Minimally invasive surgery offers numerous potential benefits over conventional abdominal surgeries, including:
- Shorter hospital stay, which can reduces costs.
- Less pain, scarring and intrapelvic adhesions.
- Less risk of wound infections.
- Less blood loss and fewer transfusions.
- Faster recovery and quicker return to normal activities.
- Better preservation of immun system
The genital organs are surrounded by the bladder, ureters, bowel, major vessels and pelvic nerves. Injury to any of these organs can occur, even when in our practice, this risk is far less than 1%. However, if any injury were to occur during the surgery, we would repair the injuries during the procedure. If necessary, we may have another surgeon specializing in the organs injured come to assist in the repair as well. Most injuries are recognized during the surgery and can be repaired successfully. If an injury is not recognized, then the patient will develop symptoms after the procedure anywhere from immediately after the surgery to a few weeks after the surgery.
Infection from the surgery is minimal. All patients receive a single shot of antibiotics about 30 minutes prior to surgery through the IV as a precaution. Depending on the surgery, some patients are sent home on antibiotics as well.
Blood transfusions are very rare. Because most of our procedures focused on the pelvic nerves, blood free dissections are absolutely mandatory. Therefore we are very careful to
avoid or minimize blood loss as much as possible during the surgery. Depending on the type of surgery or the woman’s blood count level prior to surgery, a transfusion may be
recommended to help with recovery. Some women may be candidates to donate their own blood prior to surgery in case the risk of transfusion for an individual’s surgery is higher
Undergoing anesthesia also has risks. These risks are discussed with your anesthesiologist prior to surgery. Other risks may be discussed by your surgeon depending on the woman’s past medical history, physical exam and the type of surgery being planned.
In general, most of our patients are ready to go home the same day. In cases of more extensive procedures an overnight stay is reasonable for observation, but still the majority of those patients will go home the next day. Upper back, shoulder and chest pain is normal following laparoscopy from the CO2 gas used during the procedure. It should subside within 48-72 hours. Recovery is fast and most patients are able to resume their regular activities (including work) within 2-3 weeks.
Drink lots of fluids. You will be dehydrated from fasting and the bowel prep. You should drink 128 oz (one gallon) of fluids daily. Start with a liquid diet, once you are passing gas rectally, you may advance to a soft diet; applesauce, toast, noodles, etc. If you can tolerate this, then return to your regular diet. The incisions will be closed with absorbable suture. You will have both steristrips and tegaderm dressings. These should stay on for one week unless they become wet or bloody underneath. If this happens, remove the tegaderm dressing trying not to disturb the steristrips. If the steristrips are wet or come off, do not worry. Just keep all incisions dry. Use a blow dryer (on cool setting) to dry the belly button after showering. Constipation is normal following surgery. It may take 3-7 days to get back to normal. If you are passing gas rectally you may use a gentle laxative such as Miralax or Milk of Magnesia. Reduce your use of pain medication if possible. If you continue to have problems, please contact the office.
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Our surgery fees depend on the level of complexity of your surgery. Fees generally range from $7500 to $20,000 for Prof. Possover´s fee. We do all insurance billing for you.
Hospital fees at Pyramide Clinic depend on the type of admission, inpatient or outpatient, and the length of stay. Pyramide Clinic participates with most national insurers, so for hospital, anesthesia and pathology fees your insurance will pay "in-network".
One of our representatives will be happy to work you in obtaining an appointment with Possover Medical Center. All appointments are based on availability.
Prof. Possover absolved his medical study in age of 22 years after starting his medical study in age of 15 years. Prof. Possover is a pioneer in the field of minimally invasive surgeries for gynecological malignancies and extra pelvic endometriosis since begin of the 90´s, has been successful in adapting many open procedures to laparoscopy and has introduced techniques of pelvic nerves sparing in laparoscopic gynecology. He developed the neuropelveology as a pioneer over the last 10 years. Throughout his career, Prof. Possover has been exposed to and worked with many of the masters in operative laparoscopy and oncology and has been successful in implementing the techniques he learned since the early stages of his medical career.
Prof. Possover performs all of his surgeries at Pyramide Clinic in Zurich – Switzerland.
Prof. Possover is a leading pioneer in the field of laparoscopic surgery, specializing in laparoscopic nerves sparing treatment of severe and multi-organ endometriosis, laparoscopic surgery of pelvic nerves endometriosis, and urologic and pelvic reconstruction.
He has treated thousands of women with endometriosis. Currently, he is increasing awareness of this disorder by being Ambassador of the World Endometriosis Society. He is director of the European-Certified Endometriosis Center Level 3 of Zürich located in the Possover Medical Center (www.endometriosiszentrum-zuerich.ch).
Prof. Possover is a leading pioneer in the field of laparoscopic oncological surgery in the gynecology. He learned the techniques of vaginal radical hysterectomy after Schauta-
Stoeckel and of radical trachelectomy by Prof. Dargent (who has developed this surgical technique) in Lyon. Because of his previous formation in cardiovascular surgery, he was the first performing techniques of laparoscopic pelvic and paraaortic lymphadenectomy and of radical trachelectomy in Germany in the early 90´s. He got his PhD at the University of Jena on the topic of the minimal invasive surgery of the cervical cancer and has developed the technique of “laparoscopic assisted vaginal nerves sparing radical vaginal hysterectomy after Possover”. Because of his formation in cardiovascular surgery, he has been trained in open radical multivisceral surgery for advanced ovarian cancer and extended cervical cancer (pelvic evisceration), including urological (neobladder) and genital (neovagina) reconstruction. He has treated hundreds of women with gynecological malignancies. Currently, he is increasing awareness of the technique of the radical trachelectomy that enable young women affected by cervical cancer less than 2cm in diameter to preserved fertility. Over the last 20 years, he has teached many young colleagues over the world in minimal invasive surgery for gynecological malignancies.
Prof. Possover is a leading pioneer and the founder of the Neuropelveology. The Neuropelveology is recognized as a new field in medicine and is recognoized as a University medical specialty at the university of Aarhus in Denmark. He has developed this field because of the amount of patients suffering from neuropathic pelvic pain and disorders even more because no any other specialty deals with these pathologies, except the medical pain doctors. Pain medical treatments are very usefully, but if a reason for a pathologic situation can be treated, it makes sense to treat it. However neither the neurologists nor the neurosurgeons have a proper approach to the pelvic nerves. The laparoscopy enables a reproducible and safe, minimal invasive approach to all pelvic nerves and plexus, that build the basis of neuropelveological treatments. Nerves can be explored this way, decompressed this way, but also neuroprothesis can be placed to the nerves for recovery proper functions or for control transport of pain informations. More than that, neurostimulation of the pelvic nerves may help spinal cord injured peoples and spina bifida children for recovery functions and for nerves growth.
The first step in learning neuropelveology as a gynecologist is the adaptation of the wellknown basic in neurology of the pelvic nerves that enable first an exact and individual
diagnosis that is the base for an adapted management. Medical, physiological, psychological and surgical treatments are combined for the best way of treatment. Knowledges on medical pain treatment, pelvic neuroanatomy, neurourology and techniques of laparoscopic neurosurgery are mandatory.