Gynaecological endoscopy
Gynaecological endoscopy is a surgical discipline which uses optical instruments specially designed to help diagnose the most frequent female disorders and pathologies such as some infertility problems, small vaginal hemorrhages or endometrial polyps among others. Gynaecological endoscopy employs hysteroscopy and laparoscopy for these purposes.
Gynaecological endoscopy as we know it nowadays is possible thanks to the important technical evolution as well as the sophistication and the miniaturization of the equipment. Modern anaesthetic medicine has also been important for the development of surgical procedures. This medicine is extremely effective, wears off quickly and its side effects have been reduced so that it can be used effectively in ambulatory surgery. Among other advances this made possible the so called minimally invasive surgery which owns its name to the fact that very small incisions are made and the intervention is ambulatory.
Ambulatory gynaecological surgery
Gynaecological endoscopic surgery is a modern discipline which unites advances both in gynaecological endoscopy and minimally invasive surgery which allows for surgical interventions without the need for a major operation. The recovery is prompt and the patients can return to their routine activities immediately. Local, regional anaesthesia or sedation (general superficial anaesthesia of short duration) are used. For security reasons, the procedure takes place in a fully-equipped operating theatre.
Ambulatory gynaecological surgery uses modern optical instruments such as a hysteroscope, which is introduced via the neck of the uterus, or a laparoscope inserted via a minute incision in the navel.
Hysteroscopy
Diagnostic hysteroscopy
It is an incision-free procedure which helps visualize the interior of the uterine cavity or uterus. In order to do so a small telescope called hysteroscope (it is only 4 millimeters big) is introduced inside via the neck of the uterus.
It is not necessary to have stitches or make incisions as a natural orifice of the neck of the uterus is used. Normally the intervention is carried out without anaesthetic or occasionally under local anaesthetic. This ambulatory procedure lasts between 20 to 30 minutes.
Operative hysteroscopy
When an endometrial polyp has to be removed the operative hysteroscopy allows for its extraction by means of a technically simple intervention which is often carried out under local or regional anaesthetic.
In order to do so a surgical hysteroscope is used. It allows for the introduction of the instruments necessary to carry out the intervention and resolve this and other endometrial or uterine problems (myomas).
Laparoscopy
Laparoscopy is a minimally invasive surgical technique which allows for the intervention in the abdominal cavity without the need for a major operation.
This procedure is carried out under anaesthetic sedation, the recovery is fast and the patient can leave the clinic in 2 or 3 hours. It allows for the visualization of the interior genital organs such as the uterus, the ovaries and the Fallopian tubes so that a diagnosis can be made when the patient has chronic pelvic pains, with infertility cases etc.
Advantages of endoscopic gynaecological surgery
The recovery is better and faster than in classic surgery cases as interventions are short and the patients stay in the medical centre for a very short period of time so that postoperatorial infections are less probable than with conventional surgery.
At the same time, the costs of the procedure are reduced if it is carried out in a smaller surgical unit in comparison to the larger hospitals and clinics.
It is worth mentioning that these modern surgical techniques are meticulous while anaesthetic procedures allow for a fast recovery and their side-effects are almost non-existent.
Gynaecological endoscopic surgery uses
By means of endoscopic surgery it is possible to find out without surgical intervention the origin of vaginal haemorrhages or anatomical alterations. We can discern between:
- Endometrial alterations (atrophies or hyperplasia)
- Endometrial polyps
- Endometrial adhesion
- Uterine septa or malformations
- Myomas (benign tumors)
Gynaecological endoscopic surgery prevents the need for a major operation:
- Endometriosis
- Ovarian tumors
- It is the fastest way of carrying out tubal ligation
- It is effective for diagnosing certain infertility cases