Dr. Eric Heegaard
Gynecologic Surgeon

Best Physicians for Women.  Minnesota Monthly 

America's Top OB-GYNs.  Consumer's Resesarch Council

Procedures

Dr.  Heegaard has been a leader in moving hospital based procedures into the office setting.  He and his collegues at OB-GYN West were among the first to provide office endometrial ablations, tubal sterilization (Essure Procedure) and office hysteroscopy.  The advantages of performing these procedures in the office over the hospital are many, including increased patient satisfaction, comfort, and cost effectiveness.Da Vinci Robot

 

 

 

 

 

 

 

 

 

Dr. Heegaard has been described by his patients and collegues as having a rare blend of superb surgical skills with a caring, gentle personality.  As gynecologic surgery becomes more specialized, trust your care to a surgeon who is leading the way in minimally invasive treatment.   If you would like to make an appointment to see Dr. Heegaard please call his offices at OB-GYN West  952 249 2000 or at the Midwest Fibroid Treatment Center  952 249 2009.

PROCEDURES PERFORMED

OFFICE BASED PROCEDURES

1.  Office Endometrial Ablation

Endometrial ablation is the removal or destruction of the endometrium (lining of the uterus). It does not require hospitalization, and most women return to normal activities in a day or two. Ablation is an alternative to hysterectomy for many women with heavy uterine bleeding who are wish to avoid major surgery. After a successful endometrial ablation, most women will have little or no menstrual bleeding. Patient selection and physician experience is essential to a good outcome.

2.  Essure Procedure for tubal sterilization

Essure is a permanent birth control procedure that works with your body to create a natural barrier against pregnancy. This gentle procedure can be performed in a doctor's office in less than a half an hour. The Essure procedure does not require any cutting into the body. Instead, small flexible micro-inserts are inserted through the cervix and into your fallopian tubes. The procedure can be performed in the comfort of a doctor’s office without general anesthesia, and most women resume their normal activities within one day.

 

3.  Office Hysteroscopy

Hysteroscopy is a procedure that uses a telescopic instrument called a hysteroscope. In this procedure,  the cervix is dilated and then the hysteroscope is inserted to view the inside of the uterus, the lining of the uterus and the fallopian tubes. The modern hysteroscopes are so tiny that they allow the visualisation with minimal or no dilation. This procedure can be done under local or general anesthesia.

4.  Botox

BOTOX® Cosmetic is a prescription medicine that is injected into muscles and used to improve the look of moderate-to-severe frown lines between the brows in people 18 to 65 years of age for a short period of time (temporary).

5.  Interstim

InterStim Therapy for Urinary Control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments. InterStim Therapy is not intended for patients with a urinary blockage.

HOSPITAL BASED PROCEDURES

1.  Cystocele Repair

A cystocele is when the bladder falls down and often becomes visible. Urinary leakage often accompanies a cystocele. Cystoceles may cause pelvic pressure or just be unsightly. Cystocele repair (also called Anterior Repair or Anterior Colporrhaphy is the surgical reduction of the bulge to place the bladder back into its normal anatomic location. The traditional repair of plicating or overlapping tissues with suture unfortunately has a very high failure rate ranging from 25 to 60 percent. It is certainly one of the most challenging surgeries gynecologists perform. More modern surgery treats cystoceles as a hernia of the bladder into the vagina resulting in the use of mesh or donor tissues as a patch or graft. This appears to have resulted in improved succerss rates.


2.  Rectocele Repair

When the bulge into the vagina comes from the rectum it is called a rectocele. As with other forms of pelvic organ prolapse (cystoceles, enteroceles, vaginal prolapse) childbirth, chronic cough, chronic constipation, and obesity are predisposing factors. Symptoms are similar to cystoceles such as pelvic pressure, an unsightly bulge in the vagina, and constipation. Furthermore, the need of reaching into the vagina to push stool out is not uncommon. Surgical repair consists of using sutures to bunch up the bulging tissues together. More modern repair consists of the use of mesh or donor tissues. This newer method gives success rates of over 95% in our hands.

3.  Enterocele Repair

A bulge into the vagina can also be caused by small bowel pushing the vaginal tissues. This is called an enterocele. It can occur at the same time as a cystocele and a rectocele. In fact, we often cannot tell what is causing the bulge in the vagina whether it is bladder, rectum, or bowel, or all! Modern repair uses mesh or donor tissue with excellent success found.

4.  Vaginal Vault Suspension

A vagina that looses its support may come down and out into the open air. The degree of vaginal prolapse may vary from just having the top fall down a few centimeters to ones that completely go inside out. If a woman still has her uterus then this is called a uterovaginal prolapse. If only the uterus falls out and the top of the vagina is still well suspended then it is called a uterine prolapse. Vaginal vault suspension can be done in many ways. Some physicians prefer an abdominal approach to attach the top of the fallen vagina to the sacrum. The procedure is called a sacralcolpopexy. Dr. Heegaard is one of the few surgeons able to perform this procedure robotically thus reducing recovery.

5.  Incontinence Sling

The newest and safest trend to deal with incontinence involves the use of polypropylene, an inert nylon-type material, that is placed right under the mid urethra to act as a backboard when one sneezes or coughs to then occlude or block the urethral opening and either decrease of stop the leakage of urine. These procedures are all called “Tension-Free” because the slings are not sutured into muscle, fascia, or bone and are just left alone for ones own fibroblast to ingrow and hold the mesh. You may hear the term TVT or TOT. They refer to the route the slings are placed. TVT, or tension-free vaginal tape can be placed through an incision right above your pubic bone. TOT, or transobturator tape, is placed through incisions on the crease of your inner thighs. These incisions are just about invisible. Both procedures are outpatient surgeries of about 15 to 30 minutes.

6.  Laproscopic/Robotic Myomectomy (Fibroid Removal)

Robotic myomectomy uses a combination of high-definition 3D magnification, robotic technology and miniature instruments to in removing uterine fibroids and reconstructing the uterine wall.  See procedure video to see one of Dr. Heegaard's actual procedures.  The benefits of performing a myomectomy with robotic assistance include faster recovery, decreased blood loss and less scarring.

7.  Laproscopic/Robotic Hysterectomy (surgical removal of the uterus)

Robotic hysterectomy is a minimally invasive advanced laparoscopic surgery that employs state-of-the-art robot technology and magnified 3D vision. The da Vinci® ® robotic micro-instruments translate the precise movements of the surgeons’ hands while filtering out even the slightest tremors. High-definition scaled 3D imaging allows for optimum viewing and manipulation of sensitive nerves and tissues. See procedure videos to see an actual hysterectomy performed by Dr. Heegaard.

COSMETIC GYNECOLOGY

1.  Aesthetic Vaginal Surgery/Vaginoplasty

This aesthetic vaginal surgery aims to remove excess vaginal skin to narrow the diameter of the vagina resulting in a smaller and tighter introitus (opening) and vaginal vault. This is usually done in the operating room under general or spinal anesthesia or under local anesthetic with some sedation. It takes about 30 minutes to perform.

2.  Labiaplasty

This surgery is for the removal of excess, floppy, or uneven labia minora (smaller interior vaginal lips) and/or labia majora that often causes chronic irritation, rubbing, or discomfort during sexual intercourse.  Labiaplasty is  done in the operating room. This procedure takes 30 minutes to perform.

3.  Hymenoplasty

This surgery is the reconstruction of the hymen. Cultural, religious, or social reasons predominate when this surgery is contemplated. Hymenoplasty is performed to make the patient appear virginal. It only works for women who have not had vaginal deliveries, and preferably, in those who have never been pregnant. Once healed, the act of sexual intercourse can result in bleeding when the hymen is torn or stretched. This procedure takes 15 to 30 minutes to perform.

4.  Perineoplasty/ Perineorrhapy

The visible area between the vagina and the rectum is called the perineum. This is the region where episiotomies are cut and where tears during childbirth are most common. Perineoplasty (or Perineorrhaphy) aims to make this region appear normal by excising excess skin, loose skin tags, and suturing the underlying muscles or the perineal body closer together to give a more snug feeling in the introitus or vaginal opening. The procedure almost always accompanies vaginoplasty since you are working in the same area. This procedure takes 10 to 15 minutes to perform.