KEY HOLE GYNAECOLOGICAL SURGERIES: “A new age technology”

Dr. Rahul Manchanda Senior Consultant-Endoscopic Gynaecology MBBS, MD, FICOG, FICMCH, FICS

Gynae endoscopy is minimally invasive technique of performing complex surgeries of the uterus and ovaries through smaller cuts and natural body openings in women. Now in this era we should be happy that all normal gynaecological surgeries can be done by this technique which is commonly called as KEY HOLE or PIN HOLE or LASER SURGERY. Not many people are aware of this surgical option and still have doubts and dilemmas.

This novel technique is done using hi-tech imported specialized equipments by gynaecological surgeons who are specializesd and trained in these advanced techniques of surgery and equipments.

Abnormal bleeding from uterus is caused due to excessive growth of inner lining of the uterus (endometrium), tumors arising from the wall of the uterus (fibroids and polyp), presence of foreign bodies (copper-T), etc. Now a days these diseases can be diagnosed and treated in the same sitting, using a telescope introduced through the vagina and it takes less than 15- 20 min. There is no need for prior admission in the hospital , no need for anaesthesia and patient can be discharged within 3-4 hrs or on the same day with minimal post operative medications.

Patients can resume their daily activities from the very next day as the surgery is scarless and painless. Other advantages of gynaeendoscopy are it being less costly, is associated with less bleeding and increased patient safety.

HYSTEROSCOPY is a part of minimally invasive surgery in which telescope is introduced through vaginal opening for examining cervix, uterus and tubes for any abnormality . The treatment of heavy periods can be done by removing whole of the endometrial lining of the uterus using hysteroscopy (Trans cervical resection of endometrium/ TCRE). Hysteroscopy is also done to diagnose causes of less flow during periods and painful periods. Women who cannot bear children are usually diagnosed with blocked fallopian tubes which can be opened using this simple technique and takes no time. Other causes of infertility like uterine fibroids/tumors can be cut and removed, abnormal uterine cavities because of tuberculosis and septations since birth leading to repeated abortions and pregnancy losses can be diagnosed and reconstructed. Misplaced copper can be located and removed .

Previously cancers of the uterus and cervix were detected at an advanced stage but now with the advantage of higher magnification and direct vision using HYSTYEROSCOPY cancers can be diagnosed early by taking site specific biopsies of the abnormal looking areas inside the uterus and cervix. Laparoscopy is performed to evaluate the abdominal pathologies involving the uterus, tubes and ovaries. A telescope is introduced through a small incision in the umbilicus to look for abdominal diseases. Surgeries for fibroids like myomectomy and hysterectomy, endometriosis, ectopic pregnancy, ovarian tumors, tubal reconstruction and recanalization are done via 2-3 small incisions on the abdomen. The operative time and blood loss is very less as compared to the conventional surgeries done using bigger incisions on the abdomen. The post operative pain is less and recovery time is faster. Even complicated surgeries for cancer of the uterus, cervix and ovaries are preferred to be performed by laparoscopy all over the world.

Contradictory to the age old thinking of “no pain and no gain”, we introduce to you gynae endoscopy which works for all gains without much pain. In this fast and busy life , where we can not afford prolonged surgery and even longer recoveries, endoscopy is the best option to opt for.

Gone are the days of bigger the surgery, bigger the scar, it is the age of scarless and painless surgeries, lets understand the future and accept it for its better and safer outcomes.