All Search Results
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Linda Steward, PA-C
Lake Mary 392 Rinehart Rd. Lake Mary, FL 32746 Oviedo West 7404/7408/7416 Red Bug Lake Road Oviedo, FL 32765 Phone: (407) 977-4130 Fax: (407
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Elena Smith, APRN, CPNP, DNP
Elena Smith, APRN, CPNP, DNP, is a certified pediatric nurse practitioner with Orlando Health Physician Associates.
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LEEP Loop Electrode Excisional Procedure
A LEEP procedure is indicated once moderate to high grade dysplasia (abnormal cells) are confirmed after colposcopic examination. The procedure is both diagnostic (helps to ensure abnormal cells diagnosed are not more worrisome than reported after colposcopic biopsies) and therapeutic (removes the abnormal cells preventing further growth). A loop connected to an electrical generator is used to remove the area on the cervix where the abnormal cells were identified. The Loop gets very hot and is only used to remove a very superficial layer of the cervical tissue/skin. The procedure takes approximately 10 minutes. You will be placed in the same position as you are during a pap smear, another colposcopy is typically performed prior to removing the cells to better identify the area of concern. The procedure is typically performed in the office but may also be performed in the operating room. You will go home the same day. If being performed in the office, only local anesthetic injected into the cervix will be used. You should abstain from placing anything in the vagina or intercourse for at least three days prior to the procedure and for up to four weeks after the procedure. If you start your period prior to the procedure, it should be rescheduled.
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Laparoscopic Tubal Sterilization
A Laparoscopic Tubal Sterilization is the desired birth control method for women who no longer want children and prefer permanent contraception. The procedure is considered non-reversible and should be heavily considered prior to undergoing surgical therapy. Reversal is possible but pregnancy rates are approximately 40% and the procedure also increases one’s risk for ectopic (tubal) pregnancy if pregnancy is achieved. Laparoscopy is a type of minimally invasive procedure in which small incisions between 0.5 to 1 cm are made on the abdominal wall through which an instrument called a laparoscope can be placed. The laparoscope allows the surgeon to visualize inside the abdomen and pelvis. The abdominal cavity is able to be visualized by filling it with an absorbable gas, typically, carbon dioxide. Small instruments can be placed through the small incisions allowing the surgeon to either burn, clip, or occlude the fallopian tube. Various methods are used. Patients must receive general anesthesia during the procedure and typically go home the same day.
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Urodynamics
The urodynamics procedure assesses how the
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Diagnostic Hysteroscopy
A hysteroscopy is a procedure performed to visualize inside the uterus. The procedure is typically performed to identify causes for abnormal uterine bleeding and irregular periods such as the growth of fibroid tumors or uterine polyps. We can perform this procedure in our office as well as in the operating room.
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Endometrial Biopsy
For individuals having abnormal bleeding, you may be required to undergo and
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Endometrial Ablation
An Endometrial Ablation is a procedure offered to women who have heavy menstrual bleeding and do not want to undergo a hysterectomy or prefer less invasive management options prior to considering hysterectomy. Various methods can be performed to destroy the basalis layer (lining of the uterus that has glandular tissue which bleeds monthly at the time of your menses) of the uterine lining to prevent heavy bleeding. A hysteroscope is first used to visualize inside the uterine cavity. All instruments are placed through the vagina and do not require vaginal or abdominal incisions. If polyps or fibroids exist, they will be removed hysteroscopically. If they are 2-3 cm or less they may be left in place depending on the type of ablation you undergo. The uterine lining may also be resected to prevent heavy bleeding. This procedure is performed with the hysteroscope and requires quite a bit of skill. Hot water may be used to ablate the uterine lining (Hydrothermal or Thermachoice). Bipolar electricity may also be used to burn the uterine lining. This procedure is called Novasure Ablation.
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Bladder Instillations
Bladder instillations are used to place numbing medications into the bladder for temporary pain relief due to interstitial cystitis. This procedure may also be performed to test for bladder mucosal sensitivity. First the urethra is cleaned with betadine soap. A small catheter is placed in the bladder. Through this catheter a mixture of anesthetic medications is placed. The entire procedure is done in the office setting.
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Colposcopy
A colposcopy is indicated in the setting of an abnormal pap smear. If your pap smear showedatypical cells of undetermined significance(ASCUS) with the presence of human papilloma virus, low grade squamous intraepithelial neoplasia (LSIL), or high grade squamous intraepithelial neoplasia you will be scheduled for a colposcopic examination. A colposcope is used to enlarge the cervix, and vaginal skin and labia if needed, so that your provider can better visualize potentially abnormal areas. A special solution called acetic acid is applied to the cervix which assists in visualizing areas of concern. If an area is identified, a biopsy will be taken to send to a pathologist for more accurate diagnosis. The goal of the procedure is to obtain a tissue sample if abnormal areas are identified because the tissue will aid the pathologist to make a more accurate diagnosis of the type of abnormal cells that exist than a pap smear alone.
