Gynecology Services

Hysteroscopy is a medical procedure used to examine the inside of the uterus (womb) by inserting a thin, lighted tube called a hysteroscope through the vagina and cervix. It allows doctors to visualize the uterine lining and identify any abnormalities or conditions that may be affecting a woman's reproductive health.

Hysteroscopy serves both diagnostic and therapeutic purposes. It is performed to investigate various gynecological issues such as abnormal bleeding, recurrent miscarriages, infertility, polyps, fibroids, adhesions, or suspected uterine abnormalities. The procedure can help determine the cause of symptoms and guide appropriate treatment.

Hysteroscopy is typically recommended when other diagnostic methods, such as ultrasound or imaging, have failed to provide sufficient information. It may be performed as an outpatient procedure in a clinic or hospital, depending on the complexity and purpose of the hysteroscopy. The specific timing depends on the patient's symptoms, medical history, and the suspected condition.

Hysteroscopy can be done using different techniques, including diagnostic hysteroscopy and operative hysteroscopy.

Diagnostic Hysteroscopy: In this procedure, a hysteroscope is inserted into the uterus to examine the uterine cavity. Carbon dioxide gas or a saline solution is used to expand the uterine cavity, allowing for better visualization. The doctor can view the images on a monitor and may take biopsies or samples if necessary.

Operative Hysteroscopy: This type of hysteroscopy involves not only visualization but also treatment of specific conditions. During operative hysteroscopy, the doctor may remove polyps, fibroids, or adhesions, correct structural abnormalities, or perform other surgical interventions using specialized instruments inserted through the hysteroscope.

The choice between diagnostic and operative hysteroscopy depends on the purpose of the procedure and the findings during the examination.

Laparoscopy, also known as minimally invasive surgery or keyhole surgery, is a surgical technique that allows a surgeon to access the inside of the abdomen or pelvis through small incisions. It involves using a specialized instrument called a laparoscope, which is a thin, flexible tube with a camera and light source attached to it. The laparoscope is inserted through a small incision, allowing the surgeon to view the internal organs and perform surgical procedures with the help of other instruments inserted through additional small incisions.

Laparoscopy is performed for various diagnostic and surgical purposes. It allows surgeons to examine and treat conditions affecting the abdominal and pelvic organs. Some common reasons for performing laparoscopy include:

1. Diagnosis: Laparoscopy can help diagnose the cause of abdominal or pelvic pain, unexplained infertility, or certain types of cancer.

2. Biopsy: Tissue samples can be obtained for examination and biopsy during laparoscopic procedures.

3. Treatment: Many surgical procedures can be performed using laparoscopy, such as gallbladder removal, hernia repair, appendectomy, hysterectomy, removal of ovarian cysts or tumors, and treatment of endometriosis.

Laparoscopy is performed when the benefits of minimally invasive surgery outweigh those of traditional open surgery. The decision to perform laparoscopy depends on the specific condition being treated, the patient's medical history, and the surgeon's expertise. Laparoscopy is commonly used for both elective and emergency surgeries.

During laparoscopy, the patient is placed under general anesthesia. Several small incisions, typically less than an inch in length, are made in the abdomen. Carbon dioxide gas is then introduced into the abdomen to create space and improve visibility. The laparoscope, along with other specialized instruments, is inserted through the incisions. The laparoscope transmits images of the internal organs to a monitor, allowing the surgeon to visualize the area of interest. Surgical instruments are used to perform the necessary procedures, and at the end of the surgery, the instruments are removed, and the incisions are closed with sutures or surgical tape.

A hysterectomy is a surgical procedure that involves the removal of a woman's uterus. It is a common surgical intervention performed to treat various medical conditions related to the uterus, such as uterine fibroids, endometriosis, uterine prolapse, chronic pelvic pain, certain types of gynecologic cancer, and abnormal uterine bleeding.

A hysterectomy may be performed for several reasons, including:

1. Uterine fibroids: These are noncancerous growths that develop in or around the uterus, causing symptoms such as heavy or prolonged menstrual bleeding, pelvic pressure or pain, and frequent urination.

2. Endometriosis: This condition occurs when the tissue that normally lines the inside of the uterus grows outside of it, leading to pain, infertility, and abnormal bleeding.

3. Uterine prolapse: It happens when the uterus descends from its normal position into the vaginal canal, often due to weakened pelvic floor muscles. This can cause discomfort, urinary incontinence, and difficulties with bowel movements.

4. Gynecologic cancer: In cases of cervical, uterine, or ovarian cancer, a hysterectomy may be part of the treatment plan.

Chronic pelvic pain: If other treatments fail to alleviate severe and persistent pelvic pain, a hysterectomy might be considered as a last resort.

The decision to perform a hysterectomy depends on the specific medical condition and the severity of symptoms experienced by the patient. It is typically considered after conservative treatments have been exhausted or when the condition poses significant health risks. The timing of the procedure is determined through a discussion between the patient and their healthcare provider.

There are different approaches to performing a hysterectomy, including:

1. Abdominal hysterectomy: The uterus is removed through an incision made in the lower abdomen.

2. Vaginal hysterectomy: The uterus is removed through an incision made in the vagina.

3. Laparoscopic hysterectomy: Several small incisions are made in the abdomen, and a laparoscope (a thin, lighted tube with a camera) and surgical instruments are used to remove the uterus.

4. Robotic-assisted hysterectomy: Similar to laparoscopic hysterectomy, but the surgeon controls robotic arms to perform the procedure.

The choice of approach depends on factors such as the reason for the surgery, the patient's overall health, and the surgeon's expertise.

Tubal sterilization, also known as tubal ligation or "getting your tubes tied," is a surgical procedure performed on women to permanently prevent pregnancy. It involves blocking or sealing the fallopian tubes, which are the pathways through which eggs travel from the ovaries to the uterus, thereby preventing sperm from reaching the eggs.

Tubal sterilization is chosen by women who no longer wish to have children or who have decided that their families are complete. It provides a reliable and permanent form of contraception, eliminating the need for other birth control methods.

Tubal sterilization can be done at any time, but it is often performed after a woman has completed her family or during a cesarean section after childbirth. It can also be done immediately after an abortion or in conjunction with other abdominal surgeries, such as a hysterectomy.

There are different techniques for performing tubal sterilization. The most common methods include:

1. Laparoscopic sterilization: The surgeon makes small incisions near the navel and inserts a laparoscope (a thin tube with a camera) to visualize the fallopian tubes. Small instruments are used to block or seal the tubes, usually by applying clips, bands, or electrocautery.

2. Hysteroscopic sterilization: This method involves placing small inserts or coils into the fallopian tubes through the cervix and uterus. Over time, scar tissue forms around the inserts, blocking the tubes.

3. Mini-laparotomy sterilization: A small incision is made near the navel, and the fallopian tubes are either blocked with clips or cauterized. This method is usually done after childbirth or during other abdominal surgeries.

4. Tubal sterilization is typically performed under general anesthesia, but some methods can be done with local anesthesia or even in an office setting without anesthesia.

It's important to note that tubal sterilization is considered a permanent form of contraception, and while there are techniques for reversal, they are complex and may not always be successful. Therefore, it is essential to carefully consider the decision before proceeding with the procedure.