A laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus. A small incision is made in the belly button and a tiny camera is inserted. The surgeon watches the image from this camera on a TV screen and performs the operative procedure. Two or three other tiny incisions are made in the lower abdomen. Specialized instruments are inserted and used for the removal process.
Some women do not have their ovaries removed when they undergo a hysterectomy. If the ovaries stay inside, the woman does not need to take any hormones after the surgery and she does not have hot flashes. Some women remove their ovaries because of family history of ovarian cancer or they have an abnormal growth on their ovary.
Women Can Choose To Either Keep The Cervix In Place (Called A “Laparoscopic Supra-Cervical Hysterectomy”) Or Remove The Entire Uterus And Cervix (“ Total Laparoscopic Hysterectomy”).
Keeping The Cervix In Place Makes The Operation A Little Faster And Safer. When The Cervix Is In Place There Is A 5% Chance That The Woman Will Have Monthly Spotting At The Time Of Her Menstrual Periods. Women Whose Cervices Stay In Place Need To Continue Getting Pap Smears.
If The Woman Wants To Be 100% Certain That She Will Never Menstruate Again, She Needs To Have The Entire Uterus Removed. If The Patient Has A History Of Pre-Cancerous Changes Of The Cervix Or Uterine Lining, She Should Have The Entire Uterus Removed. If The Operation Is Being Done For Endometriosis Or Pelvic Pain, Many Doctors Think The Chances For Pain Reduction Are Better If The Cervix Is Removed.
A laparoscopic hysterectomy requires only a few small incisions, compared to a traditional abdominal hysterectomy which is done through a 3-6 inch incision. As a result, there is less blood loss, less scarring and less post-operative pain. A laparoscopic hysterectomy is usually done as an outpatient procedure whereas an abdominal hysterectomy usually requires a 2-3 day hospital stay. The recovery period for this laparoscopic procedure is 1-2 weeks, compared to 4-6 weeks after an abdominal hysterectomy.
The risks of blood loss and infection are lower with laparoscopic hysterectomy than with an abdominal hysterectomy. In experienced hands, laparoscopic hysterectomy takes about the same length of time as an abdominal hysterectomy and involves no greater risk.
Most patients who are having a hysterectomy to treat abnormal uterine bleeding or fibroids can have a laparoscopic hysterectomy. It may not be possible in some cases. For example, if the uterus is bigger than a 4 month pregnancy, if she’s had multiple previous operations in her lower abdomen. It is usually not done for women with a gynecologic cancer.
Patients are put to sleep under general anesthesia
The surgeon may have the patient see their primary care doctor prior to surgery to make sure there are no medical conditions that may cause a problem with the surgery. There will be a pre-operative appointment prior to the day of surgery which will include a history and physical examination, blood samples, and a visit w a member of the anesthesia department. Patients should not eat or drink anything after midnight on the night before surgery.
The majority of our patients go home the same day as their surgery.
Myomectomy (my-o-MEK-tuh-me) is a surgical procedure to remove uterine fibroids — also called leiomyomas (lie-o-my-O-muhs). These common noncancerous growths appear in the uterus. Uterine fibroids usually develop during childbearing years, but they can occur at any age.
The surgeon’s goal during myomectomy is to take out symptom-causing fibroids and reconstruct the uterus. Unlike a hysterectomy, which removes your entire uterus, a myomectomy removes only the fibroids and leaves your uterus.
Women who undergo myomectomy report improvement in fibroid symptoms, including decreased heavy menstrual bleeding and pelvic pressure.
Myomectomy has a low complication rate. Still, the procedure poses a unique set of challenges. Risks of myomectomy include:
⦁ Excessive blood loss. Many women with uterine leiomyomas already have low blood counts (anemia) due to heavy menstrual bleeding, so they’re at a higher risk of problems due to blood loss. Your doctor may suggest ways to build up your blood count before surgery.
During myomectomy, surgeons take extra steps to avoid excessive bleeding. These may include blocking flow from the uterine arteries by using tourniquets and clamps and injecting medications around fibroids to cause blood vessels to clamp down. However, most steps don’t reduce the risk of needing a transfusion.
In general, studies suggest that there is less blood loss with hysterectomy than myomectomy for similarly sized uteruses.
⦁ Scar tissue. Incisions into the uterus to remove fibroids can lead to adhesions — bands of scar tissue that may develop after surgery. Laparoscopic myomectomy may result in fewer adhesions than abdominal myomectomy (laparotomy).
⦁ Pregnancy or childbirth complications. A myomectomy can increase certain risks during delivery if you become pregnant. If your surgeon had to make a deep incision in your uterine wall, the doctor who manages your subsequent pregnancy may recommend cesarean delivery (C-section) to avoid rupture of the uterus during labor, a very rare complication of pregnancy. Fibroids themselves are also associated with pregnancy complications.
⦁ Rare chance of hysterectomy. Rarely, the surgeon must remove the uterus if bleeding is uncontrollable or other abnormalities are found in addition to fibroids.
⦁ Rare chance of spreading a cancerous tumor. Rarely, a cancerous tumor can be mistaken for a fibroid. Taking out the tumor, especially if it’s broken into little pieces (morcellation) to remove through a small incision, can lead to spread of the cancer. The risk of this happening increases after menopause and as women age.
In 2014, the Food and Drug Administration (FDA) cautioned against using a laparoscopic power morcellator for most women undergoing myomectomy. The American College of Obstetricians and Gynecologists (ACOG) recommends you talk to your surgeon about the risks and benefits of morcellation.
You’ll need to fast — stop eating or drinking anything — in the hours before your surgery. Follow your doctor’s recommendation on the specific number of hours.
If you’re on medications, ask your doctor if you should change your usual medication routine in the days before surgery. Tell your doctor about any over-the-counter medications, vitamins or other dietary supplements you’re taking.
Depending on your procedure, you may receive one of the following types of anesthesia:
⦁ General anesthesia. With general anesthesia, you will be fully asleep and a tube will be placed in your throat. General anesthesia is used for laparoscopic myomectomy and usually for abdominal myomectomy; it is sometimes also used for hysteroscopic myomectomy.
⦁ Monitored anesthesia care (MAC). With this type of anesthesia, you typically don’t remember anything and feel as if you’re fully asleep. You don’t have a tube placed in your throat. MAC is often used for hysteroscopic myomectomy, since it’s a less invasive procedure and therefore requires less anesthesia.
Sometimes other types of anesthesia, such as a spinal or local, may be used. Ask your doctor about the type of anesthesia you may receive.
Finally, talk to your doctor about pain medication and how it will likely be given.
Doctors diagnose pelvic inflammatory disease based on signs and symptoms, a pelvic exam, an analysis of vaginal discharge and cervical cultures, or urine tests.
During the pelvic exam, your doctor will first check your pelvic region for signs and symptoms of PID. Your doctor might then use cotton swabs to take samples from your vagina and cervix. The samples will be analyzed at a lab to determine the organism that’s causing the infection.
To confirm the diagnosis or to determine how widespread the infection is, your doctor might recommend other tests, such as:
⦁ Blood and urine tests. These tests will measure your white blood cell count, which might indicate an infection, and markers that suggest inflammation. Your doctor also might recommend tests for HIV and sexually transmitted infections, which are sometimes associated with PID.
⦁ Ultrasound. This test uses sound waves to create images of your reproductive organs.
⦁ Laparoscopy. During this procedure, your doctor inserts a thin, lighted instrument through a small incision in your abdomen to view your pelvic organs.
Treatments for pelvic inflammatory disease include:
⦁ Antibiotics. Your doctor will prescribe a combination of antibiotics to start immediately. After receiving your lab test results, your doctor might adjust your prescription to better match what’s causing the infection. You will likely follow up with your doctor after three days to make sure the treatment is working.
Be sure to take all of your medication, even if you start to feel better after a few days. Antibiotic treatment can help prevent serious complications but can’t reverse any damage.
⦁ Treatment for your partner. To prevent reinfection with an STI, your sexual partner or partners should be examined and treated. Infected partners might not have any noticeable symptoms.
⦁ Temporary abstinence. Avoid sexual intercourse until treatment is completed and tests indicate that the infection has cleared in all partners.
Most women with pelvic inflammatory disease just need outpatient treatment. However, if you’re seriously ill, pregnant or haven’t responded to oral medications, you might need hospitalization. You might receive intravenous antibiotics, followed by antibiotics you take by mouth.
A laparoscopic sterilisation is a method of female contraception which is permanent. It involves blocking both fallopian tubes to prevent you from becoming pregnant.
You will no longer need to use another form of contraception.
A coil, hormone implants or, for men, a vasectomy are common methods of contraception, which have a similarly low failure rate.
The operation is performed under a general anaesthetic and usually takes about twenty minutes.
Gynaecologist will make several small cuts on your abdomen.
They will place surgical instruments, along with a telescope, inside your abdomen and perform the operation.
The most common method of sterilisation is to block each fallopian tube by putting a clip on it.
⦁ Feeling or being sick
⦁ Infection of the surgical site (wound)
⦁ Unsightly scarring
⦁ Blood clots
⦁ Damage to internal organs
⦁ Making a hole in the womb or cervix
⦁ Surgical emphysema
⦁ Failed procedure
⦁ Infection of the gynaecological organs or bladder
⦁ Ectopic pregnancy
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.
Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.
It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.
If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.
Cervical cancer is a disease in which malignant (cancer) cells form in the cervix.
Screening for cervical cancer using the Pap test has decreased the number of new cases of cervical cancer and the number of deaths due to cervical cancer since 1950.
Human papillomavirus (HPV) infection is the major risk factor for cervical cancer.
Cervical cancer is a disease in which malignant (cancer) cells form in the cervix.
The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a fetus grows). The cervix leads from the uterus to the vagina (birth canal).
Pearl Womens & Fertility Clinic Is A Gynecology And General Surgery Clinic Visited By Dr. Niveditha MS(OG), MRCOG(UK), FRM, FMAS, FART, Consultant Obstretician And Gynecologist, Fertlity Specialist At The Hive Women’s And Fertility Clinic
No 11, 2nd street, Vivekanandha Main Road, Landmark: Near Reliance Fresh, Kolathur, Chennai- 600099.