Published on Sept. 24, 2026
For years, many women live with pelvic pain, heavy bleeding, urinary incontinence or pressure from pelvic organ prolapse, often dismissing symptoms as normal. But when symptoms affect daily life, sleep, work or confidence, it may be time to talk with a physician.
At the Center for Pelvic Health, specialists help women understand their options, including minimally invasive and robotic-assisted techniques that can treat noncancerous gynecologic conditions with smaller incisions, less pain and less time away from daily life.
“Open surgery, with larger abdominal incisions, was the standard for a long time,” said Lauren de Winter, M.D., urogynecologist, medical director, Center for Pelvic Health, MemorialCare Long Beach Medical Center. “Today, minimally invasive laparoscopic techniques and robotic assistance allow us to operate through smaller incisions with greater precision, which can mean less pain, less blood loss, fewer visible scars and a faster return to normal activities.”
Conditions such as endometriosis, uterine fibroids, abnormal bleeding, ovarian cysts, pelvic organ prolapse and urinary incontinence can worsen over time, contributing to anemia, chronic pain, bladder or bowel problems and reduced quality of life.
For patients with endometriosis who want to preserve fertility, specialized fertility sparing surgery may be an option to remove endometrial-like tissue and scar tissue while protecting the uterus, ovaries and fallopian tubes whenever possible.
Pain management also is an important part of care. Depending on a patient’s symptoms and goals, treatment may include medication, physical therapy, hormonal therapy or other nonsurgical approaches to help reduce pain and improve daily quality of life.
“One of the most difficult things for patients with pelvic pain or heavy bleeding is finding someone who takes their symptoms seriously,” Dr. de Winter said. “Painful periods may be common, but women should not have to live with pain that disrupts their lives.”
Minimally invasive procedures use small instruments, cameras and specialized technology to help surgeons access the treatment area with greater precision, often avoiding the larger incisions, hospital stay and longer recovery associated with open surgery.
MemorialCare offers the latest-generation da Vinci 5 Robotic System, which gives surgeons 3D visualization and wrist-like instrument movement to help perform delicate gynecologic and reconstructive procedures in narrow spaces.
“When you have the most advanced robotic technology, you also need a team that knows how to use it well,” Dr. de Winter said. “That experience matters in the pelvis, where precision, control and familiarity with the technology can make a meaningful difference.”
For some patients, vaginal natural orifice transluminal endoscopic surgery, or vNOTES, may allow surgeons to perform certain procedures through the vagina without external skin incisions.
“With vNOTES, we can perform certain procedures without any skin incision,” Dr. de Winter said. “For the right patient, that can mean less discomfort, no visible scarring and a smoother recovery.”
Not every minimally invasive approach is right for every patient, but Dr. de Winter said women should know what options may be available and feel comfortable asking whether a pelvic health specialist or minimally invasive gynecologic surgeon is appropriate for their condition.
Medically Reviewed by:
Lauren de Winter, M.D., FACOG, URPS, medical director, Center for Pelvic Health, MemorialCare Long Beach Medical Center
