Demystifying MISP

The University of Michigan Health System (UMHS) Department of Obstetrics and Gynecology provides women with many options in diagnosing and treating abnormal uterine bleeding, including the Minimally Invasive Surgery Program (MISP). This program offers a number of procedures that may allow women to avoid large abdominal incisions, anesthesia, and/or spending the night in the hospital.

All of the procedures UMHS offers are not an option for every woman. Each patient’s medical history, needs and preferences help determine the treatment. “We make patients aware of each option and present the ones that are appropriate for each individual in order to come up with the best plan of care,” says Arleen Song, M.D., M.P.H., assistant professor, department of obstetrics and gynecology. Song is one of the three faculty in MISP. The faculty also includes Arnold Advincula, M.D., and Suzie As-Sanie, M.D., M.P.H. “Our group has a wide range of therapeutic options to offer—both medical and surgical,” says Song.

What’s Offered?

UMHS offers laparoscopic techniques, hysteroscopies, endometrial ablation and myomectomies (see definitions on page 2). The MISP is a leader in using da Vinci®-assisted laparoscopic myomectomy. In 2001, UMHS was among the first centers in the United States to utilize robotic technology for gynecological surgery. This type of surgery is not offered widely in the region or even nationally, and UMHS continues to be a leader in the number of procedures performed because of the experience of Dr. Advincula, Dr. As-Sanie and Dr. Song. Da Vinci® myomectomy is one option, but laparoscopic hysterectomy is another good option for some women. For the laparoscopic hysterectomy, UMHS offers either a total laparoscopic hysterectomy (removal of the uterus and cervix) or a laparoscopic supracervical hysterectomy (removal of uterus without the cervix).

Advantages

“I think that MISP’s most important quality is that we offer patients a wide range of minimally invasive techniques, via both laparoscopy and hysteroscopy, to treat common gynecologic conditions, including uterine fibroids. All of these techniques have the benefit of shorter hospital stays (if a stay is even required), less pain, less risk of wound infection, less blood loss, less scarring and faster recovery time,” says Dr. As-Sanie.

There are still reasons to choose to have procedures done in the operating room. For some women it is reassuring to have sedation, and some women choose a treatment that requires anesthesia, such as hysterectomy, because it is right for their needs.

Whatever decision is made between a patient and her doctor, a woman benefits from the experience of the team and all the options available to her.

Contact the U-M Department of Obstetrics and Gynecology at (734) 763-6295 or visit: www.med.umich.edu/obgyn/mis/procedures/index.htm.