Dr. Donald Rubino: Tracing the Transition of Gynecological Surgery to the Outpatient Setting

Donald Rubino, MD, FACOG, OB/GYN and vice president of the medical staff at Newton Medical Center, discussed the evolution of gynecological surgery in an interview with MD News.

Dr. Rubino explained that minimally invasive surgical techniques have significantly decreased patient discomfort, length of stay and recovery time. Laparoscopy was introduced by gynecologists and used primarily for tubal ligations and diagnosis of pelvic disorders; the technique is now used for operative surgery without opening the patient up.

Several of the procedures Dr. Rubino performs were once complex, open operations. For example, urinary incontinence used to require a large abdominal incision, whereas physicians now place a supportive ribbon of polypropylene under the urethra in a 30-minute outpatient procedure. Pelvic prolapse can also be corrected by using transvaginal mesh without the need for a hysterectomy.

Dr. Rubino said he can usually avoid hysterectomy by using hysteroscopy with resection of polyps and fibroids, combined with endometrial ablation, which destroys the endometrial lining. Hysterectomy itself can also be performed as an outpatient procedure laparoscopically.

Related Articles on Gynecological Surgery:
How ASCs Have Changed in the Last Year: 10 Business Findings From VMG Health's 2011 Intellimarker
ASC Specialty to Watch: Gynecology in 2012
Finding the New Spine: 7 Procedures Moving Into the ASC Setting

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