The vast majority of patients requiring surgery for GYN problems such as fibroids, endometriosis, infertility, pelvic pain and cancer will usually see their OBGYN for care. Patients who have seen their OBGYN physician for pregnancy and general office gynecology have received good care for these needs. Minimally invasive surgery (MIS), however, is much more specialized. CGS believes that a specialist in MIS is a much better choice than an OBGYN, who specializes mainly in obstetrics. As a patient, understand that it is impossible for OBGYN phycisians to keep up with and learn new techniques and procedures in minimally invasive surgery. There are several reasons for this.
- Practice Concentration
OBGYN’s concentrate more than 80% of their practice towards obstetrics. Because of this, these physicians perform on average only 25 – 30 surgical cases per year, most of these cases not being laparoscopic. In contrast, Dr. Danilyants and Blosser at CGS perform an average of 20 surgeries per week, or 1000 per year. The focus at CGS is the diagnosis and management of patients with GYN conditions ONLY. General obstetrics is not practiced. CGS believes that the speciality of obstetrics is best managed by OBGYN’s. Those patients needing minimally invasive procedures are best managed by those with specialty training in minimally invasive GYN surgery. - Specialty Training
Laparoscopy, also called minimally invasive surgery, uses very small incisions to complete procedures such as myomectomy, hysterectomy, endometriosis, etc. Smaller incisions mean much faster recovery, minimal pain, and greatly reduced down time. These surgeries are much more difficult to learn than standard open procedures, and require extended training in the techniques and technology required.
All CGS doctors are speciality trained in minimally invasive surgery. This means that these doctors have completed 1 – 2 years of training in MIS surgery after residency, and will no longer manage OB patients. MIS fellowship trained surgeons concentrate completely on the surgical care of patients laparoscopically. CGS surgeons have gone beyond this training, and are classified as Advanced Retroperitoneal Laparoscopic Surgeons (ARLS). ARLS surgeons have achieved the highest level of surgical skill possible, and are able to perform procedures that even a fellowship trained laparoscopic surgeon cannot. - Surgical Technique and Anatomy
By far the most important indicator of success for any surgeon is having excellent surgical technique and knowledge of anatomy. Results with standard laparoscopic surgery or robotic surgery is only as good as the skill and training of the surgeon. It does not matter how the surgeon performs the procedure – robotic, open, laparoscopic – if the skills used are average, the result will be average. Even more important is the surgeons understanding of the anatomy. This means that the surgeon understands the relationships of structures in the pelvis and where they are. If those relationships and locations are unknown, or unclear, injury occurs resulting in complications. Patients need to know that OBGYNs performing standard laparoscopic surgery do not directly identify the anatomy. The only way to ensure accurate identification of pelvic anatomy is to perform Advanced Retroperitoneal Laparoscopic Surgery using retroperitoneal techniques and extended techniques. These techniques require excellent surgical skill and training, as well as a full understanding of pelvic anatomy. All CGS surgeons are Advanced Retroperitoneal Laparoscopic Surgeons, and have a full understanding of anatomical landmarks and the use of retroperitoneal and extended techniques. This allows CGS to perform surgery with the lowest complications and highest success rates worldwide. It also allows CGS to perform procedures that would otherwise have to be done as “open”, which dramatically increase recovery time, pain, and hospital stay. - Surgical Volume
In order for a surgeon to become good at what they do, they need to practice. Most OBGYN’s perform very few surgical procedures annually, and even fewer laparoscopic cases. A surgeon's “years” of practice do not necessarily indicate how many procedures that physician has performed, or the technique used. Surgeons can certainly perform a large number of procedures with poor technique and poor results. CGS surgeons have attained a high level of surgical skill as ARLS surgeons, and perform more cases each year than an experienced OBGYN may perform over a ten year period. Dr. Danilyants has performed over 4000 cases ranging from hysterectomy, myomectomy, ovarian cysts, extensive endometriosis, hysteroscopy, prolapse surgery, and more. This is more cases than a busy OBGYN performs over their entire career. Dr Blosser currently has performed more than 2000 cases.