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Endogynaecological Surgery

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This specialty mainly focusses on women’s health conditions namely fibroid uterus, unexplained menorrhagia, prolapse uterus, cystocele, rectocele, torsion of ovarian cyst, recto-vaginal fistulas, hydrosalpinx, pyosalpinx, endometrial hyperplasia, ovarian tumoursand ectopic pregnancy.

Women are prone for certain adnexal disease conditions during their lifespan. During early reproductive age, ovarian cysts and torsion of ovarian cyst are more common, while during reproductive period, myomas, ectopic pregnancies, ovarian tumours, recto or ano – vaginal fistulas due to labour trauma, are encountered. During perimenopausal period fibroid uterus, malignant ovarian tumours and while elderly aged women are prone for prolapse uterus, cystocele, rectocele.

We are well equipped with state of the art laparoscopy unit and well trained Endogynaec surgeon as a part of GI surgical team to cater to the above surgical conditions. We offer Laparoscopic ovarian cystectomy, Laparoscopic Myomectomy, Laparoscopy assisted vaginal hysterectomy, Laparoscopic tubal recanalization, Vaginal hysterectomy with cystoele and rectocele repairs, Laparoscopic removal of ovarian tumours.

Endogynaecological Surgery FAQ

Fibroids are the benign (non-cancerous) growths that arise from the muscular wall of the uterus. They may be found at various sites like inside the uterine cavity, within its border, an outer surface, or attached to the uterus with a stem like structure.
Fibroids most commonly occur in the 30-40 years of age group. They are sometimes seen in even younger age groups.
Pain is a predominant symptom and usually, in the lower abdomen, often dull aching and feeling of heaviness may also present. They may also have pain during intercourse. The next common symptom is heavy menstrual bleeding, which may be frequent and for a longer duration. Large fibroids can cause symptoms due to pressure on the bladder or rectum, leading to difficulty passing urine or constipation. Fibroids are also blamed for miscarriages and infertility in younger women.
Myomectomy is removing the fibroid, only retaining the uterus if the patient wants to have children. Fibroids will not develop at a removed site but can grow in other areas of the uterus. Hysterectomy is removing the uterus while retaining the bilateral uterus, usually preferred in perimenopausal/menopausal women.
These are fluid-filled cavities that can form in the ovaries or on the surface of the ovaries. The size can be varied from smaller to larger. Ovarian cysts are quite common.
Fibroids that attach to the uterus with a stalk-like structure may twist and undergo ischemic changes leading to severe pain, nausea, vomiting, and may also lead to hypotension, which warrants emergency diagnostic laparoscopy and removal. Large fibroids may lead to abdominal distension and may cause pressure effects. Fibroids also can cause infertility. Very rarely, they may be associated with malignancy.
Smaller ovarian cysts usually will not cause any symptoms and go unnoticed. However, the larger ovarian cysts cause pain in the lower abdomen, fullness, and bloating sensation. Occasionally these cysts get twisted ( as the ovaries are attached by long slender fallopian tubes) to cause the cyst’s torsion, or sometimes they may rupture to cause bleeding. Both are emergency surgical conditions and present with severe pain in the lower abdomen, nausea, vomiting, and increased heart rate. The patient will need an emergency laparoscopy after initial resuscitation.
There are two functional cysts, namely, follicular cysts and corpus luteum cysts. Other cysts are namely endometrial cysts, dermoid cysts, cystadenomas. Rarely cancerous ovarian cysts are also encountered usually in elderly patients.
Ultrasound of the abdomen is the standard diagnostic modality to diagnose ovarian cysts. It can confirm the size, the content of the cyst, right/left, presence of torsion, etc. A blood test called CA – 125 will be done. If the level of CA – 125 is very high and specific findings from ultrasound are suspicious of cancer, then CT – abdomen is required to confirm the results and rule out the metastasis.
If the cyst is large enough to cause symptoms, or any complications like torsion of the cyst or ruptured cyst suspected, surgery is warranted. Laparoscopic cystectomy is removing the cyst by passing laparoscope and hand instruments through small incisions over the abdomen, and oophorectomy is the removal of the ovary. Surgery depends on the patient’s age, desire to have children, and the ovary’s status on laparoscopy. Surgery for cancerous cysts requires a more radical approach.