomy

Vaginal procedures

Vaginal surgery is a procedure that is performed within the vagina to remove the uterus, cervix or ovaries and tubes; repair the vaginal tissue that supports the bladder, rectum and uterus; or repair leakage of urine (called stress urinary incontinence). The procedures are performed vaginally so there are no abdominal incisions:

  • Cystocele repair
  • Rectocele repair
  • Tension-free vaginal tape for stress urinary incontinence
  • Uterine/vaginal resuspension (uteropexy, sacroculpopexy)

Contact

Our services are available from two locations:

Mass General Waltham

40 Second Avenue, Suite 400
Waltham, MA 02451
Phone: 781-487-3860
Fax: 781-487-3870

Minimally Invasive Gynecology Surgery Center

Massachusetts General Hospital
Yawkey 4E
Boston, MA 02114
Phone: 855-644-7644

Conditions & Diseases

At the Mass General MIGS Center, expert, board-certified physicians from every gynecologic discipline work together to deliver innovative, minimally invasive surgical care for a full range of gynecologic conditions.

  • Cervical Cancer

    If abnormal cells on the surface of the cervix spread deeper into the cervix, or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer.

  • Chronic Pain

    Chronic pain is long-standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition, such as arthritis.

  • Cystocele (Fallen Bladder)

    Cystocele is the name for a hernia-like disorder in women that occurs when the wall between the bladder and the vagina weakens, causing the bladder to drop or sag into the vagina.

  • Dysmenorrhea

    Dysmenorrhea is a menstrual condition characterized by severe and frequent menstrual cramps and pain associated with menstruation.

  • Endometrial Cancer

    Cancer of the endometrium, the most common cancer of the female reproductive organs, is a disease in which malignant (cancerous) cells are found in the endometrium. Endometrioid cancer is a specific type of endometrial cancer.

  • Endometriosis

    Endometriosis is a common gynecological condition involving abnormal buildup of tissue, often causing pain or infertility.

  • Infertility

    Infertility is defined by the American Society for Reproductive Medicine (ASRM) as a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction.

  • Menorrhagia

    Menorrhagia is the most common type of abnormal uterine bleeding characterized by heavy and prolonged menstrual bleeding.

  • Ovarian cancer

    Ovarian cancer is a disease in which malignant cells are found in an ovary.

  • Pelvic Inflammatory Disease (PID)

    Caused by a certain type of bacteria, pelvic inflammatory disease results in pelvic pain and the possibility of an ectopic pregnancy (a fertilized egg becoming implanted outside the uterus).

  • Pelvic Pain

    Pelvic pain may originate in genital or extragenital organs in and around the pelvis, or it may be psychological, which can make pain feel worse or actually cause a sensation of pain, when no physical problem is present.

  • Urinary Incontinence

  • Uterine Cancer

    Cancers that occur in each part of the uterus have their own names, such as cervical cancer or endometrial cancer, but are sometimes broadly defined as uterine cancer because the structure is part of the uterus.

  • Uterine Fibroids

    Fibroids are the most frequently seen tumors of the female reproductive system.

  • Vaginal Cancer

    Cancer of the vagina, a rare kind of cancer in women, is a disease in which malignant cells are found in the tissues of the vagina.

  • Vulvar Cancer

    Vulvar cancer is a malignancy that can occur on any part of the external organs, but most often affects the labia majora or labia minora.

News

  • A New Approach to Fibroid Management - 1/31/2014, Clinical

    The Fibroid Program at Massachusetts General Hospital offers patients access to a full range of multidisciplinary options to treat uterine fibroids.

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