Fibroid Removal with Morcellator Bears Low Cancer Risk

Dr Keith Reisler pic

Dr Keith Reisler
Image: drreislerobgyn.com

Having received his medical degree from State University of New York, Downstate College of Medicine, Dr. Keith Reisler of Plano, TX, has practiced healthcare for over 30 years. Specializing in women’s health, Keith Reisler, MD, is board certified by the American Board of Obstetrics and Gynecology and currently a private practitioner. He is trained in a minimally invasive procedure to remove uterine fibroids with the use of a power morcellator.

Recent findings by the Journal of the American Medical Association – Oncology reports that when a small power tool called a morcellator is used to remove fibroids in the uterus, the likelihood of causing the spread of hidden cancerous tumors inside the abdomen is low. Although reassuring, the device remains under restricted use. In fact Dr. Keith Reisler was interviewed by the Wall Street Journal regarding this subject in an article published April, 2014. At that time Dr Reisler cautioned against the use of this instrument until more studies were available.

The power morcellator uses a rotating blade, allowing a surgeon to break apart uterine fibroids or the uterus itself during a hysterectomy. After the tissue has been morcellated, the remains may be removed via tiny incisions.

While the Food and Drug Administration (FDA) cautioned clinicians not to use the power morcellator in removing uterine fibroids on most females due to the risk of having undiagnosed cancerous uterine tumors, the FDA states some younger females may still be adequate candidates for use with the device. Chief of gynecologic oncology, Dr. Jason Wright at Columbia University examined over 42,000 cases of females in the United States between 2012 and 2016 who had uterine fibroids removed. Of that, only three females developed uterine cancer from more than 3,200 power morcellator procedures. Dr Keith Reisler still cautions against the use of this instrument in most patients since there is also concern about the spread of endometriosis and fibroid tumors throughout the abdominal cavity with the use of this instrument.

Features of High-Risk Pregnancy

 

High-Risk Pregnancy pic

High-Risk Pregnancy
Image: drreislerobgyn.com

Keith Reisler, MD, provides high-quality obstetric and gynecological care at his private office in Plano, TX. There, Dr. Keith Reisler has welcomed numerous women with pregnancies classified as high-risk.

The term high-risk can be intimidating, particularly when applied to a pregnancy. It does not mean, however, that there is certainly or almost certainly something wrong with the baby. It simply means that the mother or baby is more likely than average to present with challenges during gestation or delivery. This can be true of any pregnant woman who is below the age of 17 or above the age of 35, is expecting multiple babies, or has experienced two or more spontaneous pregnancy losses.

Mothers with a history of previous labor and delivery problems, or who have children with genetic abnormalities, also receive the attention due to a high-risk pregnancy. The same is true for women whose current prenatal care has identified a genetic condition in the developing fetus.

An expectant mother may also be at high risk if she has certain medical issues of her own, hypertension and diabetes being prominent examples. Cardiovascular issues, history of kidney infections, history of seizures, autoimmune disease, and other chronic illnesses can similarly increase risk, as can some medications. Women who believe that they may be at high risk should consult with their obstetrician for further information.

Hysteroscopic Resection of Fibroid Tumors

Dr Keith Reisler pic

Dr Keith Reisler
Image: drreislerobgyn.com

As a privately practicing obstetrician and gynecologist, Dr. Keith Reisler, of Plano, TX, has treated numerous cases of fibroid tumors. Keith Reisler, MD, focuses on the use of hysteroscopic resection of such tumors, so as to minimize the need for additional or more intensive treatment.

Hysteroscopic fibroid resection, also known as transcervical resection of fibroids (TCRF), uses a specially designed surgical instrument to remove growths in the uterus. The procedure uses a thin scope that can pass easily through the vagina and cervix and into the uterus, where a telescopic end enables the surgeon to view the growth. A resectoscope, which includes a wire loop and electrical current, then allows the surgeon to cut away the fibroid and draw it out through the vagina.

Performed under general anesthesia, the procedure is typically done on an outpatient basis. The operation itself lasts for approximately 60 minutes, while postoperative recovery phase can last up to 2 hours. The patient then returns home for an additional one to two days of recovery. The process can be ideal for patients with fibroids that grow from the inner lining into the uterine cavity, though those that are deeper in the uterine wall may be difficult to reach by endoscope.

The Basics of Endometrial Ablation

 

Dr Keith Reisler pic

Dr Keith Reisler
Image: drreislerobgyn.com

Keith Reisler, MD, of Plano, TX, has over 30 years of training in obstetrics and gynecology. The services offered at Dr. Keith Reisler’s practice are comprehensive. Whether educating women about preventative care, discussing various gynecological problems, providing prenatal care, or performing a variety of non-invasive procedures, Dr. Reisler is committed to the health and healing of his patients. One of the non-invasive procedures performed at his Plano, TX, office is endometrial ablation.

Endometrial ablation is a procedure that is used to treat women who suffer from abnormal uterine bleeding. When medications or an intrauterine device do not help unusually heavy or long periods, ablation may be recommended. The procedure ablates, or destroys, the endometrial lining of the uterus, thereby greatly reducing or even stopping menstrual cycles.

Novasure endometrial ablation involves inserting a slender wand into a woman’s dilated cervix. Once the wand is in place, a netted device is extended from the wand and expands to fit the uterus. A precise measure of radiofrequency energy is delivered through the netting for about 90 seconds. The netting is then drawn back into the wand and the device is removed. The entire procedure takes about 45 minutes and can be performed as an outpatient procedure.

Even though pregnancy can occur following endometrial ablation, it can be very risky for both mother and baby due to the decreased thickness of the endometrial lining. Therefore, miscarriage can result. Long-term contraception is recommended for those that undergo the procedure.

Hysterectomy Methods

Hysterectomy Image: mayoclinic.org

Hysterectomy
Image: mayoclinic.org

Keith Reisler, MD, of Plano, TX, has been in private practice for over 24 years. Dr. Keith Reisler completed his OBGYN residency at highly regarded, Southwestern Medical School/Parkland Hospital. Among the issues that women are confronted with are whether to have a hysterectomy, and which approach to use.

Hysterectomy involves the surgical removal of the womb or uterus. There are many reasons why it is performed, the most common being the presences of uterine fibroids. These are benign growths which can cause medical complications.

The various hysterectomy methods include abdominal, vaginal, laparoscopic, and robotic-assisted. Abdominal hysterectomy is the more traditional approach and requires a 6-to-12-inch incision in the abdominal wall. Vaginal hysterectomy involves the removal of the uterus through the vagina. Laparoscopic hysterectomy involves three to four small incisions in the abdominal wall and is considered non-evasive. The robotic-assisted procedure is relatively new, and its effectiveness vis-a-vis other methods is still under study. It is currently the most expensive approach.

There are many factors to consider in which method to use, including technical, medical, financial, and even the availability of medical equipment. One major consideration, of course, is that the surgeon performing the operation be highly skilled in the method used.

Hysteroscopic Resection for Uterine Fibroids and Polyps

Dr Keith Reisler pic

Dr Keith Reisler
Image: drreislerobgyn.com

Over the course of his career, obstetrician and gynecologist (OBGYN) Keith Reisler, MD, Plano, Tx, has treated numerous uterine fibroids and polyps. Dr. Keith Reisler draws on an in-depth knowledge of minimally invasive techniques to offer hysteroscopic resection as a treatment option for these conditions. Due to Dr Reisler’s expertise with various removal techniques, he is able to perform many these procedures as a day surgery procedure without an incision. Many doctors without this level of training might perform these procedures with an abdominal incision as an inpatient procedure and with a much longer recovery.

Hysteroscopic resection, also known as hysteroscopic myomectomy and hyesteroscopic poypectomy, uses a specially designed surgical scope to remove uterine fibroids and polyps. To perform the procedure, the surgeon introduces a salt or sugar solution that expands the uterus and allows for better visualization of the area. Insertion of the hysteroscope enables the surgeon to view any fibroids or polyps, and to strategize removal using a looped wire. This procedure is done without making any incisions and just by dilating the cervix.

Most patients who undergo hysteroscopic resection can return home the day of the procedure. Postoperative pain is generally minimal and manageable using basic oral analgesics. Risk of infection is low, as the procedure does not involve an abdominal incision, and most patients experience no detrimental effects in terms of fertility. In fact, the procedure’s history features high pregnancy rates among those patients whose fibroids have interfered with conception.

The Pap Smear Exam

Dr Keith Reisler pic

Dr Keith Reisler
Image: drreislerobgyn.com

For more than 20 years, Keith Reisler, MD, has provided women in the Plano, Texas, area with comprehensive gynecologic and obstetric care. As an OBGYN, Dr. Keith Reisler performs minimally invasive procedures and administers preventative care for women of all ages.

A procedure that many women receive from their OBGYN is a Pap smear exam. The purpose of a Pap smear is to determine whether or not precancerous cells are present in a woman’s cervix. The tests consists of a doctor or nurse taking a sample of cells from the cervix, transferring them to a glass slide, and then sending the slide off for laboratory testing. The results can usually be processed within a week.

One in 10 Pap smear tests reveals abnormalities, but less than one percent of these cases are cancerous. If any abnormalities exist, the OBGYN who performed the exam may recommend further testing.

Some women choose to have a yearly Pap smear as part of their overall female wellness checkup. However, many physicians believe it is acceptable to have a Pap smear every three years for women between the ages of 18 and 70.