Hysteroscopy
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Uterus

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Laparscopy
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Organs

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What is keyhole surgery?

In recent years, there is a strong move in all aspects of surgery to minimize the trauma and pain of the patients, helping in faster recovery while continuing to achieve the same therapeutic results. This class of surgery is called MINIMALLY INVASIVE SURGERY.

For treating gynaecological diseases, two forms of such surgery are available:

• videolaparoscopy, or keyhole surgery, and
• hysteroscopy

How is such surgery performed?

It involves the surgeon inserting a video-camera-enabled instrument to visualize the body parts of interest eg into the abdominal cavity (laparoscopy) or cavity of the womb (hysteroscopy). Commonly the organs that need to be examined have to be inflated with gas or liquid beforehand.

A few more tiny cuts may be needed, all less than 1cm, to allow more instruments to be inserted for the surgical procedures.

What treatments can be achieved by these methods?

Using laparoscopic surgery, the following can be performed:

• removal of ovarian cysts
• removal of fibroids
• removal of ectopic pregnancies
• treatment of endometriosis
• correction of fallopian tubes blockages
• removal of adhesions or old scarrings that may cause pain
• investigations to the cause of severe pelvic or period pain or Infertility
• removal of entire womb and/ or ovaries

  On the other hand, hysteroscopy is used to :

  • investigate causes of menstrual disorders
  • investigate reasons behind recurrent miscarriages or Infertility
  • remove fibroids that protrude into the womb cavity, which tend to cause very heavy menses
  • remove any polyps or foreign bodies
  • treat heavy periods by removing the endometrium or womb lining

What are the advantages and disadvantages of MINIMALLY INVASIVE SURGERY?

The obvious advantages are the smaller wound size (1cm or less), less pain, and faster recovery. Most of the procedures can be performed in the Day Surgery and the patients can go home on the same day. The risk of infection and adhesions formation are also lower. Finally the cosmetic effect of the tiny scars is certainly welcomed.

The disadvantages include longer operating time and use of more assistants and instruments which may increase the cost. Most importantly however, is that it is technically more demanding and the surgeons need proper training and experience to acquire the necessary skills.