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MIGS Techniques & Procedures

If you have a gynecologic condition requiring a procedure, you are in caring and capable hands. Virginia Mason Franciscan Health is home to experts specializing in minimally invasive gynecologic surgery (MIGS). We use leading techniques to treat complex conditions through small incisions. 

You have access to the best available methods, including robotic and laparoscopic procedures. We also offer innovative techniques, such as vaginal natural orifice transluminal endoscopic surgery (vNOTES). Our experience treating a high volume of patients leads to excellent results and precise care that helps you feel better.

What is minimally invasive gynecologic surgery?

MIGS enables us to diagnose and treat gynecologic conditions and symptoms using techniques that are gentler on your body. These approaches help us deliver advanced therapies while minimizing disruption to pelvic organs. MIGS also helps us maintain shorter operating times with less blood loss. You can expect a quicker, more comfortable recovery.  

Our program has decades of experience and is home to surgeons with fellowship training in minimally invasive gynecologic surgery. We have performed thousands of procedures, enabling us to deliver exceptional care for common and complex conditions.

MIGS techniques

We carefully consider your medical needs and treatment goals before selecting the option that’s best for you. Our patient-focused approach means we explain what to expect and answer all your questions. These efforts lead to seamless care that helps you achieve the best possible results.

MIGS techniques available at Virginia Mason Franciscan Health include:

  • vNOTES is the least invasive MIGS technique and requires no external incisions. It enables the surgeon to carry out procedures like hysterectomy through the vagina.

    Your surgeon places a narrow cylinder in your vagina to create space for maneuvering surgical instruments. They pass slender instruments through the cylinder and make a small incision to access the uterus, fallopian tubes and ovaries. A high-definition camera provides enhanced views of the surgical area.

  • Robotic gynecologic surgery enables us to perform complicated procedures with great precision and safety. After making small incisions, your surgeon uses surgical instruments and a 3D camera guided by robotic arms to carry out the procedure. Your surgeon maintains control of the instruments at all times. 

    The surgeon sits at a control panel that displays enhanced views of the surgical area. They use the console to guide the surgical robot’s every move. Special technology interprets the surgeon’s exact hand movements, enabling us to deliver therapies with a delicate touch.

  • Laparoscopic procedures involve small incisions in the abdomen. The surgeon inserts a thin tube with a camera at the end (laparoscope) through one of the incisions. They pass small instruments through another incision. Images from the camera appear on a monitor, enabling the surgeon to access pelvic organs from multiple angles. 

    Instruments act as an extension of the surgeon’s hands to carry out a variety of procedures. The laparoscopic approach may be best for you if you are not eligible for other types of minimally invasive gynecologic surgery.

  • Hysteroscopy is a nonsurgical procedure. It uses a thin tube with a camera and instruments at the tip (hysteroscope) to evaluate the uterus lining and nearby organs. Your provider passes the hysteroscope through the vagina and cervix. The camera sends images to a monitor in the procedure room so the provider can see inside the uterus. 

    We often perform hysteroscopy during an office visit. If a more complex hysteroscopy is necessary, we will perform it in an operating room. Our gynecologic surgeons explain your options and work with you to develop a personalized plan.  

    This method enables us to diagnose and treat conditions such as uterine fibroids, polyps and malformations. As an in-office procedure, you go home after a short recovery.

MIGS procedures we perform

We use minimally invasive gynecologic surgery to carry out various procedures. For issues affecting nearby organs, we work with additional surgical specialists, including urologists, colorectal surgeons and thoracic surgeons.

MIGS is a safe, gentle technique for removing unusual growths, such as:  

  • Endometriosis
  • Ovarian cysts
  • Polyps (precancerous growths)
  • Scar tissue buildup due to Asherman’s syndrome 
  • Small tissue pouches in the uterus from a previous C-section (isthmocele)
  • Uterine fibroids 

Our surgeons use MIGS techniques to carry out other surgical procedures, including:

  • Cervical loop electrode excision procedure (LEEP) to remove precancerous cells using a heated electrical wire loop
  • Endometrial ablation, which creates scar tissue on the top layers of the uterus to stop heavy periods 
  • Hysterectomy, which removes the uterus or uterus and cervix 
  • Intrauterine device (IUD) retrieval to take out birth control devices that have migrated from their original location
  • Risk-reducing salpingectomy to remove the fallopian tubes, which may decrease ovarian cancer risk. We often perform this treatment in conjunction with other gynecologic procedures, such as hysterectomy for permanent sterilization.

Schedule an appointment

Find out more about our gynecologic surgery services in the Puget Sound area or make an appointment.