 Gynecological
Surgery
The Section of Laparoscopic Gynecologic Surgery
and Urogynecology provides specialized services in minimally invasive
surgery for pelvic organ prolapse, urinary incontinence and other
benign gynecological conditions. Our partner hospital are able
to perform most surgeical procedures. If you dont see what you
require listed please contact us.
Specialised services available include:
Some other procedures avialable are:
- Anterior vaginal SHC mesh operation
- Fibroids & laparoscopic and abdominal myomectomy
- Laparoscopic and minimally invasive vaginal
surgery for urinary incontinence, minimally invasive neurostimulation
surgery for severe urgency symptoms.
- Laparoscopic lysis of adhesions
- Laparoscopic tubal and ovarian surgery
What is a Pelvic Prolapse
Pelvic organ prolapse is the protrusion of the pelvic
organs into or out of the vaginal canal, this is caused by a hernia
in the pelvic area. The muscles and tissue supporting the organs
become damaged and the organs break through into the womb. Nowadays
the treatment of choice for a hernia is surgical repair.
Generally more than one organ is involved. Patients typically notice
a mass or protrusion from the vagina followed by pelvic pressure
and backache.
Prolapse can occur individually or in combination with a prolapse
of another pelvic organ. Patients may also have one or more symptoms
of urinary incontinence, urinary retention, sexual dysfunction and
difficulty with bowel movements.
Different types of Pelvic Prolapse:
- Complete Genital Prolapse -
Protrusion of entire female organ out of vagina.
- Uterine Prolapse - Uterine
and vaginal prolapse surgery is one of the commonest gynaecological
surgeries. Protrusion of the uterus into or through the vagina.
- Vaginal Vault Prolapse –
muscles supporting the vagina become separated causing the protrusion
of the top of the vagina into the lower portion of the vagina
or through the vagina totally inverting it. Occurs in post-hysterectomy
patients.
- Cystocele - Protrusion of
the bladder into or through the vagina.
- Rectocele - Protrusion of
the rectum into or through the vagina.
- Enterocele - Protrusion of
bowel into or through the vagina.
- Urethrocele - Protrusion of
the urethra into the vagina.
- Vaginal Prolapse - The condition
generally coexists with other types of genital prolapse such as
cystocele, rectocele, and enterocele.
Treatment
Treatment for pelvic prolapse may be either medical
or surgical. Medical or conservative options include the following:
- Lifestyle changes –
weight reduction if the candidate is overweight. Exercises to
strengthen pelvic floor muscles (Kegel exercises). Avoiding heavy
lifting or straining.
- Vaginal pessary - fitted inside
the vagina, designed to hold the uterus in place. The pessary
can be a temporary or permanent form of treatment. The device
comes in many shapes and sizes, so a doctor will measure and fit
the device.
- Hormone Replacement Therapy
- Taking estrogen after menopause seems to help older women maintain
muscle tone, including muscles in the pelvic area. However, hormone
replacement therapy (HRT) carries risks.
These measures may relieve symptoms and reduce
the prolapse. However, some women may not tolerate pessary use,
and some prolapses are not sufficiently relieved by pessaries, exercise,
or hormonal replacement therapy, in which case surgery may be the
desired option.
Surgical options
Surgical options involve reducing the prolapse
and, in many cases, restoring normal anatomy. There are many types
of procedures available, each addressing a specific prolapse or
defect.
- Uterine prolapse: Laparoscopic uterine suspension
is usually done in conjunction with a vaginal vault suspension
-- a procedure which attaches the apex of vagina to strong ligaments
toward the back of pelvis to support the vagina. The surgery is
a very simple and quick procedure with a short recovery time.
Corrective surgery is done either vaginally or laparoscopically.
- Vaginal prolapse: The condition
generally coexists with other types of genital prolapse such as
cystocele, rectocele, and enterocele. corrective surgery is the
Vaginal vault suspension, a technique which attaches the vagina
to strong ligaments toward the back of the pelvis to support the
vagina likewise is a very quick and effective procedure. Corrective
surgery is done either vaginally or laparoscopically.
- Cystocele: There are 3 different
types of cystoceles each requiring a different surgical technique.
Corrective surgery is done either vaginally or laparoscopically.
- Rectocele: A posterior colporrhaphy
procedure repairs or closes the defect in the strong tissue overlying
the rectum. Corrective surgery is done either vaginally or laparoscopically.
- Enterocele: An enterocele
repair procedure closes the defect in the strong tissue on the
top of the vaginal wall and restores the integrity of the fibromuscular
structure of the vagina. Corrective surgery is done either vaginally
or laparoscopically.
All of the above procedures are carried out under
general anaesthesia and involve a small duration of hospital stay.
Fibroids & laparoscopic
and abdominal myomectomy
What are Fibroids?
Fibroids are benign tumors. There is no evidence that benign fibroids
will become cancerous. This risk of cancer in a fibroid is estimated
to be less than 1 in 500.
The surgical procedure
to remove fibroids is a myomectomy?
This procedure can be done laparoscopically or abdominally. Which
procedure the surgeon carries out will depend on the fibroid type
and position.
The surgery is a very simple and quick procedure
with a short recovery time. It is carried out under general anaesthesia
and will involve a few days stay in hospital.
Our mission
To provide the highest quality gynecological care
involving all aspects of women's care, medically and surgically.
Advantages of laparoscopic and minimally invasive
approaches
- Decreased post-operative pain,
- Faster recovery and back to work,
- Precise view of anatomy and detail identification
for the surgeon.
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