Hysteroscopy is a minor procedure where the inside of the uterus (womb) is visualised using a fine camera inserted through the cervix. Saline (salty water) is then run into the uterus to allow a good image to be obtained. It does not involve any cuts on the abdomen and usually has a very quick recovery time. Usually, patients only require the day of surgery away from work or usual activities. This type of surgery is performed for a variety of reasons, but most commonly for the investigation of infertility or abnormal uterine bleeding. When fibroids and polyps (benign swellings of the uterus) are seen within the uterus it is usually possible for these to be removed or resected if necessary. The doctors at MC&M, are experienced at this kind of surgery either under general anaesthetic or sedation in theatre.
Please click here for an excellent summary and video information about hysteroscopy.
Laparoscopic surgery (keyhole surgery) is where the abdomen is entered through a number of small incisions (typically 5mm). Starting at the umbilicus (belly button), a fine camera is introduced and the inside of the abdomen is then inflated with carbon dioxide to allow a clear view of all abdominal and pelvic organs. Further 5mm incisions are made in the lower abdominal wall to allow surgery to be performed. Laparoscopy is often performed of the following reasons: investigation of infertility; removal of endometriosis, fibroids, and ovarian cysts; and hysterectomy. Patients having this surgery are usually able to go home the same or following day but then need to be away from work or usual activities for one to two weeks.
Please click here for an excellent summary and video information about laparoscopy.
Hysterectomy is surgery to remove the uterus (womb). It can be necessary for a variety of reasons, the most common of which are listed below:
- Management of abnormal periods where other, less invasive attempts at management have not worked;
- To remove the effect of uterine fibroids when fertility is no longer desired;
- Management of pre-cancerous or early cancers involving the lining of the uterus;
- Management of prolapse;
- Management of severe endometriosis type symptoms when fertility is no longer desired.
Hysterectomy can be performed vaginally, laparoscopically (keyhole surgery) or at open surgery (see below). Vaginal hysterectomy is commonly performed when the uterus comes too far down the vagina on coughing or straining. This is often associated with prolapse or laxity of the vagina; repairs of the vagina are often undertaken at the same time. The reason for the hysterectomy will dictate which type of surgery should be undertaken.
A common misconception is that the ovaries must be removed at the time of a hysterectomy. Most of the time, this is not necessary and for women before the age of menopause it is unusual to have to remove the ovaries as they are very important for the maintenance of healthy hormone levels. The doctors at MC&M will explain thoroughly your options and the reasons why one particular type of surgery may be beneficial over another before booking you for your surgery.
Please click here for an excellent summary and video information about hysterectomy.
In cases where laparoscopic (keyhole) surgery is either, not possible, or not appropriate, then open surgery may be necessary.
Open surgery involves an incision or cut through the skin and then entry into the abdomen (laparotomy). The cut in the skin is either low transverse (bikini line) or in the midline from umbilicus (belly button) down towards the pubic bone. A retracting device is sometimes used to enable better visualization of the pelvis and abdomen. This kind of surgery is sometimes necessary for difficult ovarian surgery, hysterectomy or fibroid removal when the size of the uterus is very large. Having an operation that involves open surgery usually requires a longer stay in hospital and more time away from work, usually four to six weeks.
The doctors at MC&M are experienced in this kind of surgery when it is necessary but will aim to perform laparoscopic surgery where at all possible as this lessens the pain of the surgery and shortens your recovery from surgery.