INVESTIGATIONS AND TREATMENT

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GYNAE SURGERIES

Have you been told by your gynecologist that you need a procedure to further evaluate a gynecological problem? You're not alone. Millions of people each year face the uncertainty of having a gynecological procedure or surgery performed.

It's a good idea to learn about these common gynecological procedures and surgeries before you need them. Then, you’ll be one step ahead if your gynecologist ever says you need more evaluation of a potential problem.

Laparoscopy surgeries

Laparoscopy is a method of doing surgery without making a large incision. The laparoscope consists of a thin, lighted tube with a small camera that is inserted into the abdomen through a small incision. In women, laparoscopy is commonly used to diagnose the following conditions:

  1. Chronic pelvic pain and pelvic floor disorders
  2. Endometriosis

Endometriosis is a disorder in which tissue similar to the tissue that forms the lining of the uterus grows outside of the uterine cavity. The lining of the uterus is called the endometrium. Endometriosis occurs when endometrial tissue grows on ovaries, bowel, and tissues lining your pelvis.

Endometriosis
Endometriosis

3. Uterine fibroids: Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas or myomas, uterine fibroids aren’t associated with an increased risk of uterine cancer and almost never develop into cancer.

Uterine fibroids

4. Ovarian cysts: Ovarian cysts are fluid-filled sacs or pockets in an ovary or on its surface. Women have two ovaries, each about the size and shape of almond on each side of the uterus. Eggs (ova), which develop and mature in the ovaries, are released in monthly cycles during the childbearing years. Most ovarian cysts are small and don’t cause symptoms. If a cyst does cause symptoms, you may have pressure, bloating, swelling, or pain in the lower abdomen on the side of the cyst.

Ovarian cysts
Ovarian cysts

Ectopic Pregnancy: Ectopic pregnancy also called extrauterine pregnancy, is when a fertilized egg grows outside a woman’s uterus, somewhere else in their belly. It can cause life-threatening bleeding and needs medical care right away. In more than 90% of cases, the egg implants in a fallopian tube. This is called a tubal pregnancy.

Ectopic pregnancy

Gynecologic Cancer: Gynecologic cancer is any cancer that starts in a woman’s reproductive organs. Five main types of cancer that affect a woman’s reproductive organs are cervical, ovarian, uterine, vaginal, and vulvar. As a group, they are referred to as gynecologic cancer.

Gynecologic Cancer

Types of laparoscopic surgery include:

i. Myomectomy (removal of uterine fibroids)
Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and, for some women, makes pregnancy more likely than before. Myomectomy is the preferred fibroid treatment for women who want to become pregnant.

ii. Hysterectomy (removal of uterus)
A hysterectomy is an operation to remove the uterus. This surgery may be done for different reasons, including: Uterine fibroids that cause pain, bleeding, or other problems. Uterine prolapse, which is a sliding of the uterus from its normal position into the vaginal canal. Cancer of the uterus, cervix, or ovaries.

iii. Endometrial ablation (destruction of uterine lining)
Endometrial ablation is a procedure to remove a thin layer of tissue (endometrium) that lines the uterus. It is done to stop or reduce heavy menstrual bleeding. But it is only done on women who do not plan to have any children in the future. The procedure is not surgery, so there will not be any cut (incision).

Endometrial ablation

iv. Oophorectomy (removal of ovaries)
An oophorectomy is a surgical procedure to remove one or both of the ovaries. Removal of the ovaries is often combined with salpingectomy, a procedure to remove the fallopian tubes. This might be an option if the oophorectomy is done to lower your risk of ovarian cancer.

Oophorectomy

v. Cystectomy (removal of ovarian cyst)
An ovarian cystectomy is surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgery technique that only uses a few small incisions in the lower abdomen.

vi. Repair of pelvic organ prolapse
Pelvic organ prolapse is when 1 or more of the organs in the pelvis slip down from their normal position and bulge into the vagina. It can be the womb (uterus), bowel, bladder or top of the vagina. A prolapse is not life threatening, but it can cause pain and discomfort.

Repair of pelvic organ prolapse

vii. Reversal of tubal ligation
A tubal ligation reversal is a procedure to reverse a tubal ligation. When the fallopian tubes are cut or blocked to permanently prevent pregnancy. During a tubal ligation reversal, the doctor removes the obstructed area of the fallopian tubes and reattaches the fallopian tubes to allow pregnancy.

Reversal of tubal ligation

Pelvic Floor Repair
The most common surgery for prolapse is a pelvic floor repair, which is a broad term used to describe simple surgical repairs of the pelvic floor. More specifically, the term anterior repair refers to correction of the front wall of the vagina; and posterior repair refers to correction of the back wall of the vagina. If the uterus is prolapsing, it may be removed (hysterectomy). If hysterectomy had been done before, then the top of the vagina (vault) can be lifted up and supported.

Vaginal Hysterectomy
A vaginal hysterectomy is a surgical procedure to remove the uterus through the vagina. During a vaginal hysterectomy, the surgeon detaches the uterus from the ovaries, fallopian tubes, and upper vagina, as well as from the blood vessels and connective tissue that support it, before removing the uterus.

Vaginal Hysterectomy

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