“Minimally invasive gynecologic surgery: Laparoscopy and Hysteroscopy” – with Dr. Farnaaz Kia

Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OBGYN and maternal-fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Dr. Farnaaz Kia, welcome to the podcast. It is so exciting to have you here at our podcast, and I know that you’ve been looking forward to this moment for months.
Dr. Kia: Thank you. I’m excited to be here. I’m a big fan of the podcast, was listening to it for months and months as well.
Dr. Fox: So as I know and you know, but our listeners might not know, you are a wonderful and recent addition to our practice in New York City. And you came all the way over from the West Coast of the United States, AKA, California.
Dr. Kia: I sure did.
Dr. Fox: How’s that transition been for you?
Dr. Kia: It’s been good. It’s been good. My husband and I have been doing the back and forth between California and New York for a while. So, spent quite a bit of time in New York leading up to this moment, but really love it here. Everyone’s been really great and not mean at all.
Dr. Fox: So, you haven’t been mugged yet in New York?
Dr. Kia: Not yet.
Dr. Fox: All right. So that’s good. All right. No one has treated you poorly on the streets of Manhattan, right, or anything?
Dr. Kia: No, the people are great.
Dr. Fox: All right.
Dr. Kia: It’s been awesome.
Dr. Fox: Wonderful. What the biggest difference, would you say, between California and New York?
Dr. Kia: Not driving everywhere. Like, my legs were physically so tired when I first moved here, and I would be like, “I can’t walk anymore.”
Dr. Fox: That’s a good one. All right. Not driving anywhere. But you are originally a Midwesterner.
Dr. Kia: I am. I’m originally from Minneapolis, Minnesota. I grew up there majority of my life. And then I did my training out in California and then started working out in Big Apple.
Dr. Fox: Right. We’re just getting you to the less and less pleasant places, Midwest where everyone’s really nice and easygoing, and then in California, like, sort of. And then New York, it’s just, you know, you’re the explosion. Yeah. Now listen, the Midwest, I’ll tell you, that’s why you’re a pleasant person.
Dr. Kia: It’s a great place to grow up. Yeah. It’s a great place to raise a family, good values. Really enjoyed my time there. I got sick of the cold.
Dr. Fox: Yeah. A lot of winter sports there.
Dr. Kia: Definitely.
Dr. Fox: As of this recording, the Minnesota Vikings and the Chicago Bears are tied for first place and won an elf.
Dr. Kia: They killed the Packers.
Dr. Fox: Yeah. So, and anyone who beats the Packers, or as we say the Packers, it’s great. So the Bears, let’s say they’re playing them this week and there’s a… I don’t do sports predictions on this podcast, and this will drop two months after the game, but there’s a high chance Bears will lose. Let’s just leave it at that.
Dr. Kia: Same as of Vikings, so.
Dr. Fox: No, the Viking’s gonna be good this year. You heard it here. They have a good team, at least in fantasy football they have a lot of players. Excellent. So we’re gonna be talking about today, minimally invasive gynecology, specifically laparoscopy, and hysteroscopy. And just to, sort of, like, I guess frame your expertise in this, tell us a little bit about your journey, how you got from the cold weather of Minnesota to medical school and to OBGYN.
Dr. Kia: Yeah. So my parents originally immigrated to Minneapolis, Minnesota from Iran. They moved about 40 years ago. Why Minnesota? I don’t know. They had one family member there at the time. And so…
Dr. Fox: Well, it’s a similar climate, I would say, you know, the Mideast and the Midwest. You know, pretty similar. Okay. Fine.
Dr. Kia: And, you know, family continued to move there. And so, we stayed there for a while, and I always stayed close to home. Family was really important growing up. And along with that, growing up, one of the values that was always taught to me is, you know, you have to find ways to give back to your community. And so, that’s how initially I decided to go into medicine because I thought, what better way to give back to your community than to serve your community and serve them by providing them better health, you know?
Dr. Fox: Wow.
Dr. Kia: But I embraced the cold for many, many years and did medical school there. And then when time for residency came around, I was ready for a change, ready to explore somewhere else. I think it’s important for your training to experience different things. And so, made the great migration to the Sunshine State. And all of my family slowly followed and…
Dr. Fox: Oh, is that right?
Dr. Kia: Yeah. Well, my brother was originally… he did his residency and moved out to California and then, you know, I followed him, and then my other brother came with us, and then my mom came, you know.
Dr. Fox: Wow. So your brother’s a doctor?
Dr. Kia: He is, yeah.
Dr. Fox: Okay. And how did you choose OBGYN?
Dr. Kia: Oh, he told me not to do OBGYN.
Dr. Fox: And that’s why you did it because your brother said not to?
Dr. Kia: Yeah. Well, so my brother started in general surgery, and then he… It’s just really brutal lifestyle and, you know, there was a lot of advice that was given to think about your life like five, 10 years down the road. And OBGYN notoriously has a tough lifestyle because babies come whenever they wanna come. But I loved working with women so much. And the really cool thing about OBGYN is that you get to be with women during all the monumental periods in their life. So if you think about it, like, their first pelvic exam, their first pregnancy, and then, you know, in the later years once they start to go through menopause too, and what a privilege to be able to take care of someone throughout all of those times. So, I really liked working with women and providing that care, and that’s what drew me to OB.
Dr. Fox: Wow. And then how did you pick California specifically, even though you’re looking for a change? I’m curious. What would drive someone out there?
Dr. Kia: I mean, the sunshine.
Dr. Fox: Sunshine.
Dr. Kia: The beaches, the mountains.
Dr. Fox: I feel like I’m done skiing. All right.
Dr. Kia: Yeah. So, you know, it just was a good change. I had some family there at the time, did some rotations, and went to California. And then, you know, my now husband and I did long distance. He was in New York at the time, and so, did long distance from New York to California. And then he moved to California for a little bit, hated it. Then, you know, we decided to move to New York together, and I love it here. I feel like I’m very much a chameleon that can kind of, like, fit into a lot of different places.
Dr. Fox: You seem to fit in nicely, you know, to the community in New York and to the surrounding areas and people. Yeah, you fit right in.
Dr. Kia: Thank you. Thank you.
Dr. Fox: Excellent.
Dr. Kia: Great.
Dr. Fox: Now, I think one of the really interesting things about segueing into our topic about minimally invasive surgery is, you know, a lot of people with medicine, sort of, assume, right, that, sort of, the longer you’ve been in the field, the better you get at certain things. And that’s probably true with certain things I would imagine, or I know. But one of the interesting things is with surgery specifically, it sometimes is the opposite. That, like, the more recently you trained, the more adept you are with some of the more recent technological advances, you know, sort of as, like, a dumb example, like, my kids are gonna be much better at anything tech-related than I would be because they grew up with it, they know it and this. And so, trying to teach someone like me to do something very technological is complex at our time.
And so, you know, with minimally invasive surgery, it’s really cool when you see people come out of training and they’re using equipment and doing things that, you know, in my training we had little exposure to, or less exposure to, and people more senior to me had no exposure to potentially. And so, I think it’s really exciting to, you know, when you come outta training, you always feel like you’re the bottom of the totem pole, but with certain things, you’re way up at the top. And I think minimally invasive surgery is one of those. What was your experience like in residency with laparoscopy, hysteroscopy?
Dr. Kia: So much laparoscopy and hysteroscopy. It’s crazy to even see the difference between, you know, how much we’re operating. I remember being in my intern year and watching my chiefs operate, and they were just starting laparoscopic suturing. And then I started doing that, you know, my second year. And so, it’s really crazy when you look back and you see even through the progression of your four years of training, like, how each class younger and younger starts learning those skills earlier in their residency.
I was at Cedars-Sinai in Los Angeles and we had amazing minimally invasive department with many world-renowned surgeons that, you know, took us under their wings. And a couple of them were some of my biggest mentors throughout my training. And, you know, I approached each surgery a little bit differently than they would because they just, you know, operate all day, every day, and they took a million of these cases. And for me, I was coming at it from a generalist point of view, like, okay, when I’m out in New York, like, you know, what instruments are they for sure gonna have, or what can I for sure call for, you know? But they really, you know, helped teach me, like, all of the little nuances that go behind every case. And the exposure that we got was incredible. It’s also very interesting because now residency programs are struggling to get enough open keys.
Dr. Fox: Right. It’s the opposite.
Dr. Kia: Yeah.
Dr. Fox: Yeah, because since so much of surgery, in general, and certainly gynecology has moved from, you know, what we call major cases where you basically, like, you know, literally open someone up and then close them up. It’s hard to have enough experience in those because it’s few of them happening. So it’s great for patients, maybe not so great for training, which is tough. Which is why there’s, you know, a lot of people have to do fellowships, additional training just to become adept at certain operations. And, you know, it depends where you train in this and where you practice. But, yeah, I was thinking the same thing that, you know, 20, 30 years ago, people probably struggled to get enough minimally invasive cases, and they were doing open cases all the time. And now it’s exactly the opposite.
Dr. Kia: Right. Right. Yeah, it’s pretty incredible when you look at, like, your caseload at the end of the year and see how many cases you’ve done at each thing. And there was, like, this, you know, department-wide announcement, like, “All the open cases, make sure their residents go to that, you know.”
Dr. Fox: As many as you can. So, what do we mean, for those of us out here who may not quite get where we’re saying, what’s the difference between surgery that’s minimally invasive versus the alternative, maximally invasive, very invasive? And we call it open surgery, but, like, so what are we talking about here, basically?
Dr. Kia: Right. So what we’re referring to is open surgery or major surgery is basically a much bigger incision that you have and the way that you enter the abdomen and the way that you operate. So those of you who are probably familiar with the type of incision that you have for a C-section for instance, and it would be that type of incision if you were to have something like a hysterectomy, which is removing the uterus. Alternatively, what we’ve, you know, migrated towards in more recent years is doing laparoscopic surgery where we make three very small incisions, largest about, like, a centimeter. One’s in the belly button, so it hides very nice that you can’t even see it, and two, around the sides of the pelvis that, you know, the incisions heal great. And then you put a camera inside the belly and fill the belly with air. And then you’re able to operate through those two side ports, is what we call them, with different instruments. So it’s not… you know, you’re operating with your hands, but your hands aren’t touching the thing that you’re operating on. It’s like you’re operating, like, through a rod or, you know, through an instrument. And so, it’s a little bit harder to learn from that sense, like, the hand, eye coordination that goes into it. It’s kind of like a video game.
Dr. Fox: Right. Because I mean, just to set it up, so the patients, you know, she’s asleep, right?
Dr. Kia: Right.
Dr. Fox: So she’s asleep, she has anesthesia, so she’s not in pain, and she’s lying on an operating table and you, the surgeon, you’re standing on her side and you put, like, a little incision in her belly button, and you put in a camera, and also you put in something, what’s called insufflator, fill her belly with air. So her belly starts to fill up like a balloon with air, and then you put in another couple of instruments. And since one of them is a camera, you’re looking on a TV screen. You’re looking inside her belly, but through a camera on a TV screen. And so, your hands are outside her belly holding these instruments that are going through her belly. And so, you’re essentially using, like, you know, like, a grabber, you would have to get something high at the supermarket, like you squeeze your hand here and it squeezes at the end of the instrument or whatever it might be, you know, that a scissors, a grabber, a sower. And you could actually, like you said, put needles in there through these things and then actually sew. So, it’s pretty cool. What would be the advantage of doing surgery that way versus the open way, or the advantages, because there’s multiple, obviously?
Dr. Kia: Yeah. So many. You know, our surgeries that we do in gynecology, they’re mostly same-day surgeries. So they come in, you know, even our major surgeries like hysterectomy, you go home the same day, which is incredible. You know, versus an open abdominal surgery, might be one, two, three nights in the hospital recovering. Patients have less pain, they heal much faster, they’re able to resume their activity, normal activity levels, you know, much quicker. So it’s much faster recovery, less pain, less hospital admissions, less complications from that standpoint. So overall, it’s preferred if possible to be able to do something laparoscopically. And so, it just kind of depends on each case. You know, one case is more complex or has more complex pathology, maybe not the best candidate for a laparoscopic surgery, but we try to do it as much as we can.
Dr. Fox: Right. I mean, I think one of the principles in surgery is less is more, meaning the smaller the incision, the fewer the incisions, shorter operative time tends to be better. Like, all these things tend to be better in terms of recovery, in terms of pain, in terms of complications, in terms of future scar tissue. Like, all the problems with having surgery. Surgery fixes problems. So, that’s great. Right. If you have something that needs to be removed, you want surgery to get it removed. But the surgery itself just sort of, like, you know, invading someone’s body and then putting it back together has potential downsides obviously, but not just immediately but long term. And the more minimal and minimalist you can be, the better it’s gonna be. Now, I was just curious because you mentioned the hysterectomy. If you have these little holes and you’re taking out a uterus, how do you geometrically get the uterus out? Right? Because you have, you know, like, okay, the hole’s the size of your finger and the uterus is the size of your fist. How does that work?
Dr. Kia: One of my favorite mentors, she would say, “My job is to get big things out of little holes.” So, you know, if you have a total hysterectomy, it comes out the vagina, which is great. The incision is made around the cervix, and so, just kind of pull it out the vagina and then suture what we call the vaginal cuff closed. And so, then you don’t need to have vagina incision to remove the specimen. And then, you know, in cases where you’re maybe not doing a hysterectomy and removing a large cyst or, you know, if you’re removing a fibroid or something, what typically happens is you extend the belly button incision a little bit because it hides so well inside the belly button. And, you know, you can do something, what we call more morcellation to help make the specimen smaller and take it out through one of the smaller holes.
Dr. Fox: You basically, like, take the specimen of sort of, like, you know, chop it up into smaller pieces and take it out that way.
Dr. Kia: Yeah, exactly.
Dr. Fox: Yeah. No, it’s really pretty cool. Now, what other things in gynecology would be amenable to laparoscopy? So C-section, we obviously can’t do minimally invasive, at least not yet, until we figure out a way to get the baby out. But other surgeries, so you mentioned hysterectomy can be done minimally invasive. So that’s one operation. What else do we do in gynecology nowadays predominantly minimally invasive with laparoscopy?
Dr. Kia: I think the big thing even is, like, ectopic pregnancies. You know, I used to rotate at a smaller community hospital in California where they were still doing, you know, bigger incisions for ectopic pregnancy, and it pained me. It was so hard…
Dr. Fox: Patient two, probably.
Dr. Kia: Yeah. But, you know, that’s a really common thing. It’s very easy. We can do bilateral, you know, like for sterilization, we nowadays do salpingectomy so we can remove the fallopian tubes. Laparoscopically, we can remove ovarian cysts. Laparoscopically, fibroids is another big one that’s been, you know, another huge advancement. So, if you have a fibroid uterus, you can remove the individual fibroids laparoscopically. What else? Endometriosis. It’s another thing where you can do laparoscopy to diagnose endometriosis and take biopsies of it. But then also if someone has severe disease, remove the implants throughout, you know, the pelvis laparoscopically.
Dr. Fox: Yeah. And it seems that pretty much all, if not almost all or all of gynecologic surgery that’s not related to cancer is pretty much done or can be done minimally invasive. There’s some exceptions, very big fibroids, or very big uterus, or, you know, just things that geometrically it’s not gonna work out, or it’s not safe, or whatever it might be. Some of the cancer cases can be done laparoscopically and some can’t. That sort of depends what type of cancer, how advanced, and those things. But for, sort of, people with what we call benign conditions, benign, not meaning it’s not a problem, but it’s not cancer, can usually be done minimally invasive. Explain, since we’re on laparoscopy, sort of the advanced level that something called robotic surgery. So what is the difference between laparoscopy and robotic surgery, which is also a formal laparoscopy?
Dr. Kia: Correct. Robotic surgery is, you know, typically, I’m sure people have heard of the da Vinci machine. I remember when it first came out, it was, like, oh my gosh, this one-million-dollar machine. But the da Vinci machine is…
Dr. Fox: You don’t like when the machine’s worth more than you are, you know? It’s not good. Yeah.
Dr. Kia: But basically, it’s like a console that you sit at. It’s in the room, so it has the same, you know, typically maybe one more incision than with laparoscopy along the abdomen. And then you place the instruments and there’s this robotic arm that has the instruments in the robotic arm that are then inserted through the abdomen and then the surgeon sits on a console that’s, like, in the corner of the room. And the camera that they’re looking at, like, they put their head into the console and they see the camera where they’re operating. And then they use, they put their hands and fingers in these graspers that essentially, like, mimic your fingers and your hands, and it has more tactile feedback. And so, you feel like you’re operating with your hands more. So, that’s one of the advantages for robotic surgery. And it’s also easier for people to learn how to do rather than, you know, laparoscopy with straight sticks because they can articulate your risks and move it 360 degrees, and backwards, and forward, and that type of thing, which you can’t do when you’re operating, like, through a long rod.
Dr. Fox: That’s interesting. Wow. I mean, this was when I was training, the robot was around but it was really new. A few people, like, had access to it and they were, like, the chosen ones. You know, like, very few people they would trust with this machine. Now it’s very common for people to train with it.
Dr. Kia: Yeah. And I find that, you know, our institution where I did residency was the majority of people use the straight stick. And so, if you wanted to learn the robot, you can. And so, whatever you can do, the argument is, you know, whatever you can do on the robot, you can do in straight stick type of thing. Some people that really love the robot feel differently, but it’s, like, typically one or the other is, you know, depending on your surgeon’s comfort level with which one they feel more comfortable with.
Dr. Fox: Fascinating. Now, the other type of minimally invasive surgery is called hysteroscopy. So, what exactly is that? And it sounds like laparoscopy because it has oscopy at the end, which just means we put a camera in. That’s all oscopy means for those of you who wanna know the tricks of medical jargon. Scope equals camera. So oscopy means you’re looking with the camera. So what is hysteroscopy?
Dr. Kia: So hysteroscopy is really great. It’s basically, we put a camera through the cervix and descend the uterine cavity with, you know, usually saline or lactated ringers. And we look around and can see inside the uterus. And then, you know, you can have a diagnostic hysteroscopy where you’re just looking, or if you have polyps or small fibroids that are inside the uterus and along the lining, you can actually operate through that little camera too. And so, there’s devices that have come out now where, you know, you can remove the specimen through there. And, you know, nowadays, you can do it in the office too. It’s really come far, and it’s a quick procedure. It’s usually, you know, 30 minutes max, and same day people go home, minimal complications that are associated with it. So, it’s a really great way to see inside the uterus.
Dr. Fox: Yeah. And as opposed to laparoscopy, everything is done with one instrument, right?
Dr. Kia: Yeah.
Dr. Fox: That one instrument is the camera.
Dr. Kia: Correct.
Dr. Fox: Also has the things that you would, sort of, like, sneak through it to, you know, grab things or cut things. You don’t do as much with it, but you don’t need to do as much with it. Meaning, there’s no reason you would… you don’t sew things through it in the same way and you don’t have to… You know, it’s really just to look and maybe, look and remove is typically what it is for those things, so things like polyps, like fibroids. You know, it’s interesting that if it’s done in the hospital, usually people get anesthesia because either can and be, usually, there’s more going on. In the office, usually, it’s gonna be a smaller camera. Some people get tolerated, some people can’t. It sort of depends exactly also how easy is it to get the instrument through the cervix. Like, that’s where a lot of the pain might be.
So someone, you know, let’s say maybe has had a bunch of kids, their cervix tends to be a little looser and you can get a camera in easier. So there is some, you know, nuance to this exactly where it’s done but conceptually. And that was a very big advancement because also just the ability… you know, with laparoscopy it was the ability to do something less invasive. For the hysteroscopy, it was the ability to see it before you did it. because typically, the procedures that it replaced, the hysteroscopy, were not things that used to cut open the uterus for it, it was things that you just, like, blindly go in and, like, scrape things or grab things, and, you know, hope you got ’em.
Dr. Kia: Hope for the best.
Dr. Fox: You know, so, for the hysteroscopy, you get to really look inside. You know, with laparoscopy, you always got to look inside, but you had to cut someone open to do it. So that’s, you know, the advantage for laparoscopy is it makes it much more minimally invasive. I think for hysteroscopy, it was always sort of minimally invasive, but here it’s much more precise because you can, like, literally see the thing, diagnose it, remove it, and remove nothing else, and sort of be done. So I think that that’s pretty. And I imagine you did about a bajillion of these when you were a resident.
Dr. Kia: Oh, yeah. So it’s funny because…
Dr. Fox: It’s, like, the first thing you do as an intern.
Dr. Kia: Totally. Because it’s such a low-risk procedure, right?
Dr. Fox: Right.
Dr. Kia: So the interns all do ’em. But then my last year, I’d started taking them all back.
Dr. Fox: Yeah. You’re, like, “Wait, I can remember how to do this.” It’s really fascinating because it’s a pretty straightforward procedure. It does require skill, again, because you have one instrument that you’re looking with and trying to operate with, and at the same time, you have to keep track of where everything is and what the fluid is going on. And there’s a lot of stuff they’ll sort of set it up.
Dr. Kia: They can be hard, you know?
Dr. Fox: Yeah.
Dr. Kia: They’re not always, like, routine and straightforward, and I don’t know. My mantra in life is, like, you can never be an expert at anything. There’s always more to learn or, you know, every additional case that you do, you’re gonna learn something. So, I always try to do as many as I could. But yeah, hysteroscopy can be hard, but it’s a really great thing that we have available for patients and, you know, quick recovery and…
Dr. Fox: Yeah. And, sort of, in our setup for laparoscopy, everyone’s in the operating room. For hysteroscopy, there’s a few people have it done in the office. But again, if you need to do a lot of stuff, it’s gonna be operating…
Dr. Kia: It’s hard, yeah.
Dr. Fox: … because the camera, you need a bigger instrument, and that sort of hurts more. So people tend to get anesthesia. All of it is like you said, basically, people show up to the hospital, you know, they meet the anesthesiologist, they go in the operating room, the procedure takes 30 minutes, and it’s a laparoscopy. It can be longer based on what you’re doing. They wake up and they go home usually a couple hours later. I mean, nothing too remarkable. Now, for a hysteroscopy on the recovery, and there tends not to be much pain because there’s no incisions, there’s no stitches. There’s just, you know, maybe some cramping or bleeding, but nothing remarkable. Laparoscopy is surgery, so people do have pain afterwards, and there’s instructions afterwards. And, you know, it’s less pain than they would’ve if they had major or open surgery, but it’s still more than a hysteroscopy.
Dr. Kia: Correct. Yeah.
Dr. Fox: Yeah. And those two are sometimes done together, right?
Dr. Kia: Yeah.
Dr. Fox: So unless people do both at the same time, you know, if you have to look at different things, you may as well have one anesthetic for both.
Dr. Kia: Right. Because laparoscopy, you can look inside the abdomen. With hysteroscopy, you can’t, it’s just inside the uterus. So, sometimes, you know, people start with hysteroscopy and see if they can find the pathology there. And if not, you know, go laparoscopy or vice versa. But yeah, I mean, hysteroscopy patients don’t even, like, just Tylenol or Motrin, it’s typically what we give patients now. They don’t really require anything more in terms of pain management, which is great.
Dr. Fox: Yeah. Now, for our listeners out there, right, they’re all over the place, all over the country, all over the world. Hey, shout out to all of you guys in Nigeria who are listening by the way. Love it. Happy to have you. Keep coming back. How would someone know if, number one, they’re a candidate for minimally invasive surgery? Meaning if someone says, they’re meeting with their doctor, say, “All right, you need surgery now. I’m gonna do A, B, and C.” Could someone just say, “Hey, am I a candidate for laparoscopy and hysteroscopy?” Is that a question that a patient can ask?
Dr. Kia: Absolutely. I think, you know, if you have the proper workup done beforehand that, you know, looks at, like, let’s say for instance you want a hysterectomy. And you want a hysterectomy because you have fibroids. So let’s say you have a transvaginal ultrasound done that shows the number of fibroids and, you know, you have one little tiny, small fibroid and you just want the uterus out. Like, I think that’s a reasonable situation to ask your doctor, like, “Hey, can I have this done laparoscopically?” However, let’s say you have the workup done and it shows that you have, like, 20 large fibroids. Maybe you’re not the best candidate, but, you know, you can still have that discussion and talk about, you know, what makes a good candidate or not.
Dr. Fox: Yeah, I think it is definitely a question you can ask your doctor. And sometimes the answer will be, “Yes, that was my plan.” Sometimes the answer will be, “No.” And if it’s no, I think it’s important to know is the answer no because I’m not the right candidate for it. If so, why?
Dr. Kia: Or is it because, you know…
Dr. Fox: Right, there’s no, because this is something I’m not trained in or, you know, this is more complex than I personally do. And then, you know, regionally, is there someone who does it? You know, this is a legitimate conversation to have with your doctor.
Dr. Kia: Totally.
Dr. Fox: You may come to the conclusion that, listen, maybe there’s someone who could do it minimally invasive, but they’re not within three hours of this place, so you can either travel somewhere else and do it, or we’re gonna do it this way, which is perfect, you know, safe, and it’s not like it’s bad to have another way. It just may be a little more, maybe not exactly what you were looking for surgery-wise, or is there someone who does it? Or, you know, this should be an open conversation about what are the options and what is the best option for me specifically.
And these are also, again, unless it’s an emergency, these are things you can get a second opinion. You can meet with someone else and see what they say. Now, if you’re in the emergency room and you’re bleeding from an ectopic and your life is at risk, you know, you’ve… Listen, I hope, you know, someone’s goods gonna come and see me and take care of me, and that’s really what matters. That’s lifesaving. But if it’s talking about, you know, an elective surgery or one that’s not rushed, you know, you have cyst, you know, needs to be removed, but it could be any time the next month, then yeah, you have time to, sort of, “chop around” and figure out, you know, who’s gonna off your wedding. Listen, it could go the other way. You could have someone say, “Listen, it can be done minimally evasive, but the surgery’s gonna take 12 hours. And if I do it open, it’s gonna take 20 minutes, and maybe that’s better. Maybe it’s better to have a shorter operation with more, you know, cutting, so to speak, than a longer operation. I don’t know. Like, you know…
Dr. Kia: And some patients prefer that, you know. Some patients prefer to have, like, a… because, you know, depending on your pathology, even if you have an open surgery, it’s not necessarily, like, this giant incision that needs to be made, you know. So some people are, like, “Oh, I don’t want those tiny incisions on my abdomen. I’d rather have, like, a small one in my bikini line.” You know, so, I think those are all really reasonable things to talk about.
Dr. Fox: Cool. All right. Dr. Kia, welcome to New York City.
Dr. Kia: Thank you.
Dr. Fox: We’re happy to have you.
Dr. Kia: Thanks for having me.
Dr. Fox: Thanks for coming on the podcast. I know you just been Just been to, “Please, I wanna be in the podcast. Please, just get me on. Enough already.” Yeah, no, you did great. You’re a natural.
Dr. Kia: Thanks. I’m sure I’ll be back.
Dr. Fox: All right. Thank you for listening to the “Healthful Woman Podcast.” To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s H-E-A-L-T-H-F-U-L-W-O-M-A-N dot com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day.
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