Gynecological Endoscopy

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Dr. Prashanth HegdeQ. What does gynecological endoscopy mean in layman terms?

Dr. Hegde: “Gynecological endoscopy is an immensely technology-laden surgical discipline which uses optical instruments specially designed to help diagnose and treat the most frequent female gynecological disorders and pathologies. These
include: infertility problems, womb related problems, uterine malformations and/ or genital pre-cancers. Gynecological
endoscopy employs laparoscopy, hysteroscopy and colposcopy for these purposes.”


Q. What are the cutting edge technological advances used in gynecology today?

Dr. Hegde: “Gynecological endoscopy is a reality today, thanks to advances in the field of medicine and technology. Gynecological endoscopic surgery is a modern discipline which unites advances both in gynecology and minimally invasive surgery which allows for surgical interventions without the need for a major operation. Recovery is quick and the patients can return to their routine activities at the earliest. Local/regional anesthesia or sedation is used. For reasons of patient safety, the procedures are carried out in a fully-equipped operating theatre.”

Q. What is laparoscopy? 

Dr. Hegde: “Laparoscopy is a minimally invasive surgical technique which allows intervention in the abdominal cavity without the need for a major operation. This procedure is carried out under anesthesia in which recovery is fast and the
patient can leave the hospital in four to six hours. It allows the gynecologist to visualize internal genital organs such as the uterus, the ovaries and the fallopian tubes so that a diagnosis can be made when the patient has chronic pelvic pain, infertility, and ectopic pregnancy and so on, and also surgery can be performed when indicated. Today laparoscopic
surgery can be performed in almost all gynecological conditions wherein routinely open surgery is performed; for example, removal of fibroids from the womb, removal of the womb, ovarian cyst removal, endometriosis, removal of adhesions, tubal microsurgeries, and tubal ligation (Sterilization) operations. Surgery is carried through a small nick in
the naval area.”

Q. What is hysteroscopy?

Dr. Hegde: “Hysteroscopy is an incision-free procedure which helps visualize the interior of the uterine cavity or womb. In order to do this, a hysteroscope–a modern optical instrument, similar to a miniscule telescope of only four millimeters in diameter– is inserted via the neck of the uterus. This procedure helps in both diagnosing and treating the womb related pathologies such as polyp, fibroids, malformations, or septum without any cut as the procedure is carried out through natural orifice. Normally the intervention is carried out without a diagnostic aesthetic and occasionally local/ regional anesthetic is used for operative hysteroscopy. This ambulatory procedure lasts between 20 and 30 minutes.”

Q. Can you please explain what colposcopy is in layman terms?

Dr. Hegde: “Colposcopy is the endoscopic procedure for diagnosing/treating the disease of the cervix and vagina. Colposcopy is the gold standard investigation in diagnosing one of the most common and preventable cancers of women – cancer of cervix in the precancerous stage and subsequent treatment. Visualization of cervix and vagina under magnified
illumination helps in the early detection of precancerous and early cancerous lesions and immediate treatment resulting in
better survival for women.”

Q. What are the benefits of endoscopic surgery?

Dr. Hegde: “The recovery from endoscopic gynecological surgery is faster than in conventional (open) surgeries as interventions are minimal, less blood loss along with shorter hospital stay. Postoperative pain is minimal and infections are less likely than with conventional surgery. Above all, patient satisfaction rates are very high with laparoscopic  surgeries as they are minimally invasive as name suggests and cosmetically appealing.

Though the procedures per se are more expensive than conventional surgery, the overall cost to the patient is less in view of a reduced length of stay in the hospital, less use of pain relievers/antibiotics, early recovery and early return to work.”

Q. How safe are these procedures?

Dr. Hegde: “It is worth mentioning that these modern surgical techniques are meticulous and if carried out by a well trained and experienced gynecologist endoscopic surgeon is completely safe. Side-effects are almost nonexistent. No surgery is out of risk/ complications. Having said so, proper patient selection, planning and performing the surgery shall
eliminate/minimize the risks.”

Experience as a male gynecologist.

Dr. Hegde: “I must admit my appreciation when I came initially here especially in a culturally sensitive society. Looking
back at my 15 years of professional clinical practice, it is encouraging to see a preference for a male gynecologist especially
among women with complicated gynecological conditions requiring treatment. Having said so, gender I feel is not a constraint as long as you practice the profession ethically with dignity and respect for your patients.”

Credit:
Dr. Prashant Hegde
Medical Director and Specialist Gynecology,
Endoscopic Surgeon
GMC Hospital, Ajman

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