Gynecology

Diagnostic methods in the Department of Gynecology

The key to successful treatment is accurate diagnosis, so the management of the Medical Center tries to get only the most modern equipment of the expert class. Let's consider the peculiarities of the diagnostic process in the Maimonides clinic.

1. Check-up

In order to find a problem in time, and this is especially relevant for malignant diseases of the female genital organs, you need to attend preventive examinations regularly. The "check-up" concept provides for the fastest and most complete gynecological preventive examinations that a woman can receive in one place in one visit. It is convenient, saves time and is the best prevention of reproductive system diseases.

As a rule, a gynecological check-up in our clinic includes: examination by a gynecologist, ultrasound of the pelvic organs and mammary glands, smear on the flora, Pap test (liquid cytology), colposcopy (examination of the cervix using a special device – a colposcope that magnifies the image ). This set of examinations is enough to assess the women's health condition and make a plan for future follow-up examinations in case of abnormalities.

2. Modern methods of medical imaging

In gynecology, it is often necessary to apply such informative and modern examination methods as CT, MRI and PET-CT. Patients of our clinic undergo diagnostics only on expert-class devices. If there is a require to conduct these studies, the patient is referred to affiliated medical centers or partner clinics. Only specialists who have undergone appropriate training and internships in the best clinics in Israel, Europe, and the United States are engaged in deciphering the received images.

3. Diagnostic hysteroscopy and laparoscopy

Hysteroscopy is a minimally invasive examination of the uterine cavity using a special device with a camera – a hysteroscope. The real-time image is displayed on a large screen in the surgery room, which allows the doctor to examine every square millimeter of the endometrium and detect pathological changes carefully. If necessary, we provide a biopsy or, for example, a medical procedure – removal of a polyp, dissection of the membrane in the uterus, etc.

Laparoscopy is a minimally invasive technique for abdominal cavity examining. Similar to hysteroscopy, it is performed using instruments and a camera that are inserted into the abdominal cavity through small incisions (usually no more than 1,18 in up to 0,39 in long). After the healing of postoperative wounds, almost no surgery trace remains on the skin.

With the help of laparoscopy, the gynecologist examines the abdominal cavity, analyzes the state of all internal organs of the reproductive system in detail, and if necessary, performs diagnostic (biopsy, checking the patency of fallopian tubes) or medical (dissection of adhesions, excision of myomatous nodes, endometrioid ovarian cysts, etc.) procedures.

4. Colposcopy and biopsy

Colposcopy is conducted for a cervix targeted examination. This is a completely non-invasive procedure, which is applicated with the help of a special colposcope device. It is a microscope that magnifies the image 20 times or more, which allows you to examine the entire surface of the cervix carefully, as well as provide a targeted biopsy from the desired suspicious area.

When the clinic's specialists provide a biopsy, the tissue samples are sent for testing to Maimonides' Israeli, American or German affiliated medical centers or partner clinics.

Thanks to such "molecular checks", we are absolutely sure of the final diagnosis correctness and the effectiveness of individually selected treatment scheme.

Modern treatment methods in gynecology

The Department of Gynecology gives its patients access to the most modern treatment methods of various female problems, including malignant tumors of the external and internal genital organs.

In addition, there are different clinical studies are constantly conducted on the basis of the Israeli partner clinics of the Maimonides Medical Center. It gives the opportunity to confirm the effectiveness of innovative drugs and therapy methods for gynecological diseases. Therefore, all our patients can participate in these experimental studies absolutely free of charge if they wish.

As a rule, patients are selected for research in case when standard treatment scheme was inefficient, and participation in research is the only real chance for a healthy future.

1. Robotic gynecological surgery "Da Vinci"

This innovative minimally invasive surgical procedure applying "Da Vinci" robot has found wide application in surgical gynecology for the various female problems treatment.

This system is designed specifically for surgeries without surgeon’s direct access to the surgical wound. All manipulations with the human body are carrying out by mechanical hands controlled by the operator (surgeon). The gynecologist sees the entire picture of the operating field on the screen behind the control panel in multiple magnification. The advantages of such robotic surgery are: all manipulations are performed with high precision, the risk of complications is minimal, little blood loss, quick recovery after surgery, minimal risk of infection of the surgical wound.

2. Single Port surgery

This surgical intervention is provided with the help of a robotic unit Single Port, which means "one incision". The procedure is conducted through one small incision below the umbilical ring. A special port containing manipulators, a camera and other necessary tools is entered into this incision. The Manipulator is a robot controlled by a surgeon at a distance. This approach allows us to minimize all operational risks and achieve effective results with a single, small approach.

3. Single-port video-assisted thoracoscopy in gynecology

This is a new minimally invasive method of surgical interventions, which allows excellent wide access to internal organs from one small incision. As a rule, this technique is used, for malignant neoplasms of the internal genital organs in woman. It has all the advantages of high-tech minimally invasive surgical techniques.

4. Fertility preservation in young women with oncogynecological diseases

Radical complex treatment of malignant neoplasms in reproductive age women is often accompanied by the loss of the ability to bear a child and premature menopause. That is why our specialists in the field of gynecology and reproductive medicine offer patients a delayed motherhood program before starting radical treatment. In case of consent, reproductive specialists carry out stimulation of superovulation, puncture and collect eggs with their subsequent cryopreservation. If the woman already has a husband, doctors provide the procedure of in vitro fertilization and cryopreservation of all ready embryos.

After the received complex oncology treatment, even in the case of fertility loss, the patient or married couple will be able to have their genetically native children in future. It can be provided by performing the IVF procedure.

5. Surgical cytoreduction in combination with chemotherapy

As you know, the best results in malignant diseases treatment of reproductive system in women are achieved by combining surgery with the most complete removal of all tissues affected by the tumor process and subsequent courses of chemotherapy to destroy every single parasitic cell remaining after surgery. According to clinical studies, this comprehensive approach is the most effective, and the survival rate of patients increases several times.

6. Photodynamic therapy in gynecology

This procedure is used to treat pathology of the cervix. Today, it is considered one of the most gentle, painless, non-contact methods of cervix treating diseases. In addition, it does not even require the applying of local anesthesia. This is an outpatient procedure that does not need hospitalization in the Department of Gynecology. The effect of the procedure is based on the ability to destroy cells as a result of the action of the photosensitizer on them and the light waves it absorbs. At the same time, the photosensitizer accumulates only in "bad" cells, which leads to the destruction of only such cells.

7. Evisceration of pelvic organs

This is a radical and disabling operation with the removal of the uterus, surrounding anatomical structures, rectum, and bladder. It is used only in extreme cases, when the rest of the treatment methods have proved to be ineffective or in case of cancer relapse.

This is far from a complete list of modern and highly effective methods of gynecological diseases treatment practiced by our doctors under the guidance of their Israeli mentors.

If necessary, our patients can also access the following treatment methods and unique procedures:

• 3D conformal radiation therapy (3D-CRT).
• Brachytherapy is a type of radiation therapy.
• Vaginal surgery using synthetic materials.
• Sacral-spinous fixation.
• Colporrhaphy.
• Combined (hybrid) reconstruction of the pelvic floor.
• Robotic surgery in urogynecology using the “Da Vinci” device.
• Laparoscopic promontofixation and correction of genital prolapse.
• Plastic surgery TVT (Tension-free Vaginal Tape) when the internal genital organs are prolapsed.
• Supravaginal amputation of the uterus.
• Neuromodulation.
• Sacrocolpopexy.
• Uterus and cervix removal (extirpation).

his is only a part of the list of all surgeries and medical procedures that are provided to preserve women's health in the Department of Gynecology Maimonides Medical Center.