Gynecologic Surgery
Surgical Consults and Your Experience
Dr. Tang is one of the few fellowship-trained minimally invasive gynecologic surgeons in Eastern Pennsylvania, and one of the most experienced. This means that she has the skills and expertise to offer surgical options that get you on the road to recovery as quickly and comfortably as possible! Dr. Tang is an expert in a wide range of conditions like endometriosis, fibroids, ovarian cysts, tubal sterilization, abnormal uterine bleeding, polyps, cervical dysplasia (pre-cancer), gender affirming surgery for transgender men and non-binary people assigned female at birth. She also offers tubal reversal surgery and labiaplasty.
Virtually all surgeries are done same-day, meaning you are up and able to walk around within a few hours, and can recover in the comfort of your own home. You don’t need to stay in the hospital unless you have a medical concern that needs monitoring. If you’re traveling from more than an hour away for surgery, we recommend staying overnight in a hotel or rental to allow you to rest comfortably before traveling home post-op.
At your surgical consult, Dr. Tang will discuss all of your medical and surgical options for conditions, as well as what to expect with both post-op recovery, and long-term results! No rushed consults – she will spend time with you explaining each procedure, and answering questions until you feel confident and comfortable with your plan.
Endometriosis
Fibroids
Dr. Tang offers the full range of treatment options for fibroids – from hysteroscopic myomectomy (removal of fibroids from the cavity of the uterus) to laparoscopic myomectomy (removal of fibroids from the wall or outer surface of the uterus), laparoscopic hysterectomy (removal of the uterus). Dr. Tang is also one of the first doctors in Pennsylvania to offer the Acessa procedure for laparoscopic radiofrequency treatment of fibroids – one of the most cutting edge treatment options available to treat fibroids while preserving the uterus. She will also discuss medications to help control bleeding or pain from fibroids, or refer for uterine fibroid embolization (UFE). Many patients with fibroids are told that a hysterectomy is their only option, and this is almost never the case – you deserve to hear ALL of your options!
NOTE: Because Dr. Tang no longer performs open surgery with a large abdominal incision for very large uteri or cases with a very large number of fibroids, she will review your imaging reports for free before scheduling a fibroid surgery consult. If you would need to be referred to another specialty practice for open surgery, Dr. Tang will help coordinate this referral for you by directly contacting those surgeons on your behalf, if you give us permission.
Tubal Sterilization
Dr. Tang is very proud to offer tubal sterilization (laparoscopic bilateral salpingectomy, or complete removal of both fallopian tubes – sometimes known as “bisalp”) to any patient 21 years old or over, regardless of whether they have had children before. At Thrive, we believe strongly in reproductive bodily autonomy, and the ability of adults to make personal medical decisions. If you are 100% certain in your decision, we will support it. Part of the legal requirements for counseling for a tubal include a discussion of the alternatives, including reversible birth control or vasectomy, but once we have counseled you on these options and the fact that a salpingectomy is not reversible, the decision is entirely yours.
Gender Affirming Surgery
Dr. Tang has proudly offered gender affirming hysterectomy since she began training in 2005. Our staff at Thrive cares deeply about the comfort of our gender diverse patients. We will ask for and respect your pronouns and gender identity, and reinforce these with the operating room and recovery room staff if you need surgery. Since decisions about gender affirming care are personal and individualized we will counsel you about all options – birth control, menstrual suppression, hysterectomy, oophorectomy, sterilization, and the risks vs benefits of each, so that you can make the right decision for you. We will also discuss any plans for fertility if you wish, and refer you to a specialist for fertility preservation or assisted reproduction if needed.
Hysterectomy
Hysterectomies (surgery to remove the uterus, cervix, tubes) are options for treating adenomyosis, fibroids, uterine pre-cancer or risk of cancer, gender dysphoria, or heavy / uncontrolled bleeding. Dr. Tang performs hysterectomies laparoscopically, and almost all patients can go home the same day after a hysterectomy!
Note: that the word hysterectomy only refers to the uterus – not the ovaries, which make the hormones. Dr. Tang will usually leave the ovaries in place for hormone production, unless there is a genetic / family risk of ovarian cancer, if you’re post-menopausal, or if you request ovary removal for gender affirming care. But the risks and benefits of leaving versus removing the ovaries will always be discussed.
Ovarian Cysts
If you have ovarian cysts, they do not necessarily need to be removed surgically if they’re small and benign appearing. But if they are larger, causing you pain, and/or are endometriosis or dermoid cysts, we can discuss your options of surgery versus monitoring. If you need surgery and are not yet menopausal, almost always the ovary can be saved and the cyst simply removed laparoscopically, You may have been told that the entire ovary must be removed, but this is rarely the case unless there is concern for cancer, or if you are already menopausal. Please bring a copy of your most recent pelvic ultrasound or MRI for review, or we can perform an ultrasound in the office to begin evaluation for the cyst if you prefer.
Hysteroscopy
If you have an issue inside the cavity of the uterus, such as polyps, small fibroids, a uterine septum, or a retained IUD with missing strings, these are managed with a procedure called a hysteroscopy. This is a small, narrow camera that is inserted through the vagina and cervix into the uterus, and tiny instruments or electricity are used to remove the abnormalities.
Dr. Tang can perform many hysteroscopies in the office with just local anesthetic and ibuprofen, with nitrous oxide for additional comfort if you wish. But if you would like more sedation, or need to remove a fibroid, the hysteroscopy would be performed as an outpatient procedure in an operating room under anesthesia.
Labiaplasty
If your labia minora (the lips of the vulva) feel too long or bothersome, if they’re catching in your clothing or making it painful to exercise or have sex, Dr. Tang can perform an exam and discuss the option of labiaplasty. This is removal of the excess tissue and carefully reconstructing the labia minora to have a natural and comfortable appearance. There are different surgical techniques depending on your anatomy, and sometimes if there is not enough extra tissue to safely remove, surgery may not be the best option. Note that Dr. Tang does not operate on the clitoral hood, to minimize the risk of affecting nerves and sensation.