Procedures

Office Based Procedures

Fertility Treatments

Intrauterine Insemination

Hysteroscopy

Endometrial Biopsy

Cervical LEEP Procedure

Permanent Birth Control

  • The Essure procedure is a method of permanent birth control. This procedure is outpatient and is done in an office or day surgery setting without any incisions. The Essure procedure is a form of tubal ligation because it blocks the fallopian tubes. Small “spring-like coils” are inserted into the Fallopian tubes thru the cervix and tissue naturally grows into them thus blocking the Fallopian tubes. This tissue takes three months to fully grow and block the tubes. After this three month period an Essure Confirmation Test, also known as an “HSG”, is done to insure that the tissue growth has fully blocked the tubes. The Confirmation Test is done by inserting radiopaque fluid and examining its pathway with an x-ray. This procedure is not reversible, and is intended for patients who are not interested in having children in the future.

Endometrial Ablation

  • Endometrial ablations can be done in several ways and usually can be performed in the office. The Novasure procedure is a common endometrial ablation treatment. This can be done as an outpatient in the office or day surgery setting. This procedure is done to manage heavy menstrual bleeding when other options have failed. Novasure is done by using energy to remove the lining of the uterus. This procedure is done by inserting a wand made of mesh through the cervix. The wand expands and conforms to the shape of the uterus. Next radio frequency energy is carried through the mesh wand into the lining of the uterus. Finally, the wand closes to its original shape and is withdrawn through the cervix.

3D & 4D Sonography

  • Sonography can be performed in the office to evaluate both Gynecological as well as Obstetrical conditions. The 3 & 4D images can show fetal faces in remarkable clarity.

Long-term Implantable Birth Control

  • The Nexplanon device is an implantable hormonal contraceptive. The device is a single soft insert that is placed under the skin of the arm. It slowly releases hormones into the system to prevent pregnancy, and is active for 3 years. The device is placed or removed in a simple in office procedure.

IUD Placement

  • An IUD is a type of birth control that is placed inside the uterus. It is reversible and is effective for five to 10 years. Candidates for an IUD are those who have had at least one child and do not wish to become pregnant within the next five years or more. There are two IUDs currently available, Mirena and Paragard. Paragard is a copper and plastic device that is hormone free. It works by preventing sperm from reaching the egg which prevents fertilization; it also prevents the egg from attaching to the uterus. Mirena is a plastic device and works by releasing small amounts of the hormone levonorgestrel. It is estrogen free, thus preventing estrogen related side effects, but works similarly to the Paragard. There are currently smaller IUDs which can be used by patients who have never been pregnant.

Hospital Based Procedures

Laser Surgery

Hysterectomy

Tubal Ligation

Laparoscopic/Vaginal Hysterectomy

  • A vaginal hysterectomy is one in which the surgery is done through the vagina, and typically has a shorter recovery period. Laparoscopy is sometimes done first in order to allow the surgery to be completed vaginally.

Laparoscopy

  • Laparoscopy is used in diagnosing and treating many problems including pelvic pain, infertility, ovarian cysts and other conditions. In this procedure a small incision is made in the abdomen and a laparoscope is inserted to view the uterus, fibroids, ovarian cysts, endometriosis and ectopic pregnancies. This minimally invasion procedure usually has a shorter recovery period than procedures requiring larger incisions.

Obstetrical Care

  • We are associated with Collin County’s best hospitals. Inpatient high risk obstetrical care, level three Neonatal Intensive Care units, and full time Neonatology services are all available.

Robotic Surgery

  • Many procedures can be performed using the da Vinci robotic platform including hysterectomies, ovarian surgery, endometriosis treatment, myomectomies and other procedures.

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3D & 4D Sonography

Sonography, or Ultrasound, is a powerful imaging technique for visualizing the pelvis. This includes the uterus, ovaries, tubes and the fetus during pregnancy. Obstetrical as well as gynecological imaging can be performed in our office using our state of the art equipment. 3D and 4D sonography can provide amazing images of the fetus during pregnancy.

In obstetrical imaging, sonography can be used for dating the pregnancy, diagnosing twins, evaluating fetal size, determining fetal wellbeing and many other reasons. 3D-4d sonography can be used for dynamic images of fetal anatomy and dramatic images of the fetal face.

In gynecology, sonography can be used to evaluate ovarian cysts, uterine fibroids, ectopic pregnancy, pelvic pain, endometriosis and many other conditions.

 

Obstetrical Care

Obstetrical Care

Pregnancy is one of the most exciting and anxious times in a women’s life. We are here to make this time as close to your expectations as possible. Our staff is dedicated to fulfilling your expectations for a memorable pregnancy experience. Dr. Duncan has delivered thousands of babies for his patients in the Plano and Frisco area d

uring his career. All of our patients are delivered by Dr. Duncan personally. We are associated with the best hospitals in Collin County for obstetrical care. Baylor Medical Center of Frisco, Medical Center of Plano, and Presbyterian Hospital of Plano are all equipped to provide high level obstetrical, neonatal and in-hospital antenatal care. We provide in-office as well as in-hospital care as needed.


Office Obstetrical Services

  • Routine Ob care
  • 3D and 4D Sonography
  • Non Stress testing
  • Genetic testing
  • Cord Blood Banking – CBR, Viacord, CryoCell, StemCyte
  • Diet and exercise counseling

High Risk Pregnancy Care

  • Advanced maternal age
  • Diabetes – Gestational and pre-existent
  • Hypertension
  • Incompetent cervix – Cervical cerclage
  • Multiple gestation – Twins, triplets
  • Recurrent pregnancy loss

Hospital Based Services

  • Preterm labor
  • Neonatal Intensive Care
  • C/Sections
  • VBACs – vaginal birth after C/Section
  • Amniocentesis
  • Prenatal classes – Baylor, MCP, Presbyterian
  • Epidural
  • Natural childbirth

Medications During Pregnancy

Most patients need medication sometime during their pregnancy. There are many common symptoms that should be treated and some that can be treated depending on the severity. Also many common medical conditions require treatment during pregnancy to protect the mother or fetus. These include asthma, thyroid disease, diabetes, seizure disorder, hypertension and others. Any chronic medication should be discussed to determine the optimal use during pregnancy including possible change or discontinuation of the medication. Many common conditions can be treated with over the counter medication and some of these are listed below. If any questions are present regarding medication these should be directed to our nurses and Dr. Duncan.

Gynecology

Women’s Healthcare

Many patients see their Ob/Gyn as their primary health care provider. Most routine treatment can be provided in our office. If more involved medical care is needed, specialists are available in most areas of health care in the local area. We work closely with local internists, surgeons, and specialists to provide comprehensive care to our patients. Some of the types of office care provided are listed below.

We also wish to provide an educational resource for women to empower them to make informed decisions regarding their health.


Office Care

Annual Exams

Abnormal Pap Smear Evaluation and Treatment

Breast Cancer Screening

Endometriosis Evaluation and Treatment

Hormonal Therapy

Infertility Evaluation and Treatment

Infertility is present in 10% of couples.

  • The evaluation of this can include laboratory testing, sonography, examination and even laparoscopic surgery. A complete evaluation can be done with many tests performed in an office setting.

Menopause

Menstrual problems

Obstetrical Care

Office Surgery and procedures

Ovarian Cancer Screening

Pelvic Pain Evaluation and Treatment

  • Pelvic pain can be a longstanding and debilitating condition. Many causes are possible including endometriosis, ovarian cyst, infection and many others. The evaluation of this can include examination, laboratory testing, sonography and commonly laparoscopic surgery and intraoperative laser treatment.

Pelvic, Vaginal and Bladder Infections

Polycystic Ovaries

Robotic Surgery

Sonography – 3D and 4D

STD Treatment

  • STD information and treatment is available in our office. The Gardisil vaccination for HPV (human papilloma virus) can be given for ages 10-26 and is the only vaccine available to help prevent cervical cancer.