Operative gynecology

The Clinical Department of Gynecology and Obstetrics at the MHH offers a wide range of minimally invasive(laparoscopic, hysteroscopic) treatment and surgical procedures for benign diseases of women.

The surgical spectrum includes

• laparoscopic myoma enucleation
• laparoscopically assisted vaginal hysterectomy (LAVH), total laparoscopic hysterectomy (TLH), laparoscopically assisted supracervical hysterectomy (LASH) with/without adnexa
• laparoscopic ovarian cyst excision
• laparoscopic adnexectomy
• Laparoscopic treatment of endometriosis in the small pelvis with bowel surgery if necessary
• Laparoscopic treatment of adhesion problems
• Laparoscopic chromopertubation
• Laparoscopic treatment of extrauterine pregnancy (tube-preserving)
• Laparoscopic sterilization
• hysteroscopic excision of uterine septa
• hysteroscopic ablation of submucosal fibroids
• hysteroscopic removal of polyps
• hysteroscopic endometrial ablation / including the gold mesh method

AWMF guideline LASH -
Laparascopic supracervical hysterectomy (LASH)

We are able to carry out every necessary surgical intervention in the context of fertility problems in our own Clinical Department and also provide inpatient treatment for complications such as ovarian hyperstimulation syndromes on a 24-hour standby basis.

The surgical interventions include

• Outpatient diagnostic and, if necessary, surgical hysteroscopies for septa, fibroids, polyps, synechiae, etc.
• Outpatient or inpatient laparoscopies with chromopertubation of the fallopian tubes, endometriosis treatment, removal of fibroids, ovary drilling for PCO, removal of ectopic pregnancies, etc.
• Extensive reconstructive surgery with removal of fibroids, treatment of endometriosis of any degree as well as reconstructive, fertility-preserving tubal surgery under inpatient conditions.

The surgical removal of the tumor is an important pillar in the treatment of genital cancer. Practice shows that the quality of the first operation is decisive for the subsequent treatment steps and their success. The highly experienced and experienced surgeons at the Gynecological Cancer Center of the MHH offer you the following spectrum of conservative and minimally invasive treatment and surgical procedures for female genital malignancies, with the involvement of the relevant specialist disciplines:

Range of services in surgical gynecologic oncology

• multivisceral debulking surgery for ovarian cancer or ovarian cancer recurrence
• laparoscopic omentectomy and appendectomy for borderline ovarian tumors
• Abdominal radical hysterectomy with/without adnexa with pelvic and paraaortic lymphadenectomy (sentinel technique) for cervical and endometrial cancer
• Exenterative surgery for advanced/recurrent cervical carcinoma
• Laparoscopic pelvic and paraaortic lymphadenectomy for cervical and endometrial cancer
• laparoscopic sentinel lymph node technique for cervical and endometrial cancer
• laparoscopically assisted radical vaginal hysterectomy with formation of a vaginal cuff over the tumor with/without adnexa for cervical cancer as part of studies (e.g. DKG-funded G-LACC study led by the MHH Women's Hospital)
• Laparoscopic-assisted radical vaginal trachelectomy for early cervical cancer (fertility-preserving procedure)
• (Radical) vulvectomy (incl. reconstructive procedures/plasty) with/without inguinal lymphadenectomy (sentinel technique) and, if necessary, laparoscopic or retroperitoneal pelvic lymphadenectomy for vulvar cancer

Publications on the topic

Information about our services in breast surgery.

The 3D 4K laparoscopy (abdominal endoscopy) in the operating theater of the Women's Clinic enables a better visual and spatial representation of the tissue structures during the operation. Our camera control robot also allows a wobble-free image and thus significantly reduces the surgeon's workload. The assistant is also relieved so that he can support the operation more efficiently. This enables more careful preparation during the operation.

Particularly for complex procedures, such as surgery for cervical cancer, surgeons report a significant improvement. Marking of the sentinel lymph node with indocyanine green (ICG) is also used during this operation. In our center, this represents an important and progressive approach in the diagnosis and treatment of cervical/endometrial cancer.

The Women's Clinic at the MHH has been using the most modern da Vinci robotic system (da Vinci Xi) in the Hanover region and beyond since the beginning of 2018. A two-person robotic system was installed so that two experienced surgeons can work together to further maximize patient care. There are four board-certified gynecologists in the Department of Gynecology with advanced expertise in robotic-assisted surgery.

Gynecological procedures that are increasingly being performed with robotic assistance as part of the certified Gynecological Cancer Center and the certified Endometriosis Center Level III are radical hysterectomy for cervical cancer, lymph node removal for patients with gynecological cancers and the radical treatment of deep infiltrating endometriosis (TIE). Nerve-sparing surgical procedures are of particular importance.

We also focus on ICG/fluorescence-guided sentinel lymph node/sentinel diagnostics as well as tumor compartment resection of malignant diseases. The new technology will greatly accelerate our many years of experience in this field. Surgery for borderline malignancy and hysterectomies for obese patients with endometrial carcinoma round off our range of services.

• The final decision on the route and method of surgery depends on which is the safest procedure for the underlying gynecological disease.

Studies on benign gynecologic and gynecologic cancer surgery suggest that robot-assisted surgery is associated with fewer complications, bleeding and thrombosis compared to the open abdominal approach (laparotomy).

Further advantages of robot-assisted gynecological surgery are

• rapid convalescence,
• short hospital stay,
• low blood loss,
• low postoperative pain,
• few wound complications and infections.

The excellent 3D visualization with high resolution (10x plus 2-4x digital zoom) is outstanding. This improves the surgeon's ability to identify tissue planes, blood vessels, nerves and other critical structures. The modern control electronics of the da Vinci system also enable jitter-free and precise movement of the instruments in the smallest of spaces.

Press / Media: Hannover.de | Image |

Training offer: German Robotic Gynecology Curriculum