Gynaecological Laparoscopy & Hysteroscopic Surgery

What is TLH?

TLH is a major surgical procedure which involves removing the uterus and cervix using keyhole (laparoscopic) surgery. Ovaries and fallopian tubes may or may not be removed depending on the reason for surgery. ... Hysterectomy can be carried out vaginally, abdominally, laparoscopically or in a combination of these.

What is the difference between LAVH and TLH?

By definition, in TLH, total uterine removal is performed laparoscopically; LAVH implies performing laparoscopic removal above the uter- ine vessels, which are secured during the vaginal phase. Both TLH and LAVH are associated with many advan- tages over total abdominal hysterectomy (TAH).

Is a total laparoscopic hysterectomy a major surgery?

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. ... If the ovaries stay inside, the woman does not need to take any hormones after the surgery and she does not have hot flashes.

Laparoscopic Myomectomy

Laparoscopic or robotic myomectomy. In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions. Laparoscopic myomectomy. Your surgeon makes a small incision in or near your bellybutton.

How long is recovery from laparoscopic myomectomy?

Recovery times for each procedure are: abdominal myomectomy: four to six weeks. laparoscopic myomectomy: two to four weeks. hysteroscopic myomectomy: two to three days.

Is a myomectomy a major surgery?

Also known as an "open" myomectomy, an abdominal myomectomy is a major surgical procedure. It involves making an incision through the skin on the lower abdomen, known as a "bikini cut," and removing the fibroids from the wall of the uterus. ... Blood loss during the surgery may require a blood transfusion.

What can you eat after a laparoscopic myomectomy?

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common.

How long do you bleed after myomectomy?

You should expect vaginal spotting for up to 6 weeks and you cannot have sex or intercourse during recovery. The recovery time varies, depending upon the approach, anywhere from 2 - 6 weeks. Complications After Myomectomy May Include: Bleeding, which is the most frequent complication.

Is laparoscopic myomectomy major surgery?

In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions.

How long does myomectomy surgery last?

The hospital stay can last from 1-3 days and recovery time is generally 2-6 weeks.

Laparoscopic Management of Ectopic Pregnancies

An ectopic pregnancy is associated with certain demise of gestation, a threat to a woman's life, and a subsequent successful pregnancy in less than 50% of patients. In our country more than 80% of ectopic pregnancies are diagnosed after rupture. With high resolution trans-vaginal sonography, serum ?-HCG assay and increased vigilance of the clinician, more and more cases are being diagnosed before rupture. The incidence of ectopic pregnancy has been on the increase. In the last two decades, there has been a 6-fold increase in incidence in the United States, and a 4-fold increase in the United Kingdom . Now the incidence of ectopic pregnancy is 1%-2% of reported pregnancies. Several developments in the management of ectopic pregnancies have led to remarkable success in saving the mother's life. Further developments recently have resulted in a shift in focus from saving the mother's life to additionally saving the woman's fertility. In the past, successful surgical treatment of a tubal gestation was total salpingectomy. Since then, to improve future fertility, salpingostomy is generally adopted. Recently, laparoscopy in gynaecological surgery has developed from a diagnostic aid to a highly efficient surgical tool. Laparoscopic salpingostomy and laparoscopic salpingectomy are being performed for ectopic pregnancy. The purpose of this paper is to study these changing trends and to study the safety and efficacy of laparoscopic management of ectopic pregnancies in our hospital.

Laparoscopic treatment of endometriosis

Endometriosis can be considered as a chronic disease which is characterized by the presence of ectopic endometrium outside the endometrial cavity and which is associated with symptoms as pelvic pain and infertility. Medical treatment is often not sufficient in patients with moderate to severe endometriosis and deep infiltrative endometriosis (DIE), therefore requiring surgical intervention. Over the past 15 years, we have built a multidisciplinary surgical team to perform a radical but fertility preserving resection of extensive endometriosis with involvement of surrounding organ systems, realizing a good clinical outcome with low complication and recurrence rate, a very good improvement of QOL and a high pregnancy rate. However, for future research evaluating surgical treatment of extensive endometriosis, it is important to reach agreement on study design and on reporting clinical outcome data. A multicenter study with clear patient identification and well defined outcome parameters needs to be set up. Moreover, prevention of DIE with colorectal extension is important, ideally by early identification and management of girls and women at risk. Years of pain and disability as well as a lot of money could be saved when patients, at risk of developing extensive forms of endometriosis could be diagnosed during adolescence.

What is a laparoscopic ovarian cystectomy?

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 your lower abdomen.

How long does it take to recover from laparoscopic ovarian cystectomy?

six to eight weeks

After surgery. After the ovarian cyst has been removed, you'll feel pain in your tummy, although this should improve in a day or two. Following laparoscopic surgery, you'll probably need to take things easy for two weeks. Recovery after a laparotomy usually takes longer, possibly around six to eight weeks.

How is ovarian cyst removed laparoscopically?

Surgery Overview. When an ovarian growth or cyst needs to be closely looked at, a surgeon can do so through a small incision using laparoscopy or through a larger abdominal incision (laparotomy). Either type of surgery can be used to diagnose problems such as ovarian cysts, adhesions, fibroids, and pelvic infection.

How do you flush your fallopian tubes?

Tubal cannulation may be done immediately after you have a procedure called hysterosalpingography In this, your doctor flushes dye through the catheter to identify and locate a fallopian tube blockage. You may or may not get anesthesia during the procedure. Your doctor might give you a mild sedative to help you relax.

Can HSG clear blocked fallopian tubes?

The HSG helps the doctor check out two important factors: Whether or not the fallopian tubes are blocked or open. If the fallopian tubes are blocked, a woman will not be able to get pregnant, because the egg can't meet the sperm. You can read more about diagnosis, causes, and treatment for blocked fallopian tubes here.

How do they fix blocked fallopian tubes?

Surgery can be used to try to correct this common cause of infertility. The specific type of surgery depends on the location and extent of the fallopian tube blockage. Some tubal procedures can be done using microsurgical techniques, either during open abdominal surgery or using laparoscopy through a small incision.

How do I know if my fallopian tube is blocked?

There are three key tests to diagnose blocked fallopian tubes: An X-ray test, known as a hysterosalpingogram or HSG. A doctor injects a harmless dye into the womb, which should flow into the fallopian tubes. ... If the fluid does not flow into the fallopian tubes, they may have a blockage.

What are the signs of blocked fallopian tubes?

In addition to fertility problems, some common signs and symptoms of endometriosis include:

• Pelvic pain.
• Painful intercourse.
• Painful urination.
• Painful bowel movements.
• Severe abdominal pain.
• Lower back pain.
• Heavy periods or spotting between periods.
• Fatigue.

Can you still ovulate if your fallopian tubes are blocked?

Overview. Each month, when ovulation occurs, an egg is released from one of the ovaries. ... If one or both fallopian tubes are blocked, the egg cannot reach the uterus, and the sperm cannot reach the egg, preventing fertilization and pregnancy. It's also possible for the tube not to be blocked totally, but only partially.

Can you unblock fallopian tubes?

Blocked fallopian tubes are a common cause of infertility. Sperm and egg meet in the fallopian tube for fertilization. A blocked tube can prevent them from joining. If both tubes are fully blocked, pregnancy without treatment will be impossible.

What can I expect after a hysteroscopy?

Hysteroscopy is most often done on an outpatient basis. Otherwise, you won't need any special care after a hysteroscopy. You may have cramping and vaginal bleeding for a day or two after the procedure. Report fever, severe abdominal pain, or heavy vaginal bleeding or discharge.

What are the side effects after a hysteroscopy?

What are the side effects, risks, and complications of hysteroscopy? Women should expect to experience light vaginal bleeding and some cramping after the hysteroscopy procedure. Some cramping may be felt during the procedure, depending upon the type of anesthesia.

What is the recovery time for uterine polyp removal?

Recovery from a polypectomy usually takes about 2 weeks. Patients may feel pain following the procedure, particularly immediately after the procedure. Taking the pain medication the doctor prescribes can help.

How long does it take to heal from a hysteroscopy?

These symptoms usually go away in 1 or 2 days. If the doctor filled your uterus with liquid during the procedure, you may have watery vaginal discharge for a few days. Many women are able to return to work on the day after the procedure.

Can you get pregnant with a uterine septum?

A septate uterus does not typically affect a woman's ability to conceive, but it does significantly increase their risk of a miscarriage. Women with septate uteri can also go on to have recurrent miscarriages. ... A septate uterus is believed to be the most common type of abnormal uterine development.

How common is a uterine septum?

The extent of the septum varies; usually, it partially affects the uterine cavity rather than completely dividing it. The septate uterus, the most common type of Müllerian anomaly, has been estimated to occur in 3%-7% of the general population.

How do you know if you have a uterine septum?

Most women with uterine anomalies do not experience symptoms and may not discover they have an abnormal uterus until they have a routine pelvic exam or an ultrasound. When symptoms do occur, women may experience: Never having had a period. Recurrent miscarriages or infertility.

Is a uterine septum hereditary?

A septate uterus is a congenital malformation in which a thin membrane called the septum divides the uterus either partially or completely. It is a genetic abnormality a woman is born with but one that can be treated surgically, if needed, to improve the chances of successful pregnancy.

Can fibroids be removed by hysteroscopy?

A myomectomy is a surgery to remove fibroids without taking out the healthy tissue of the uterus. ... Myomectomy has traditionally been performed through a large abdominal incision, however advances in technology have provided less invasive alternatives such as hysteroscopic and laparoscopic myomectomies.

Is hysteroscopic myomectomy safe?

Hysteroscopic Myomectomy Safe and Easy. Contrary to what many still believe, hysteroscopic myomectomy can be one of the safest, mostly easily learned surgical procedures in gynecology. ... The resection of submucosal myomas transcervically is a less invasive approach than are other surgical procedures.