What are some surgeries in gynaecology?
- laparoscopic surgery
- myomectomy
- adhesiolysis in endometriosis
- endometrial ablation
- hysteroscopy with resection of submucosal fibroids
- hysterectomy -abdominal/laparoscopic/vaginal
- Hysterectomy and bilateral salpingo-opherectomy
- miscarriage dilation and curettage
- uterine artery embolisation
- Ovarian drilling
- Ovarian cyctectomy
- oophorectomy
- colposcopy biopsy or excision
- tension-free vaginal tape
- autologous sling procedures
- colposuspension
- intramural urethral bulking
- word catheter
- marsupialisation
What does a myomectomy involve?
- involves surgically removing a fibroid via laparoscopic surgery or laparotomy (open surgery) depending on stability of patient
- only treatment known to potentially improve fertility in patients with fibroids
What does endometrial ablation involve?
- involves destroying the endometrium
- second-generation non-hysteroscopic techniques are used
- an example of one of these techniques is balloon thermal ablation, where a balloon is passed into the endometrial cavity filling it with high-temp fluid that burns the endometrial lining
What conditions can endometrial ablation be used for?
- fibroids
- menorrhagia -> last resort when medication fails
- adenomyosis
What does a hysterectomy involve?
- involves removing the uterus.
- may be laparoscopic, laparotomy, or vaginal approach
- ovaries may be removed or left depending on patient preference, risks and benefits
What does adhesiolysis in endometriosis involve?
- Laparoscopic surgery can be used to excise or ablate the ectopic endometrial tissue.
- In women where there is chronic pelvic pain due to adhesions, surgery can be used to dissect the adhesions and attempt to return the anatomy to normal -> this is called ahesiolysis
What does uterine artery embolisation involve?
-radiologist inserts catheter into an artery, usually femoral artery –> catheter passed through to the uterine artery under X-ray guidance–> once in correct place, particles are injected that cause a blockage in the arterial supply to the fibroid/adenomysis
What can uterine artery embolisation be used for?
- large fibroids
- adenomyosis
What is the surgical management options for menorrhagia?
- endometrial ablation
- hysterectomy
What is the surgical management options for endometriosis?
- laparoscopic surgery to excise or ablate endometrial tissue and adhesiolysis
- hysterectomy
- laparoscopic treatment may improve fertility
What are the surgical management options for fibroids?
for smaller fibroids (<3cm):
- endometrial ablation
- resection of submucosal fibroids during hysteroscopy
- hysterectomy
for larger fibroids (>3cm)
- uterine artery embolisation
- myomectomy
- hysterectomy
-GnRH agonists, such as goserelin (Zoladex) or leuprorelin (Prostap), may be used to reduce the size of fibroids before surgery.
What are the surgical management options for ovarian cysts?
- laparoscopic ovarian cystectomy
- oophorectomy
- theatre
