Reproductive Surgery
After thoroughly testing both partners and identifying potential factors contributing to a couple’s infertility, treatment options will be recommended based on their individual needs. If abnormalities causing infertility and other gynaecological disorders are found, the doctor may suggest a surgical procedure to best treat the condition. Most of these procedures are performed safely at the Centre for Gynaecological Endoscopy (CGE), which is in-house to Vitalab.
Laparoscopy
A laparoscopy is a surgical procedure that allows for the evaluation of the uterus, ovaries, fallopian tubes and all other reproductive structures of a female. Examining these parts of the body can provide insight into possible abnormalities and problems that could be causing infertility or other gynaecological disorders. A laparoscopy is not always required in all cases.
A laparoscopy is used to diagnose and treat:
• Fibroids
• Specific Ovarian cysts
• Endometriosis
• Scar tissue
• Ectopic pregnancies
• Other circumstances
What To Expect
A laparoscopy requires general anaesthesia and can last 45 minutes to many hours, depending on what is found and the extent of surgery required. Usually three small incisions are made. One incision is made just below the navel, where a special needle is used to inflate the abdominal cavity with gas to insert the laparoscope used to visualise the pelvic organs. Two other small incisions are made to insert the surgical forceps and instruments to perform the operation. Once the surgery is complete the instruments are removed, the gas is allowed to escape and the incisions are closed with stitches. Stitches may need to be removed 3 to 4 days later or may dissolve on their own.
Patients will go home on the same day of the procedure and are usually discharged several hours after the surgery. Patients may experience bloating, abdominal discomfort, pain in the shoulders and nausea for 24-48 hours after the surgery. It is recommended that patients take 2 to 3 days off work for recuperation, as mild pain can be expected for 7 days. Medication for pain will be prescribed.
Hysteroscopy
A hysteroscopy enables a doctor to look at the inside of the cavity of a uterus and surgically correct abnormalities. The procedure involves the insertion of a narrow telescope-like instrument with an attached camera, called a hysteroscope, through the vagina and cervix into the cavity of the uterus. The procedure is best carried out when the lining (endometrium) is thin (after menstruation has occurred) as the uterus can be viewed optimally at this time.
A hysteroscopy is used to diagnose and treat:
• Cause of abnormal bleeding
• Fibroids or polyps
• Uterine septum
• Adhesions/ scarring of the uterus
• Endometrial cancer
• Other circumstances
What To Expect
The hysteroscopy procedure is performed under general anaesthetic. During the procedure the doctor inserts the hysteroscope into the uterus and will inflate the uterus with liquid to visualise the cavity. The actual procedure only takes 30 minutes depending on what is found, while more extensive procedures can take longer. Usually the patient will be discharged a couple of hours after the procedure is completed. A hysteroscopy is less invasive as no cutting or stitching is involved. It causes a minimal amount of discomfort and pain medication is prescribed if required.
Laparotomy
A laparotomy is a surgical procedure that allows access to the abdominal cavity. It is similar to a C-section and is necessary only for severe pelvic disease that cannot be performed via laparoscopy or hysteroscopy.
A laparotomy is used to treat:
• Multiple/large fibroids or those inaccessible by endoscopic surgery
• Severe endometriosis
• Severe scar tissue
• Other circumstances
What To Expect
An incision is made in the lower abdomen, which allows direct access to all structures of the pelvis. Patients undergoing this surgery will have general anaesthesia and the operation will last approximately one hour or longer, depending on what is required. Once the surgery is complete, all the organs and structures are returned to their correct anatomical positions, and the wound is closed with stitches. The patients will recuperate in hospital for 3 to 4 days and be off work for 4 to 6 weeks.
