Surgery
Surgery
Hysteroscopy
A hysteroscopy is a procedure that allows the surgeon to diagnose and/or treat conditions in the uterine cavity. The procedure involves inserting a small telescope into the uterine cavity, and the image is projected on to a screen.
Hysteroscopy may be recommended for:
Diagnosis of the cause of abnormal or heavy bleeding
Removal of scar tissue in the uterine cavity
Removal of a lost IUD
Diagnosis of causes of infertility or recurrent miscarriage.
Hysteroscopic Polypectomy and Myomectomy
Surgery to remove polyps and sub mucosal fibroids(myomectomy) is often done using hysteroscopy using instrument that can resect and cauterize the removal site of the tissue.
Recovery after surgery is quick and most patients are discharged home on the same day.
Endometrial resection/ablation
Endometrial resection is a procedure that removes the uterine lining(endometrium). The endometrium is the tissue that thickens throughout your menstrual cycle and is shed as your period when a pregnancy does not occur. Women who suffer from irregular or heavy bleeding, and do not desire future pregnancy, may have an endometrial resection to manage their symptoms. Following this procedure, the periods may disappear altogether or there may be a significant decrease in menstrual flow.
Laparoscopic Ovarian Cystectomy
An ovarian cystectomy is a surgical procedure to remove cysts on the ovaries. A cyst is a sac of fluid that can develop inside the ovaries. The cyst is most often benign and can rarely be cancerous. A biopsy will need to be taken of the cyst to determine if the cyst is cancerous.
A benign ovarian cyst can be removed while leaving the ovary intact. However if the cyst is cancerous, an oophorectomy- removal of one or both ovaries may be required.
Laparoscopic Surgery
This minimally invasive procedure only requires a few small incisions in the abdomen. A camera is inserted into the abdomen, allowing the surgeon to see the ovary and cysts. Long thin surgical instruments are then expertly inserted into the incisions to carefully separate the cyst from the normal ovarian tissue.
This surgery is performed under general anaesthesia.
Laparoscopic surgery usually has a quicker healing times and less pain, thus allowing a faster return to normal physical activities.
Tests required before a laparoscopic ovarian cystectomy
Ultrasound scan
This is a painless non-invasive procedure, and it helps achieve a proper diagnosis. The cyst is examined for size, shape and the composition of the cyst to determine if it is solid, fluid filled, or a combination of the two.
MRI or CT scan
This may be required for further investigation of ovarian tumors.
Blood tests
A serum CA-125 tumor marker may be performed to rule out ovarian cancer. If the CA-125 and characteristics of the cyst on ultrasound or MRI indicate cancer, you will be referred to an oncologist for further management.
Loop excision of the transformation zone - LLETZ procedure
If abnormal cells are found in the cervical tissue, also known as cervical dysplasia, this tissue may need to be surgically removed to reduce the risk of cancer developing. This is a LLETZ procedure that is done to remove and treat the abnormal tissue that was found during a colposcopy and cervical biopsy.
LLETZ results
When a sample of abnormal cervical tissue is removed by LLETZ, it is sent to the lab for testing. You will be reviewed in 2 weeks with the results. If the results were abnormal, that means there are cancerous or precancerous cell changes in your cervix. This would have been detected in a colposcooy /biopsy done prior to the procedure. These abnormal cervical cells are known as Cervical Intraepithelial Neoplasia (CIN) and there are three grades of severity.
CIN1- Mild dysplasia
CIN11 – Moderate dysplasia
CIN 111 – Severe dysplasia.
Risks of LLETZ procedure
Cervical stenosis - This is a complication where the cervix narrows.
Premature birth - Studies show that the LLETZ can cause cervical incompetence, and may result in premature delivery in a future pregnancy.
Hemorrhaging.
Infection
About 3-4 months after the procedure, you will need another pap smear to monitor the cells of your cervix.
How can I decrease my risk of cervical cancer?
There are a few things you can do to reduce your chances of cervical cancer –
Get vaccinated against HPV. The Gardasil 9 vaccine is recommended for women and men over age 9 to protect against the high risk strains of HPV most likely to cause cervical cancer.
Stop smoking. Smoking harms your immune system and increases the risk of cervical cancer.
Have regular pap smears until age 65 years.
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