Dr. Pemberton performs her surgeries at Newark Beth Israel Medical Center and Overlook Medical Center. These hospitals have superb nurses, provide excellent care and have state of the art surgical and inpatient facilities. Dr. Pemberton is well-trained, experienced and skilled at many procedures including minimally invasive surgeries.
Minimally invasive surgeries have changed the way of operative gynecology. These procedures enable surgical patients to recuperate faster, with less pain, less risk of infection and better cosmetic results with smaller incisions on the abdomen. Some procedures can even be done without incisions.
MINIMALLY INVASIVE SURGERIES that Dr. Pemberton performs are:
Hysteroscopy (diagnostic and operative)
- Endometrial Ablation for treatment of abnormal bleeding with Hydrothermal Ablation (ThermaChoice)
- Incisionless Hysteroscopic Permanent Sterilization with Essure
Laparoscopy (diagnostic and operative)
- Robotic Hysterectomy and Myomectomy
- Laparoscopic surgery for endometriosis
- Laparoscopic surgery for removal of ovarian cysts
- Tubal ligation via laparoscopy
- OTHER SURGERIES
A hysterectomy is the surgical removal of the uterus. The procedure is a way to treat problems that affect the uterus such as fibroids, endometriosis, adenomyosis, pelvic support problems, pelvic pain and abnormal bleeding. There are other less invasive options that can be tried before hysterectomy that you should discuss with your doctor before deciding to proceed with a hysterectomy. For conditions that are severe and/or have not responded to other treatment options, a hysterectomy may be your best choice.
A complete or total hysterectomy is when the entire uterus and the cervix are removed. A partial or supracervical hysterectomy is when the upper portion of the uterus is removed but the cervix remains. If the cervix remains, you may still experience some periodic bleeding and you should continue to have an annual pap smear to screen for cervical cancer. One or both of the ovaries and/or fallopian tubes may be removed at the same time if medically indicated and this additional procedure is called a salpingo-oophorectomy. There are several ways a hysterectomy can be performed including a vaginal approach, an abdominal approach or a laparoscopic approach. Dr. Pemberton will help you decide what the best and appropriate choice for you will be.
Laparoscopic Hysterectomy (Robotic)
This method uses a thin, lighted, instrument with a camera called a laparoscope that allows Dr. Pemberton to see the pelvic organs on a screen. It is used, along with additional, small surgical instruments that are inserted through 3 to 4 tiny incisions in the navel and abdomen, to detach and remove the uterus. The uterus is then removed in small pieces through the navel and/or abdominal incisions, or through the vagina. A laparoscopic supracervical hysterectomy (LSH) is when the uterus is detached but the cervix remains and the pieces are removed through incisions. A total laparoscopic hysterectomy (TLH) is when both the uterus and the cervix are detached and the pieces are removed through incisions. A laparoscopic assisted vaginal hysterectomy (LAVH) is when the uterus and cervix are detached and then removed intact or in pieces through the vagina. Unlike more traditional abdominal or vaginal methods, laparoscopic hysterectomy procedures usually require only 1 day or less in the hospital and only 6-14 days of recovery time. Patients also experience less scarring and pain compared to other hysterectomy methods.
This method is a procedure in which the uterus and cervix are surgically removed through the vagina. One or both of the ovaries and/or fallopian tubes can be removed during this procedure if medically indicated (salpingo-oophorectomy). The top of the vagina is then sewn together and there are no visible scars. A vaginal approach may be considered if the uterus is not large and if the reason for surgery is not cancer. In comparison to an abdominal approach, a vaginal hysterectomy has fewer complication, shorter hospital stay and allows a faster recovery. Typical hospital stay is 1-2 days. Average recovery time is 4 weeks.
This method is a procedure in which the uterus is surgically removed through an abdominal incision. If the uterus and the cervix are removed, it is called a total abdominal hysterectomy (TAH). If the uterus only is removed and the cervix remains, it is called a supracervical hysterectomy (SCH). One or both of the ovaries and/or fallopian tubes can be removed (salpingo-oophorectomy) during this procedure if medically indicated. There is a visible scar as the incision is made on the abdomen. This procedure can have a higher risk of blood loss, infection and a longer recovery. Typical hospital stay is 2-3 days. Average recovery time is 6-8 weeks.
Laparoscopic Treatment for Endometriosis
Endometriosis is a chronic condition where tissue from the inside of the uterus (endometrium) is implanted outside its normal anatomic position. These implants can be found on the ovaries, fallopian tubes, bladder, rectum and/or ligaments that support the uterus. Patients complain of pelvic pain, painful periods, painful bowel movements and/or infertility. The diagnosis is made with the assistance of a laparoscope where the surgeon can visualize the entire pelvis and take appropriate biopsies. Endometrial lesions can be cut away (excised) or burned away. Treatment with laparoscopy is more difficult with advanced disease that involves dense, scar tissue or larger areas involving the pelvic and abdominal organs.
Essure is a permanent sterilization procedure that does not require abdominal surgery. There are no incisions and it can even be performed in the office. Dr. Pemberton places tiny inserts through the vagina into the fallopian tubes using a special instrument called a hysteroscope. This instrument is a thin tube with a camera that allows her to see inside the uterus allowing for correct placement of the micro inserts. Over the next 3 months, your body heals over the inserts and forms a barrier that prevents sperm from reaching the egg. As you heal, another form of birth control is needed. After 3 months, a confirmation X-ray test is performed to confirm that your tubes are indeed blocked.
You will need to consult with Dr. Pemberton to determine if this procedure is a good choice for you.
Hydrothermal Ablation (ThermaChoice)
The Hydrothermal Ablation (ThermaChoice) procedure is used to treat women who suffer from excessive uterine bleeding AND who no longer want to bear children. The procedure involves using a hysteroscope, a special computer-controlled pump and a water heater. During the HTA, the inside of the uterus is flushed with heated water under controlled pressure for 10 minutes. This permanently destroys the inner lining of the uterus. This procedure can be done in the hospital or office, and patients can quickly resume normal activity within one day.
After the procedure, in most cases, patients will experience lighter bleeding and some will have no bleeding. Since the uterine lining is removed, pregnancy after this procedure is not likely. Because of this, it is very important that you are sure you do not want any more children.
Before this procedure can be scheduled, Dr. Pemberton must make sure that you are an appropriate candidate for HTA. She will perform a pelvic examination and several diagnostic tests to try and find the cause of the abnormal bleeding first. These tests include, but are not limited to, an endometrial biopsy, an ultrasound and blood work. At times, these tests may diagnose abnormal findings such as tumors, polyps or hormonal imbalances that may require other forms of treatment.
A hysteroscopy is a procedure that allows Dr. Pemberton to look inside the uterus with a special scope. These scopes are very thin and cause minimal discomfort to the patient. This procedure can be done in the hospital or office, and patients can quickly resume normal activity within one day.
A hysteroscopy can help find fibroids, polyps, and/or scar tissue that have developed in the uterus and may be causing severe menstrual cramping, heavy periods, bleeding between periods, or bleeding after sex.
Once Dr. Pemberton identifies the problem, she may be able to remove the problem immediately. More complex situations may require scheduling additional time in the operating room. After the procedure, Dr. Pemberton will discuss the findings with you and recommend an appropriate treatment.