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Operative Procedures
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Cervix Biopsy / Cryo Cautery |
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Cervical Cerclage |
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Thermal Balloon Ablation |
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Clearance of Endometriotic cysts / Adhesions / Hydrosalpinx |
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Laparoscopic electro coagulation of ovarian surface (LEOS) |
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Fibroid Removal |
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Adenomyosis reduction |
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Hysterectomy |
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Vaginoplasty (Reconstruction of Vagina) |
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Cervix Biopsy / Cryocautery
Cervix biopsy like the endometrial biopsy is used to diagnose any lesion in the cervix. It may be done as an office procedure or in combination with cryocautery where short anesthesia may be required. Cryocautery is done as one of several therapeutic procedures for women with one or more abnormal pap smears. It is especially done in benign cases giving good results. Normally a heavy vaginal discharge is expected following the procedure and abstinence from sexual activity is advised for a period of 10 days. For a better understanding kindly visit the following link.
http://lib-sh.lsuhsc.edu/fammed/pted/cryo2.html
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Cervical Cerclage
This is done for patients who have exhibited previous cervical incompetency, demonstrated patulous internal os at diagnostic laparoscopy and/or repeated threatened abortion in current pregnancy. In our center, we perform the procedure at 16 weeks of gestation after ensuring a sonographically normal fetus and absence of chorioamnionitis. Prior to the procedure which is done under general anesthesia, the patient is put on prophylactic antibiotics to prevent any infection and also medications to keep the uterus relaxed (tocolytics). During the procedure 3 sutures are applied antero - posteriorly, thereby closing the mouth of the uterus (Cervix). We have found that it is ideal to do this procedure between 14th to 16th week of pregnancy, since the risk of abortion is higher when done earlier or later than this crucial period.
.Kindly view our article provided as PDF |
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Thermal Balloon Ablation
A woman menstruates every 28 to 30 days; the bleeding normally lasts for 3 to 4 days, sometimes with mild discomfort. Menorrhagia or heavy bleeding is an abnormal condition, which is not very uncommon. The reason for this abnormal bleeding could be a hormonal imbalance, in women between 35 – 45 years of age, especially before menopause. Non-cancerous uterine growths such as fibroids or polyps, infection or chronic illness can also lead to excessive bleeding. However the thermal balloon ablation is a technique employed to destroy the endometrium in order to either reduce the bleeding or stop it completely. It can be done as a day care procedure with short anesthesia. It is an alternative to hysterectomy in patients with benign conditions belonging to the younger age group and who have preferably completed their family. |
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Clearance of Endometriotic cysts / Adhesions / Hydrosalpinx
These individual conditions exert their own effects on fertility, sometimes necessitating the need for in vitro fertilization (IVF). However research has proven that clearance of these pathologies prior to application of the different modalities of assisted conception significantly improves results. Mostly we perform adhesiolysis, removal of endometriotic cysts in the ovary and the removal of gross hydrosalpinx (fluid collection in the fallopian tube) laparoscopically. Sometimes when two or more conditions co-exist in the presence of dense adhesions we perform an open surgery.
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Laparoscopic electro coagulation of ovarian surface ( LEOS )
This is done as one of the therapeutic modalities in treatment of poly cystic ovarian syndrome. Previously a portion of the ovary was resected surgically leading to complications like adhesions and premature ovarian failure. Recently simple electro cauterization of the ovarian surface is achieved laparoscopically leading to better ovulation and pregnancy rates. Normally 5-8 points on each ovarian surface are cauterized. The advantages are shorter recovery and less adhesion formation. |
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Fibroid Removal (Myomectomy)
Fibroids are benign tumors arising from the uterine musculature. They are hormone dependant and have a tendency to grow. Sometimes these tumors due to their size and location tend to interfere with normal fertility. Hence their removal either laparoscopically or by an open surgery (laparotomy) improves chances of conception. The decision of assessing these tumors and judging the mode of removal lies with the infertologist.
http://www.myomectomy.net
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Adenomyosis reduction
Adenomyosis is defined as the presence of endometriosis within the wall of the uterus-Endometriosis interna. The inner lining actually proliferates as a down growth into the Myometrium. Diagnosis can be made by conventional ultrasound and is also seen laparoscopically, as a uniformly enlarged uterus with more prominence either on the anterior or posterior wall. Most cases co-exist with pelvic endometriosis and its associated complications. They are primarily treated with medical therapy like Danazol or Gonadotropin releasing hormone analogues (GnRh-a) but in some cases may require surgical correction.
http://www.diagnose-me.com/cond/C537734.html
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Hysterectomy
Hysterectomy is the one of the most common surgical procedures done in women who are in the peri and post menopausal age group. In most cases it involves removal of the uterus and its appendages, while some times the ovaries may be spared in specifically indicated situations. It can be performed vaginally or abdominally and by laparoscopy or open method. All these choices are subject to the indications for removal. Some of the common indications are multiple fibroids, abnormal /dysfunctional uterine bleeding and presence of malignancy. Since ours is primarily a centre dealing with infertile women, this procedure is restricted to our gynec population.
http://www.womhealth.org.au/factsheets/hysterectomy.htm
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Vaginoplasty (Reconstruction of Vagina)
At our centre, Vaginoplasty is mainly performed on patients with Mayer Rokitansky Kustner Hauser Syndrome (MRKHS) where there is non-unification of the uterine horns as well agenesis of the vagina. The purpose of the procedure in such cases is to aid sexual intercourse and also to enable us to retrieve oocytes from hyper stimulated ovaries in the event of an ART procedure. Our visiting plastic surgeon performs this procedure using the labia minora as the mold / flap known as a horse-shoe flap. Kindly refer to the following article published in British journal of plastic surgery which gives an interesting account of the procedure done by our visiting plastic surgeon.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
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