Minimally Invasive Gynaecology Surgery

Minimally invasive gynaecology surgery offers precision, faster recovery, and improved long-term pelvic health. Using advanced laparoscopic and hysteroscopic techniques, modern surgery can diagnose and treat conditions affecting fertility, menstrual function and pelvic pain with minimal disruption and optimal outcomes.

Dr Rebecca Mackenzie-Proctor is an experienced laparoscopic surgeon. Her approach integrates surgical excellence, reproductive expertise and holistic decision-making to ensure patients receive high-quality, personalised care. She has extensive surgical training across Australia and New Zealand, including tertiary-level CREI fellowship training at the Royal Women’s Hospital Melbourne. This provides a level of expertise in:

• Advanced laparoscopic endometriosis excision

• Ovarian and tubal surgery

• Surgical management of fibroids and uterine abnormalities

• Fertility-enhancing procedures

• Early reproductive anatomical assessment

Her experience spans both public and private hospitals, allowing her to perform complex surgery with the rigour of tertiary-level standards.

A Deliberate, Individualised Approach

Dr Rebecca Mackenzie-Proctor’s surgical philosophy is grounded in four key principles:

Evidence-Based Decision-Making

Surgery is recommended only when it offers a clear clinical benefit. Decisions are aligned with RANZCOG, ESHRE, ASRM and AAGL guidelines.

Precision and Reproductive Preservation

As a fertility specialist, she prioritises:

• ovarian tissue preservation

• minimising adhesion formation

• maintaining tubal function when appropriate

• optimising the pelvic environment for future embryo implantation

Whole-Person Care

Surgery is integrated with:

• Hormonal therapies

• Physiotherapy

• Nutritional support

• Fertility planning

• Long-term symptom management

This ensures patients feel supported before, during and after surgery.

Clarity, Communication & Consent

Patients are provided with clear explanations, diagrams, imaging review and realistic expectations. Shared decision-making is central.

Laparoscopy

Laparoscopic (keyhole) surgery uses small incisions, fine instruments and a camera to treat a range of gynaecological concerns with minimal postoperative impact.

Conditions Treated:

• Endometriosis [Make a hyperlink to the endometriosis page] excision

• Ovarian cysts and endometriomas

• Fibroids (selected intramural/subserosal fibroids)

• Adhesions

• Hydrosalpinx or fallopian tube obstruction

• Chronic pelvic pain

• Ectopic pregnancy

• Fertility assessment and tubal patency testing

Benefits of Laparoscopic Surgery:

• Smaller incisions and improved cosmetic result

• Less postoperative pain

• Faster recovery and early mobilisation

• Lower adhesion risk compared to open surgery

• Superior visualisation of pelvic structures

Endometriosis Excision Surgery

Excision is considered the gold-standard surgical approach for endometriosis. Dr Mackenzie-Proctor performs:

• meticulous excision of superficial and deep endometriosis

• management of endometriomas with ovarian preservation

• restoration of pelvic anatomy

• targeted treatment of bowel and bladder involvement in multidisciplinary teams

Her fertility background ensures careful handling of reproductive structures, particularly ovarian cortex and fallopian tubes.

Hysteroscopy

Hysteroscopy involves passing a fine telescope through the cervix into the uterus, allowing diagnosis and treatment without external incisions. It is essential for evaluating the uterine cavity in women with menstrual issues, infertility or recurrent pregnancy loss.

Diagnostic Hysteroscopy

Used to assess:

• uterine contour

• endometrial lining

• polyps or fibroids

• congenital anomalies (septum, arcuate uterus)

• adhesions (Asherman's syndrome)

• Histological assessment of immune and inflammatory cells, such as chronic endometritis.

Operative Hysteroscopy

Performed to treat:

• endometrial polyps

• submucosal fibroids

• uterine septum

• retained tissue

• intrauterine adhesions

Fertility Importance

Restoring a normal uterine cavity:

• improves embryo implantation

• reduces early pregnancy loss

• enhances IVF success rates

• supports natural conception

PRP (Platelet-Rich Plasma) in Reproductive Medicine

PRP is an emerging, experimental therapy that uses a patient’s own plasma enriched with platelets to promote tissue healing.

Potential Indications:

PRP may be considered in carefully selected cases such as:

• Recurrent implantation failure (RIF)

• Thin endometrium unresponsive to standard therapies

Use in “ovarian rejuvenation” remains experimental and is discussed only with full counselling around uncertainties and current evidence.

Approach to PRP:

• evidence-reviewed

• fully consented

• used selectively

• aligned with current ASRM/ESHRE guidance

Hysteroscopy

Used for diagnosis and treatment of:

• Polyps

• Fibroids

• Uterine septum

• Asherman’s syndrome

• Abnormal bleeding

• Recurrent implantation failure

Fertility Importance

Correcting uterine abnormalities improves implantation, reduces miscarriage risk, and supports overall fertility outcomes.

PRP (Platelet-Rich Plasma)

PRP is an emerging therapy considered in selected cases such as:

• Recurrent implantation failure

• Thin endometrium

• Experimental ovarian applications for poor ovarian response 

A full discussion of benefits, risks and evidence is provided before proceeding.