Gynaecology

What is laparoscopy?

Laparoscopy is a way of doing surgery without making a large incision (cut). A thin tube known as the laparoscope is inserted into the abdomen through a small incision(3-10 mm). The 3D LAPAROSCOPY OT laparoscope allows your health care provider to see the pelvic organs. If a problem needs to be treated, other instruments are used. These instruments are inserted either through the laparoscope or through other small cuts in your abdomen.My doctor said, I can go home next day after laparoscopic surgery…..is it true! ?Laparoscopy often is done as outpatient surgery. You usually can go home the same day, after you have recovered from the anesthesia. More complex procedures, such as laparoscopic hysterectomy, may require an overnight stay in the hospital.

How is laparoscopic surgery performed?

Your doctor will make a small incision in your navel and insert the laparoscope. During the procedure, the abdomen is filled with a gas (carbon dioxide or nitrous oxide). Filling the abdomen with gas allows the pelvic reproductive organs to be seen more clearly. The laparoscope shows the pelvic organs on a screen. Other incisions may be made in the abdomen for surgical instruments. These incisions usually are no more than one 5 mm. Another instrument, called a uterine manipulator, may be inserted through the cervix and into the uterus. This instrument is used to move the organs into view. Dr Mehul Sukhadiya has a patented design of mainipulator called Sukhadiya manipulator, which reduces the operative time and thus helps in early post operative recovery.

What is involved in recovery?

If you had general anesthesia, you will wake up in the recovery room. You will feel sleepy for a few hours. You may have some nausea from the anesthesia. If you have had an outpatient procedure, you must have someone drive you home. You may be sore around the incisions made in your abdomen and navel. Sometimes, the tube put in your throat to help you breathe during the surgery may give you a sore throat for a few days. If so, try throat lozenges or gargle with warm salt water. If pain and nausea do not go away after a few days or become worse, you should contact your doctor..

What are the benefits of laparoscopic surgery?

Laparoscopy has many benefits. There is less pain after laparoscopic surgery than with open abdominal surgery, which involves larger incisions, longer hospital stays, and a longer recovery. The risk of infection also is lower. You will be able to recover from laparoscopic surgery faster than from open abdominal surgery. It often can be done as outpatient surgery, so you usually will not have to spend the night in the hospital. The smaller incisions that are used allow you to heal faster and have smaller scars.

What are the reasons for having to undergo hysterectomy?

A hysterectomy may be done to treat conditions that affect the uterus:

Uterine fibroids
Endometriosis
Pelvic support problems (such as uterine prolapse)
Abnormal uterine bleeding
Cancer
Chronic pelvic pain

What are uterine fibroids?

Uterine fibroids are benign (not cancer) growths that develop from the muscle tissue of the uterus. They also are called leiomyomas or myomas. The size, shape, and location of fibroids can vary greatly. They may be present inside the uterus, on its outer surface or within its wall, or attached to it by a stem-like structure. A woman may have only one fibroid or many of varying sizes. A fibroid may remain very small for a long time and suddenly grow rapidly, or grow slowly over a number of years.

Changes in menstruation
Longer, more frequent, or heavy menstrual periods
Menstrual pain (cramps)
Vaginal bleeding at times other than menstruation
Anemia(from blood loss)
Pain
In the abdomen or lower back (often dull, heavy and aching, but may be sharp)
During sex
Pressure
Difficulty urinating or frequent urination
Constipation, rectal pain, or difficult bowel movements
Abdominal cramps
Enlarged uterus and abdomen
Miscarriages
Infertility

Fibroids also may cause no symptoms at all. Fibroids may be found during a routine pelvic examor during tests for other problems.

When is treatment necessary for fibroids?

Fibroids that do not cause symptoms, are small, or occur in a woman who is nearing menopause often do not require treatment. Certain signs and symptoms may signal the need for treatment:

Heavy or painful menstrual periods that cause anemia or that disrupt a woman’s normal activities
Bleeding between periods
Uncertainty whether the growth is a fibroid or another type of tumor, such as an ovarian tumor
Rapid increase in growth of the fibroid
Infertility
Pelvic pain

What types of surgery may be done to treat fibroids?

Myomectomy is the surgical removal of fibroids while leaving the uterus in place. Because a woman keeps her uterus, she may still be able to have children. Fibroids do not regrow after surgery, but new fibroids may develop. If they do, more surgery may be needed. Hysterectomy is the removal of the uterus. The ovaries may or may not be removed.

What is stress urinary incontinence?

Stress urinary incontinence is leakage of urine with physical activity, such as exercise, or when coughing, laughing, or sneezing.

What causes stress urinary incontinence?

Stress urinary incontinence may be caused by a weakening of the sphincter muscle that controls the urethra, which may occur from pregnancy, childbirth, or aging.

How can SUI be treated with latest options in medical care ?

Sling surgeries by TVT and TOT can significantly improve quality of life of patients. Selected group of patients benefit from laparoscopic Burch colposuspension.

What is endometrial ablation/ TCRE?

Endometrial ablation destroys a thin layer of the lining of the uterus and stops the menstrual flow in selected group of women. In some women, menstrual bleeding does not stop but is reduced to normal or lighter levels. Some women continue to have troublesome spotting after TCRE. If ablation does not control heavy bleeding, further treatment or surgery may be required.

What is an ovarian cyst?

An ovarian cyst is a sac or pouch filled with fluid or other tissue that forms on the ovary. Ovarian cysts are quite common in women during their childbearing years. A woman can develop one cyst or many cysts. Ovarian cysts can vary in size. In most cases, cysts are harmless and go away on their own. In other cases, they may cause problems and need treatment.There are different types of ovarian cysts. Most cysts are benign (not cancerous). Rarely, a few cysts may turn out to be malignant(cancerous).

How are ovarian cysts treated?

Birth control pills may be prescribed to treat some types of ovarian cysts. This treatment will not make cysts you already have go away. But it will prevent new cysts from forming.

If your cyst is large or causing symptoms, your may need surgery. The extent and type of surgery that is needed depends on several factors:

Size and type of cyst
Your age
Your symptoms
Your desire to have children

The organs that can be affected include the following:

Uterus
Top of the vagina in women who have had a hysterectomy(the vaginal vault)
Front (anterior) wall of the vagina (usually with the bladder, which is called a cystocele)
Back (posterior) wall of the vagina (usually with the rectum, which is called a rectocele)
The pouch between the rectum and back wall of the uterus (usually with a part of the small intestine, which is called an enterocele)

Reconstructive surgery reconstructs the pelvic floor with the goal of restoring the organs to their original position using artificial mesh. Some types of reconstructive surgery are done through an incision in the vagina. Others are done through laparoscopy.