What is Laparoscopy?
Laparoscopy is an innovative way of performing a surgical procedure. A thin telescope is inserted through your navel and a small digital camera that is attached to the end of the scope shows the anatomical structures in a big screen or TV monitor. Three more incision ( 5mm each) are performed in your abdomen. Then your surgeon performs the procedure using special instruments that are inserted through the small holes. Laparoscopy is minimally invasive surgery, and it allows a patient to have a comfortable postoperative recovery, reducing the amount of narcotics used for pain relief and having a faster recovery with a quick return to your normal activities.
Am I a candidate for laparoscopic surgery?
Most patients can have major surgery performed through the laparoscope rather than through a big abdominal incision. It depends on your specific condition but what it is more important it depends on the proper training and laparoscopic experience of your Gynaecologist.
What is a hysterectomy and how is it performed?
A hysterectomy is a major surgical procedure to remove the womb or uterus. Therefore you will stop having periods and you can not become pregnant.
There are different types of hysterectomy:
- Abdominal hysterectomy: The surgery is done through a big incision of usually 15 cm in length. You are likely to need pain relief by narcotics. Your stay in hospital is around 5 to 7 days. Full recovery may take 6 to 8 weeks before returning to work.
- Vaginal hysterectomy: The uterus is removed through the vagina without a cut in your abdominal wall. It is usually done in the case of a prolapsed uterus and when there is no reason to suspect any other intra-abdominal problem particularly related to your ovaries, as they may be very difficult to remove vaginally.
- Laparoscopic Hysterectomy: This is an innovative surgical procedure where a thin telescope (laparoscope) connected to a digital camera is placed through a small 10mm incision in the navel. Three other incisions of 5mm each are made to enable other instruments to be used. The degree of pain is minimal reducing the need for narcotics. The usual hospital stay is 1-2 days and the return to normal activities is around 2 weeks.
If I do need a hysterectomy, will my ovaries be removed?
The ovaries are important for the production of female hormones. So, the short answer is no. Your Gynaecologist however, may recommend in special situations the removal of your ovaries. For example when you are already postmenopausal. This of course, should be discussed with you, as you must be comfortable with the type and extent of the surgery to be done.
What is endometriosis?
Endometriosis is the growth of the uterine lining (which normally grows inside the uterus and comes away with menstruation) in other parts of your body, for example the ovaries, tubes and other parts of your pelvis or abdominal cavity. More info
Why is endometriosis a problem?
Although endometriosis is not a life-threatening condition, it may seriously impair your quality of life as it may cause painful periods, pain with sexual intercourse, bowel and ovulation pain, lower backache and infertility.
If I have endometriosis, will I need a hysterectomy?
Hysterectomy is not the surgical treatment for endometriosis. Conservative surgery is the ideal surgical treatment and by this I mean the removal of endometriosis with the preservation of your pelvic organs.
What are the surgical options for treating endometriosis?
I believe laparoscopic surgery is the best surgical option because allows your Gynaecologist to have adequate access to every part of your pelvis; that otherwise would not be possible with a conventional open surgical procedure. On the other hand, proper diagnosis and treatment can be achieved at one single procedure. More info.
Do I have endometriosis?
Apart from suspecting endometriosis if you have symptoms, the only way of making a correct and proper diagnosis is by laparoscopy. Furthermore, it is of the upmost importance for you that your diagnosis of endometriosis is done properly, and by this I mean confirmation of endometriosis through histology. Visual inspection of the endometriotic implants in your pelvis is not enough, as it has been showed that there are other conditions that resemble endometriosis. I believe that laparoscopic excision and histology is the correct way of making a proper diagnosis and treatment at the same time and in one surgical procedure. It is not enough to burn (diathermy) the endometriotic implants, as the implants may be deep into your tissues and they need to be excised completely. More info
What is urinary incontinence?
Urinary incontinence or urinary “leakage” is the involuntary loss of urine that becomes a social or hygienic problem. It is often wrongly considered as a normal part of aging. It may seriously affect your quality of life. More info
What are Urodynamic studies?
They are a combination of tests that provide information about your lower urinary tract (bladder and urethra). Urodynamics “draws a picture” of what happens when your bladder fills up and when it empties by measuring volumes and pressures. They have become indispensable before any type of surgery for correcting incontinence is decided.
I have urinary leakage or incontinence. Do I need surgery?
Not every patient with urinary leakage or incontinence needs surgery and there is not a single surgical procedure that fixes all problems of incontinence. Your treatment, if surgical, should be individualised. More info.
What is a uterine prolapse?
Uterine prolapse is the condition in which the uterus or womb falls downward into the vagina and below its normal position in the pelvis. It may present with other prolapses, for example: prolapse of the bladder or prolapse of the rectum through the vaginal canal. More info.
What are the symptoms of genital prolapse?
Mild degrees of prolapses may not give symptoms. However substantial prolapses may give a sensation of fullness or even a bulge in the vagina, difficulty with passing urine, urinary frequency or pelvic pressure. Sometimes is associated with urinary leakage. A rectal prolapse may cause pressure in the rectum, constipation or a feeling of incomplete emptying the rectum. Any prolapse may have a detrimental effect on your sexual life by interfering with penetration and by lack of vaginal wall tones. More info.
What is the treatment for a prolapse?
There is non-surgical treatment (use of pessaries) in special circumstances. But many patients can have reconstruction of the pelvic floor anatomy through surgery.