Some gynaecological conditions warrant a surgical approach. The more common operations include:
Under a full anaesthetic, gas is passed via a needle through the belly button into the abdomen. Several small incision may then be made, through which small instruments can be passed to grasp, move and cut structures inside the abdomen. Although sometimes more technically difficult, the advantage of laparoscopic surgery is the pain is less and recovery faster, often meaning patients can be discharged from hospital the same day.
A hysteroscopy involves passing a narrow telescope into the vagina and through the cervix to view the inside of the uterus. Biopsies may be taken or polyps removed. Given no cuts or stitches are required, recovery is usually very quick.
Repair of a uterine or vaginal prolapse will usually be performed by operating through the vagina. Sometimes a hysterectomy can be completed by the vaginal route entirely. Some vaginal and vulval cysts are best treated this way. Recovery tends to be faster with vaginal surgery compared with an open abdominal operation.
Removal of the uterus may be needed to treat heavy periods, pelvic pain or prolapse if other simpler options have been unsuccessful. Cancers and very large fibroids will usually require hysterectomy as the first and only option. There are 3 main ways to perform a hysterectomy - laparotomy / open abdominal hysterectomy, vaginal hysterectomy and laparoscopic hysterectomy. Each has its’ own advantages and disadvantages which will be discussed with you prior to planning your operation. Consideration also needs to be made whether to leave or remove the ovaries and Fallopian tubes.