“Small incision, quick recovery, quick return home”
Presently, most gynecologic surgery is performed using minimally invasive techniques, such as laparoscopic surgery. While under general anesthesia, specialized surgeons will create 1 to 4 small incisions, each about 0.5-1 cm in size, depending on the type of surgery. After that, cameras and instruments are used to perform the surgery on the uterus, ovaries, or fallopian tubes, and the images will be displayed on a screen. Because the images displayed from laparoscopic surgery are magnified, laparoscopic surgery is highly accurate and safe.
Gynecological Conditions Eligible for Laparoscopic Surgery
- Uterine fibroids
- Ovarian cysts or tumors
- Ovarian endometrioma (chocolate cysts)
- Chronic pelvic pain
- Infertility
- Ectopic pregnancy
- Chronic anovulation
- Female tubal sterilization
Gynecological Conditions Eligible for Hysteroscopic Procedures
Uterine polyps, adenomyosis, abnormal uterine bleeding, and others
Two Types of Minimally Invasive Gynecologic Procedures
- Laparoscopic Surgery The use of an endoscope (a thin, flexible tube with a video camera) to diagnose and perform surgery. This includes three types:
- General Laparoscopic Surgery in which specialized surgeons will perform surgery by making 3 to 4 small incisions, each about 0.5-1 cm in size. This approach can be used on almost all common gynecological conditions.
- Single Incision Laparoscopic Surgery (SILS) or Laparoendoscopic Single Site (LESS) Surgery in which the patient receives 1to 3 incisions that are about 0.5-2 cm in size, hidden by the navel (belly button). This technique leads to quicker recovery, less chance of infection, and a faster return to work. This approach is mainly used for hysterectomies in patients with uterine fibroid, female tubal sterilization, and other surgeries on the ovaries and fallopian tubes. A medical specialist will perform a gynecologic evaluation with the patient before every surgery.
- Natural Orifice Transluminal Endoscopic Surgery (NOTES) in which a 2- to 3-cm incision is made at the vagina, allowing the surgeon to use special tools to perform the transvaginal surgery. Most commonly, this technique is used for hysterectomies, removal of fallopian tubes following an ectopic pregnancy, or removal of ovarian cysts. By using this approach, which does not require any incisions to the abdomen, the patient may have less pain and be able to recover faster.
- Hysteroscopic Surgery The use of a hysteroscope (a thin, lighted tube), which is inserted through the vagina and cervix, to diagnose and surgically remove any abnormal growths on the uterine wall. The technique can be used to treat endometrial polyps, submucous myoma, abnormal bleeding from the uterus, uterine synechiae, and infertility. This type of surgery does not require any incisions to be made to the abdomen.
Currently, Bangkok Hospital Khon Kaen can offer surgery using Advanced 3D Laparoscopic Surgery, which helps increase the accuracy by allowing the surgeon to see a clear and detailed picture. The surgeon can make precise measurements, almost like going inside the patient’s abdomen. This helps surgery to be safe and fast. The surgical incisions are small, reducing wounds, which is important to help patients recover faster. It also reduces complications from the surgery and avoids unsightly abdominal scars. Using a 3D Hi-Definition camera, the sharper images allow for reduced chance of infection and blood loss. This new technology gives the gynecologic surgery room a whole new atmosphere.
Minimally invasive surgery can be used to treat almost all conditions, but not in every patient. It depends on the presentation of the condition and the constraints of each surgical method. Therefore, it is necessary to have a doctor individually evaluate each patient. The doctor will give advice on ways to treat the condition that are appropriate for the patient, as well as help each patient to understand the risks and benefits, before deciding on surgery.
