The department of advanced Endoscopic Surgery of Iasis Hospital offers state of the art service to our female patients. Endoscopy in gynecology has given new prospects in diagnosis and treatment of gynecological conditions.
Iasis Hospital has a modern laparoscopic and hysteroscopic theater, with medical and nursing personnel of high specialization.
Which operations can be done laparoscopically?
Laparoscopic operations are distinguished in:
small or light, such as diagnostic laparoscopies, loosening of thin adhesions and cross-section of fallopian tubes in women who wish interruption of fertility
medium, such as the removal of ectopic pregnancies, ovarian cysts, hydrosalpinxes, peritoneal endometriosis and unblocking of fallopian tubes
big operations, such as the abstraction of fibroids, uterus and ovaries, extensive solutions of intestinal adhesions, urogynaecological procedures and abstraction of retroperitoneal endometriosis.
In specialised centres even gynaecological oncological operations are feasible.
In which cases is laparoscopy not advised?
There are relative and absolute cases when laparoscopy is not advised. Relative are those cases that are relative to the surgical experience of the surgeon. In practice it is up to the surgeon to decide where his limits are. For example, big fibroids or big fibroid uteruses are relative non advisable cases, but not for all surgeons. A lot of previous laparotomies constitute a relative non advisable case. Enormous masses however, or general abdominal malignancy constitute for absolute contraindication and should be done with open surgery because of the exceptionally limited abdominal area. Today most gynaecological operations are done with laparoscopy.
How safe is laparoscopy?
In the past 25 years enormous numbers of operations have been held internationally and the results have proved that the dangers and complications are comparable or even less than those of an open surgery. The laparoscopic technique is exceptionally safe as is the anesthesia that is granted for as long as the operation lasts. Both techniques have been improved through the years and fast recovery from laparoscopic operations is to a big extent owed to new medicines and to the techniques of anaesthesiology. Proof of the safety of these operations is the continuously large numbers of people that are submitted internationally to such operations and the incredible technological improvement that dominates in endoscopic congresses. Also, throughout the past 10 years, a lot of foreign universities teach laparoscopic surgery and therefore constituting an autonomous post-specialty training.
What is a hysterectomy?
The term hysterectomy refers to the surgical removal of the uterus, the cervix and possibly the ovaries and fallopian tubes (Drawing 1).
The uterus is commonly removed in benign pathologies such as metrorrhagias, pelvic pain and fibroids.
There are three basic types of hysterectomy: abdominal hysterectomy, which is done with a cross section in the abdomen, similar to the Caesarean section, vaginal hysterectomy, which is done through the vagina and the laparoscopic assisted vaginal hysterectomy.
How is a hysterectomy done?
Established 150 years ago, abdominal or open hysterectomy is the method of surgically removing the uterus. Since then minimal changes have been made. However, the most important change was to the section in the abdomen, which from oblong became traverse, similar to that of the Caesarean section. The average recovery time required from an abdominal intervention is 4-5 days in the clinic and up to one month at home.
What is a vaginal hysterectomy?
It is the removal of the uterus through the vagina. This method is mainly applied in cases, where the pelvic area has suffered loosening and the uterus has descended. During the intervention pathologies such as cystic fibroids, loosening of anterior vaginal wall and loosening of the ovarian rear wall can be corrected.