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Abortion, Induced
A dilatation and curettage is used to perform an abortion up to 10 weeks gestation (A). Over 10 weeks, the physician may use dilatation and evacuation to achieve the abortion (B). (Illustration by GGS Inc.)

Hysterectomy
In a hysterectomy, the reproductive organs are accessed through a lower abdominal incision or laparoscopically (A). Ligaments and supporting structures called pedicles connecting the uterus to surrounding organs are severed (B). Arteries to the uterus are severed (C). The uterus, fallopian tubes, and ovaries are removed (D and E). (Illustration by GGS Inc.)

Tubal Ligation
In a tubal ligation, a woman's reproductive organs are accessed by abdominal incision or laparoscopy (A). The fallopian tubes are cut and tied (B), cauterized (C), blocked with a silicone band (D), or clipped (E) to ensure sperm is not able to fertilize an egg. (Illustration by GGS Inc.)

In Vitro Fertilization
A microscopic image of a needle (left) injecting sperm cells directly into a human egg (center). The broad object at right is a pipette used to hold the ovum steady. (Phototake NYC. Reproduced by permission.)

In Vitro Fertilization
Forin vitrofertilization, hormones are administered to the patient, and then eggs are harvested from her ovaries (A). The eggs are fertilized by sperm donated by the father (B). Once the cells begin to divide, one or more embryos are placed into the woman's uterus to develop (C). (Illustration by GGS Inc.)

Episiotomy
During childbirth, the area called the perineum is often cut to facilitate delivery (A). First, a local anesthetic may be given (B). The perineum is cut on an angle with scissors (C). After delivery, the layers of muscle and skin are repaired (D and E). (Illustration by GGS Inc.)

Cesarean Section
To remove a baby by cesarean section, an incision is made into the abdomen, usually just above the pubic hairline (A). The uterus is located and divided (B), allowing for delivery of the baby (C). After all the contents of the uterus are removed, the uterus is repaired, and the rest of the layers of the abdominal wall are closed (D). (Illustration by GGS Inc.)

Pelvic Ultrasound
Fetal ultrasound during the second to third trimester. (Brigham Narins. Reproduced by permission.)

Myomectomy
Uterine fibroids can occur within the uterine cavity, in the mucous layer, or in the muscle (A). To remove them by myomectomy, an incision is made into the woman's lower abdomen (B). An incision is made in the uterus over the tumor (C), and it is removed (D). (Illustration by GGS Inc.)

Dilatation and Curettage
For a D & C, the patient lies on her back, and a weighted retractor is placed in the vagina (A). A dilator is used to open the cervix (B), and a curette is used to scrape the inside of the uterus (C). (Illustration by GGS Inc.)

Salpingostomy
A tubal or ectopic pregnancy can be removed in several ways. If the fallopian tube is ruptured (A), the tube is tied off on both sides, and the embryo removed. If the tube is intact, the embryo can be pulled out the end of the tube (C), or tube can be cut open and the contents removed (D). (Illustration by GGS Inc.)

Femoral Hernia Repair
To repair a femoral hernia, an incision is made in the groin area near the hernia (A). Skin and ligaments are pulled aside to expose the hernia (B). The hernia sac is opened, and the contents are pushed back into the abdominal cavity (C). The neck of the sac is tied off, and excess tissue is removed (D). Layers of skin and tissues are repaired (E). (Illustration by GGS Inc.)

Laparoscopy for Endometriosis
For this procedure, three or four incisions may be made in the woman's lower abdomen (A). Carbon dioxide is pumped into the abdomen to create a condition called pneumoperitoneum, which gives the surgeon more room to work (B). A laparoscope with video monitor is used to view the internal structures, while endometrial growths are removed with other tools (C). (Illustration by GGS Inc.)

Retropubic Suspension
Weak pelvic floor muscles (A) can cause stress incontinence. In a retropubic suspension, the neck of the bladder is elevated and stitched to the pubic bone to hold it in place (B). (Illustration by GGS Inc.)

Patent Urachus Repair
A patent urachus is an abnormal opening from the bladder to the umbilicus, which is retained from fetal life (A). To repair it, an incision is made in the baby's abdomen (B). The patent urachus is removed (C), and the opening to the bladder is closed (D). (Illustration by GGS Inc.)

Salpingo-Oophorectomy
In a salpingo-oophorectomy, a woman's reproductive organs are accessed through an incision in the lower abdomen, or laparoscopically (A). Once the area is visualized, a diseased fallopian tube can be severed from the uterus and removed (B and C). The ovary can also be removed with the tube (D). The remaining structures are stitched (E), and the wound is closed. (Illustration by GGS Inc.)