Procedure Description:
Removing uterus through a laparoscope

What To Expect:
Of the three approaches used to perform hysterectomy - abdominal, vaginal, and laparoscopic, laparoscopic hysterectomy is the least painful and least debilitating route of surgery for women who need hysterectomy. Most gynecologists have shied away from performing laparoscopic hysterectomy because of the technical challenges that are associated with it. Very few of today's operating OB/GYN doctors (<5%) have learned this procedure which has been only available for the past few years. Abdominal hysterectomy is the least preferred route by patients because of the hospital stay, abdominal scar, pain, and disability.

For patients who need hysterectomy, 95% of the times, Dr. Pei removes the uterus using laparoscopy. This only involves 0.5 to 1.2 cm tiny abdominal incisions. Dr. Pei has been successfully removed uterus up to 1 kg. Dr. Pei only performs abdominal hysterectomy for the few patients who had multiple surgeries with severe intra-abdominal scars which prevent visualization through laparoscope.

Preprocedure:
Normally requires simple bowel preparation.

Postprocedure:
Patients typically stay in the hospital for 1 or 2 days, with recovery expected in 1 to 2 weeks.
Patients who have open abdominal hysterectomy very often stay in hospital for 3 to 4 days because more post-operative pain and slow return of bowel function, and take 4 to 6 weeks to recover.

Procedure Description:
Minimally Invasive Gynecological Surgeries

What To Expect:
Dr. Pei applies minimally invasive principal to virtually all gynecological procedures. These includes removing ovarian cysts, fibroids, endometriosis, ectopic pregnancies, ect. These are minor procedures as compared to laparoscopic hysterectomy which are performed by Dr. Pei routinely. The open abdominal technique is ALWAYS the last option under his care due to his strong surgical background and tremendouse experience.

Dr. Pei also has expertise in video LASER laparoscopy. Laser when used to destroy lesions inside the abdomen, it causes minimal scar formation, thus least long term complications. This laser technique is ideal for patients with infertility problems, and frequently used to desdroy endometriosis, remove adhesions, and reconstruct blocked uterine tubes.

Preprocedure:
None

Postprocedure:
Most patients go home the same day after surgery.

Procedure Description:
Repair prolapsed uterus, bladder, rectum

What To Expect:
The prolapse of pelvic organs through vagina most commonly results from trauma during child birth. Pelvic prolapse can cause symptoms ranging from pelvic/back pain or presure to inability to walk and intercourse.

Mild birth trauma can also cause vaginal relaxation, which affects sexual function for patient and her partner.

After pelvic reconstruction, patients enjoy normal sexual function with relief of pre-existing symptoms.

Preprocedure:
Most of the reconstruction was performed on patients who have completed their child-bearing.

Postprocedure:
Patients should avoid heavy lifting and constipation for 3 months.

Procedure Description:

What To Expect:
Surgery sometimes becomes necessary, when patients leak urine with coughing, sneezing, or laughing. These patients have stress urinary incontinence, which is believed to result from trauma during child birth. Very often, patients have co-existing pelvic organ prolase which is needed to be repaired together with urinary incontinence. The stress urinary incontinence can be repaired through vagina or abdomen depending upon the types of other procedures performed at the same time.

Some patients develop fecal incontinence after child birth. These can also be repaired by reconstructing the anal sphincter.

Preprocedure:
Most of the reconstruction was performed on patients who have completed their child-bearing.

Postprocedure:
Patients typically become continent.

Procedure Description:
Vaginal delivery and Cesarean Section

What To Expect:
Dr. Pei conducts meticulous full-range prenatal care. Dr. Pei performs ultrasound examination and aminocentisis in the office.

All deliveries are at the world-renowned Fairfax Hospital. Dr. Pei is experienced with both normal and complicated deliveries. When Cesarean section is needed, Dr. Pei also applies his minimally invasive and cosmetic techniques to the operation, which results in small and well hidden scar.

Procedure Description:

What To Expect:
A wide range office procedures are being offered at Dr. Pei's office. These include:

Colposcopy (microscopic examination of the cervix and vagina);

Cervical Biopsy (LEEP procedure);

Endometrial Biopsy;

Termination of unwanted pregnancy;

Diagnostic hysteroscopy for abnormal uterine bleeding;

Hysteroscopic bilateral tubal ligation;

Office cosmetic procedures:
Botox injection, Cosmetic filler injection, Mesotherapy, Scleratherapy for varicose and spider veins, Labiaplasty and Vaginoplasty for vaginal relaxation, Scar revision and mole removal

Procedure Description:
Observing uterine cavity with a thin telescope

What To Expect:
Hysteroscopy is used to evaluate the uterine cavity for patients who have severe cramping (dysmenorrhea), heavy menstrual periods (menorrhagia) and bleeding between periods (metrorrhagia). Unless a women has major medical problems, I do diagnostic hysteroscopy in my office. I numb the cervix. I attach a video camera to the hysteroscope, so my patient can also see, and then insert the hysteroscope into the uterus under direct vision while using saline to fill the uterus. Usually this causes mild cramping. We then can look for fibroids, polyps, and other problems that may be causing abnormal uterine bleeding. This often takes about a minute or two. Small polyps can be removed and biopsy can be taken during the procedure.

Preprocedure:
Patients were given medication to decrease the discomfort during the procedure.

Postprocedure:
Patients ware instructed to take Motrin/Aleve to decrease the pain, and doxycylin for 7 days to prevent infection. Mild vaginal spotting is common. Patient can return to work next day.

Procedure Description:
Observing the cervix under a special microscope

What To Expect:
Colposcopy is needed when you have an abnormal PAP smear. During the procedure, a speculum is inserted into the vagina just like doing PAP smear. 3% Acetic Acid is applied onto the cervix to make the lesion more visible. A biopsy of the cervix and the cervical cannal is done most of the time. Tissue obtained will be sent for pathological examination.

Postprocedure:
You might have some spotting or brownish discharge after the procedure. No tampon or intercourse for 2 weeks. No restrictions on daily activities.

Procedure Description:
Removing diseased cervix using loop electrodes

What To Expect:
When cervical precancerous lesion is severe or won't go away on its own, removing the lesion is neccessary to prevent progression to cervical cancer. I perform the LEEP procedure in the office. After I numb the cervix, I use electric loop to removed the diseased cervix. This often takes a minute or two. Usually, this cause mild cramping.

Postprocedure:
Mild vaginal spotting and brownish discharge are common. Nothing in the vagina for four weeks.