Surgical techniques

Some surgical techniques are: Surgical hysteroscopy, Surgical laparoscopy or Laparotomy.

Surgical hysteroscopy
Surgical histeroscopy is a surgical procedure indicated for the treatment of endo-uterine pathology; that is, polyps, uterine septa and myomas previously diagnosed by other techniques such as ecography, diagnostic hysteroscopy or magnetic resonance.

Surgical hysteroscopy consists of a sheath about 10 mms approx. in diameter and equipped with various concentric cylinders through which an optical instrument equipped with a video unit, an electroscalpel and a continuous flow of serum are passed to provide a clear vision of the uterine cavity at all times.

This technique can be carried out under general anaesthetic, sedation or local anaesthetic and provides a highly satisfactory post-operative recovery with a very low complication rate (1%).

Slight blood loss through the vagina often occurs shortly after surgery and may continue for a few days, sometimes until the onset on the next period, in addition to pelvic pains similar to those experienced during menstruation.

The patient is recommended to abstain from immersion baths and sexual relations involving vaginal penetration for a few days subsequent to hysteroscopic surgery in order to reduce the risk of infection.

Surgical laparoscopy
Surgical laparoscopy is a minimally invasive technique providing access to the interior of the abdominal cavity by means of small incisions performed at the level of the navel and the ileum, in gynecology, with the purpose of treating pathologies of the uterus, fallopian tubes and ovaries.

In the majority of cases this technique is carried out under a general anaesthetic. The small incisions made in the abdominal wall reduce discomfort to a minimum and facilitate post-operative recuperation, enabling patients to recovery more quickly and cut down on time spent in hospital. It likewise reduces the risk of post-surgical effects (adhesions) as well as speeding up convalescence and assisting in a prompt resumption of normal everyday life.

Laparoscopic surgery is indicated in the treatment of ovarian cysts, some types of myomas or fibroids, tubal ligation, ectopic pregnancy (outside the uterus), hysterectomy or extraction of the uterus, incontinence or bladder neck suspension, as well as for the staging and initial treatment of certain gynecological cancers.

The most frequent immediate complications are due to the fact that CO2 gas must be insufflated into the peritoneal cavity in order to perform the operation, and this causes digestive problems, abdominal pain and or compensatory pain felt in the shoulders.

The C02 remaining after surgery is expelled through the intestine and through normal breathing.

Laparotomy
Laparotomy is a procedure consisting in accessing the interior of the abdominal cavity by means of an incision made through the skin and muscle layers.

This can be performed with a a longitudinal incision known as the midline incision (midline laparotomy), the length of which depends on the pathology to be treated, or by a transversal incision called the Pfannenstiel incision, which is that normally employed in cesarean section and is indicated for benign pathologies that are not suitable for treatment by means of laparoscopic surgery.

Short and long-term recovery is slower and may involve more complications, but it is the best way of tackling large abdominal tumours.