Minimal Access Surgery

Minimal Access Surgery (or ‘keyhole ) surgery has become very popular over the last 10 years and is the preferred method for many gynaecological operations. These techniques reduce postoperative pain and hospital stay, ensure faster recover from surgery and have obvious cosmetic benefits because the scars are small and hardly visible.

In gynaecology there are two types of Minimal Access Surgery procedures.

1. Laparoscopy

2. Hysteroscopy

What is a laparoscopy?
Laparoscopy is a surgical procedure that is performed under general anaesthetic. During this procedure, a small telescope called a laparoscope is inserted into your abdomen through a small incision (cut) made in your belly button. This allows the doctor to check your womb, fallopian tubes, ovaries and the surrounding pelvic organs.

What are the benefits of laparoscopy?
A laparoscopy can help find the cause of a problem you are having, such as:
• Pelvic pain
• Painful periods
• Pain during sexual intercourse
• Infertility caused by blockage of fallopian tubes.

The following gynaecological operations can be done by laparoscopy:
• removal of ovarian cysts
• removal of fibroids (laparoscopic myomectomy)
• removal of endometriosis
• subtotal and total hysterectomy
• removal of pelvic adhesions(scar tissue)

How is laparoscopy performed?
A laparoscopy is performed under a general anaesthetic. A small cut measuring approximately 1cm is made at or just below the belly button. A special hollow needle is inserted at this point to inflate your abdomen with carbon dioxide gas. This creates a gas bubble inside and the doctor uses this safe space to carefully insert the laparoscope into your abdomen. In most cases, one or two additional 1cm skin cuts are made on the lower part of the abdomen to allow insertion of other surgical instruments to inspect the internal structures carefully and to perform the above surgical procedures where necessary..

What is a hysteroscopy?
A hysteroscopy is a procedure which uses a fine telescope, called a hysteroscope, to examine the lining and shape of the uterus (womb). It is performed either in the outpatient department under local anaesthetic or as a day procedure in the hospital under general anaesthetic

What are the benefits of having a hysteroscopy?
A hysteroscopy can help to find the cause of the problems you are having, such as:
• heavy periods
• irregular periods
• bleeding between periods
• bleeding after sexual intercourse
• bleeding after menopause
• persistent vaginal discharge.

In some cases, once a diagnosis has been made, the hysteroscope can also be used in the treatment of the problem. For example, problems that can be treated during a hysteroscopy are:
• fibroids
• polyps
• uterine septum
• removal of displaced intrauterine contraceptive devices

How is Hysteroscopy performed?
A  hysteroscope is a small ‘telescope’, which is passed along your vagina and through your cervix in order to look at the inside of your uterus. Sterile fluid is run into your uterus to expand it so that the lining of your uterus can be seen. After the lining of your uterus has been examined, a tiny sample of the lining is removed – this is called a biopsy. If you have a fibroids or polyps, an instrument called a resectoscope is used to remove them.