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Leslie, Lauri & Jill Diamond BC Women's Surgical Services

Surgeries

We provide elective surgery for a variety of gynecologic health issues such as fibroids, infertility, abnormal bleeding, ovarian cysts, pelvic pain and many other conditions. 

Our surgeons are experts in minimally invasive surgical techniques. Innovations in minimally invasive surgery allow surgeons to complete complex surgeries through tiny incisions (less than 1cm) in the abdomen, or through the vagina (no abdominal incisions). This translates into less post-operative pain, fewer complications, and faster recovery.

Most of our procedures are 'daycare' procedures, meaning that you will go home the same day of the surgery. We also inpatient care as required depending on the nature of your surgery.

The development of this program was made possible by a transformational donation from Leslie, Lauri & Jill Diamond to the BC Women's Health Foundation.

Types of surgeries we perform

 

A dilatation and curettage is where the cervix (opening to the uterus) is stretched and then tissue lining the uterus is removed with a spoon-like instrument. This procedure is used to diagnose causes of abnormal bleeding, or sometimes to ensure that miscarriage is complete.

 
A hysteroscopy is a procedure where your doctor inserts a narrow telescope (hysteroscope) through the cervix (opening of the womb) into the uterus. This allows your doctor to look into your uterus to identify causes of abnormal menstrual bleeding, infertility, recurrent miscarriage, and causes of abnormal bleeding in menopause.

 

If necessary, surgery can be carried out through the hysteroscope to treat abnormal menstrual bleeding, infertility, recurrent miscarriage, or postmenopausal bleeding. Common hysteroscopic procedures include removal a lost intrauterine device (IUD), uterine polyps, fibroids, uterine septae, or scar tissue (adhesions).

 

This is a hysteroscopic procedure used to treat heavy menstrual bleeding. During this procedure, a device is inserted inside the uterus and uses either thermal energy (heat) or electrical energy to damage or inactivate the cells in the lining of the uterus (endometrium). This drastically reduces menstrual flow and has minimal downtime; women can return to normal activities within one or two days.

 

 Laparoscopy is a surgical procedure where the doctor makes a small incision (cut) in your belly button and two or three more incisions in your lower abdomen.  A narrow (5 mm) telescope-like instrument with a video camera, is inserted into the abdomen allowing the surgeons to look at your uterus, ovaries, fallopian tubes and other pelvic organs. Small instruments are used to perform various surgeries such as removal of endometriosis, fibroids (myomectomy), or ovarian cysts and even hysterectomy. 

 

 

This is a novel minimally invasive treatment for fibroids that are associated with bulk symptoms or heavy menstrual flow. This is done as a day surgery (home the same day), and has fewer complications and shorter recovery compared to alternative treatments of fibroid embolization or myomectomy.  Safety of this procedure when planning future pregnancy has not been well studied and this procedure is therefore not recommended if future pregnancy is desired.

 

 

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This type of surgery involves a larger incision in the abdomen, often at the bikini line (similar to a C-section), or in the midline of the abdomen. This is performed typically for hysterectomy or myomectomy (fibroid removal) in the setting of large uterine fibroids or if there are significant adhesions from prior surgeries. 


 

Prepare for Surgery


Preparing for surgery: what you need to know
These are general instructions to prepare for and recover from surgery. For detailed information specific to your procedure, refer to the aftercare instruction sheet you will be given in hospital.

We want you to have the best recovery possible after your surgery. To make this happen we need your help. Please review 

 

Complete all lab tests, and attend any consultations (Anesthesia, Internal Medicine) suggested by your gynecologist.

Ensure you have a responsible adult to take you home on the day of surgery and stay with you overnight after surgery.


Purchase 4% chlorhexidine antiseptic soap  (Hibiclens or Dexidin) from your pharmacy if you are having surgery through the abdomen (laparoscopy or laparotomy). You will need this to wash the surgical site the day before, and the morning of surgery.

Arrange an interpeter for the day of surgery, please call Translation Services (604-297-8400). This service is free of charge.

 
  • ‎You will receive an email communication providing information about your surgery including:
    • Instructions regarding pre-surgical skin wash with 4% chlorhexidine antiseptic soap (Hibiclens or Dexidin 4) if you are having surgery through the abdomen
    • arrival time
    • any specific instructions regarding your taking your medications before surgery
    • location of the BCW Surgical Suites and parking
    • a contact phone number in case  you have more questions
  • Avoid shaving around the surgical site for at least 3 days before surgery to reduce the risk of infection
  • Remove nail polish
  • If you are unwell prior to your surgery (fever, cough, shortness of breath, runny nose, diarrhea, flu-like symptoms), please notify us (604-875-2278) as soon as possible; in this case, your procedure should be rescheduled for when you are healthy
  • Please confirm who will take you home and stay with you on the day of surgery
 

 

Shower/bathe on the day of surgery with 4% chlorhexidine skin wash; if you are having laparoscopy, please ensure your navel (belly button) is cleaned.


Leave jewelry and valuables at home (you may bring a cell phone)


‎If you are unwell on the day of surgery (fever, cough, shortness of breath, runny nose, diarrhea, flu-like symptoms), please do not come to the hospital; call us (604-875-2278)and/or your gynecologist so that we can arrange to reschedule your procedure when you are healthy.


Bring your BC Care Card and one piece of photo ID.


Leave enough time to find parking and arrive on time.

Please review our printable Pre-operative Instructions for key reminders on the day of surgery.

 

Pain Control After Surgery

  • your doctor will review suggestions for pain control depending on the nature of your surgery

  • for most patients going home on the same day as surgery, a combination of pain medication is recommended:

                     acetaminophen 975 - 1000 mg every 8 hours

PLUS

                       naproxen 440 - 500 mg every 12 hours with food


  •  If you have an allergy or intolerance to one of these options, please discuss alternatives with your doctor

  • Some patients may require additional pain medication (opioids) and these will be provided as a prescription from your doctor
  • opioid medications can have serious side effects and use should be limited in the post operative course

After having an anesthetic:

  • you cannot drive or operate a vehicle for 24 hours

  • you should have an adult stay with you overnight

  • you should not consume alcohol or use recreational drugs, stimulants or sedatives for 24 hours

  • you should not make important decisions for 24 hours‎

After surgery:

  • clean your hands with soap and water before handling your dressing or incisions
  • you can remove dressings after 24 hours
  • remove steri-strips after 7 days or as recommended by your surgeon
  • you may shower 24 hours after surgery; cover dressings with plastic wrap and tape, pat dry as necessary

 

It is common to feel slightly nauseous or drowsy on the day of surgery. Drink fluids and take pain medication as prescribed by your surgeon.

Call your surgeon if:

  • You are unable to keep down food or liquids by the morning after surgery.

  • Your pain is not manageable.

  • Your pain is worsening after 48 hours.

  • You have heavy bleeding (soaking more than one pad per hour for 3 hours).

  • You have fever greater than 38 C (101 F).

 

 

It is important that you are healthy when you undergo surgery. There is evidence that having major surgery soon after COVID 19 infection may increase the risk of complications. 


Please notify your surgeon if you have COVID 19 in the weeks leading up to surgery, as it may be safest to delay your surgery. The decision to delay will be made in discussion with your surgeon and anesthesiologist. 


For asymptomatic patients that may be early in COVID 19 infection, there may be risk of transmission to your healthcare team if you have surgery while COVID positive. 

 


Anesthesia Options

General Anesthesia

Many procedures, such as laparoscopy, require general anesthesia. In this case you will be completely asleep with a breathing tube. Following your procedure, you may feel drowsy or nauseous until the following day.

Procedural Sedation

Many minor procedures including hysteroscopy, endometrial ablation, among others, can be performed with nurse administered procedural sedation. In this case you will be awake but drowsy (sedated) during the procedure.

This method has the advantage of allowing you to wake up more quickly so that you may feel less drowsy or nauseous following your procedure.

Your eligibility for procedural sedation depends on your health status and other factors. Your doctor will discuss with you what anesthesia option is right for you. 

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