Gynecological endoscopic surgery

Medical science technologies are still evolving, so new therapies appear all the time. In modern operating gynecology doctors try to ensure, that all treatment methods are based on the principles of minimal invasion surgery. Laparoscopy and hysteroscopy – are not only minimally invasive endoscopic surgery methods, but have other qualities, such as: less pre-operative stress for the patient , less postoperative pain, faster patient’s recovery.

Laparoscopy (Gr. lapara – abdomen, scopeo – see) – a method of surgery, when the necessary operational actions in the abdominal cavity are made through a few small incisions in the abdominal wall while using an optical system and fine manipulators. A special Veres needle is used through a small incision in the abdominal wall, it doesn’t damage organs underneath it and gives the possibility to inject carbon dioxide gas, which lift the abdominal wall and separates it from the organs. This operation gives the doctor a possibility to inspect abdominal organs and gives enough space to perform diagnostic and therapeutic procedures. Later, special surgical instruments are inserted through small (from 0.5 cm to 1 cm) incisions (incision length and number depends on the complexity and size of the available instruments) in the abdominal cavity, these instrument’s working parts are similar to conventional surgical instruments, but they are managed by the surgeon from outside the abdominal cavity. The surgeon sees what’s happening in the abdomen through a monitor, the picture is transmitted by a small camera, which lens is also injected into the abdominal cavity. Laparoscopy is a unique approach to the use of technical optics, television, electrical appliances, mechanical possibilities, surgical experience, skills and knowledge to open up huge opportunities for diagnosis and treatment. The patients suffer a lot less surgery, small incisions are responsible for easier post-operative period and a shorter recovery time. It may be a an “easy” surgery for the patient, but it is a difficult major surgery for the endoscopist, because even the smallest intervention requires a lot of specific knowledge ,skills and experience .

Gynecological diagnostic laparoscopy is performed mostly in cases of: Unexplained acute or chronic abdominal pain in the lower abdomen or lumbar area; Suspicion for gynecological inflammation; Ectopic pregnancy; Endometriosis; Ovarian tumors (cysts); Cervical accessory twirling; Infertility, because fallopian tube passability, and other important factors relating to infertility (accretion, endometriosis).

When a disease is found during the diagnostic laparoscopy, surgical treatment – surgical laparoscopy, can be immediately applied: the doctor can remove cists, adhesions, myomas, perform ovarian plastic operations, surgically treat endometriosis.

It is confirmed that laparoscopic surgery is safe and effective. It has the following advantages compared with traditional surgery: the patient is recovering faster, the amount of time the patient needs to stay in hospital is reduced, decreased cost of treatment, better cosmetic results

Hysteroscopy is a diagnostic and therapeutic method to examine and evaluate the uterine cavity changes and carry out surgical operations there. During the study obstetrician-endoscopist inserts a thin hysteroscope into the uterus through the cervix – a hysteroscope is a device similar to a telescope. The doctor can see the cervical canal, uterine cavity, and all it’s changes: flourished endometrium, as well as polyps, myoms on uterine walls, adhesions left after procedures performed in the uterus, on the video monitor, he can also evaluate the fallopian tubes and the form the uterus.

Hysteroscopy can be performed because of: endometrial polyps or myoms, endometrial hyperplasia, intense and prolonged, as well as irregular uterine bleeding, recurrent miscarriages, infertility and other causes. Hysteroscopic uterus mucous ablation can be a saving alternative for the women who don’t want a radical uterus removal operation because of the abnormal uterus bleedings, but you should consult with the operating doctor on this topic.

This method is also suitable for those who can not get pregnant or carry out a fetus and are experiencing early miscarriages. Often, uterine abnormalities, adhesions, uterine myoms deforming the cavity, can be the cause of infertility. After hysteroscopy, it is possible to assess, diagnose or rule out a possible disease.

The main advantage of hysteroscopy is that everything is clearly in sight, no action, such as the uterine cavity endometrium destruction or a biopsy is not made blindly anymore. This is a very reliable method of uterine cavity diagnosis.

In addition, since there are no cuts or wounds in the abdomen, the post-operative pain is minimal, and there is no wound infection risk.

Most women can return to work the next day or within one – two days after hysteroscopy – it is determined by the quantity of actions made by the doctor.

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