Gynaecological surgery
Gynaecological surgery refers to surgical procedures involving the female reproductive system, including the uterus, ovaries, fallopian tubes, cervix, vagina, and external genitalia. These surgeries are performed to treat conditions ranging from benign issues to cancers, and they can be performed using minimally invasive (laparoscopic) techniques or through traditional open surgery. Here are the major types of surgeries that fall under gynecological surgery:
Hysterectomy
A hysterectomy is the surgical removal of the uterus, and it can be performed for various conditions like cancer, fibroids, endometriosis, or prolapse.
- Total Hysterectomy: Removal of the entire uterus, including the cervix.
- Subtotal (Supracervical) Hysterectomy: Removal of the uterus while leaving the cervix intact.
- Radical Hysterectomy: Removal of the uterus, cervix, parts of the vagina, and surrounding tissues (often done for cervical or endometrial cancer).
Oophorectomy
This is the surgical removal of one or both ovaries, often due to cancer, cysts, or other ovarian diseases.
- Unilateral Oophorectomy: Removal of one ovary.
- Bilateral Oophorectomy: Removal of both ovaries, which can lead to menopause if the patient is pre-menopausal.
Salpingectomy
The removal of one or both fallopian tubes, which is often done in conjunction with other surgeries, like a hysterectomy, or in cases of ectopic pregnancy or tubal cancer.
Myomectomy
This is the removal of uterine fibroids (non-cancerous tumors in the uterus) while preserving the uterus. It is commonly performed for women who wish to retain their fertility.
Pelvic Organ Prolapse Surgery
Pelvic organ prolapse occurs when the pelvic organs (uterus, bladder, rectum) drop down due to weak pelvic floor muscles. Surgical treatments can include:
- Vaginal Vault Suspension: Reinforcing or repositioning the uterus or vaginal vault to treat prolapse.
- Colpocleisis: Closing the vagina to treat severe vaginal prolapse (performed in older women who no longer require vaginal function).
- Sacral Colpopexy: A procedure that attaches the vagina to the sacrum to correct prolapse.
Cervical Surgery
Surgical procedures related to the cervix are often performed to treat precancerous conditions, cancer, or structural abnormalities.
- Cone Biopsy (Cone Excision): Removal of a cone-shaped portion of the cervix to treat or diagnose cervical dysplasia or cancer.
- Cervical Cerclage: A procedure where a stitch is placed around the cervix to prevent premature delivery in cases of cervical insufficiency.
- Trachelectomy: Removal of the cervix, sometimes done to treat early-stage cervical cancer while preserving fertility.
Endometriosis Surgery
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus, causing pain and sometimes infertility.
- Laparoscopic Endometriosis Surgery: Removal or destruction of endometrial lesions via laparoscopy.
- Hysterectomy with Oophorectomy: In severe cases, a combination of hysterectomy and removal of the ovaries may be necessary to treat endometriosis.
Fertility Preservation and Surgery
These procedures are performed to treat infertility or preserve fertility before undergoing treatments like chemotherapy.
- Tubal Ligation (Sterilization): Permanent closure or removal of the fallopian tubes to prevent pregnancy.
- Tubal Reanastomosis (Tubal Reversal): Reconnecting the fallopian tubes after a tubal ligation to restore fertility.
- Ovarian Cystectomy: Removal of ovarian cysts that may be causing infertility.
- Ovarian Drilling: A procedure used in women with polycystic ovary syndrome (PCOS) to help improve ovulation.
Vaginal Surgery
These surgeries address conditions affecting the vaginal area, such as prolapse, abnormal growths, or structural abnormalities.
- Vaginoplasty: Surgical reconstruction of the vagina, often performed for vaginal agenesis (absence of the vagina), vaginal atrophy, or vaginal tightening after childbirth.
- Vulvectomy: Removal of part or all of the vulva, often due to cancer.
- Perineoplasty: Repair of the perineum (the area between the vagina and anus), often after childbirth or injury.
Laparoscopic Surgery (Minimally Invasive Surgery)
Laparoscopy, also known as minimally invasive surgery, is frequently used in gynecology for diagnostic purposes and to treat various conditions.
- Diagnostic Laparoscopy: A minimally invasive procedure to examine the pelvic organs and diagnose conditions like endometriosis, pelvic inflammatory disease, and ovarian cysts.
- Laparoscopic Hysterectomy: Removal of the uterus using small incisions and a camera.
- Laparoscopic Myomectomy: Removal of fibroids using laparoscopy.
- Laparoscopic Oophorectomy: Removal of the ovary using laparoscopic techniques.
- Laparoscopic Tubal Ligation: Sterilization by blocking or removing the fallopian tubes using a laparoscope.
Cystectomy
This procedure involves the removal of cysts, often from the ovaries (ovarian cystectomy), but it can also refer to the removal of other types of cysts found within the reproductive organs.
- Ovarian Cystectomy: Removal of benign cysts on the ovaries, often done laparoscopically.
- Bartholin Gland Cystectomy: Removal of a Bartholin gland cyst, which can cause pain or infection near the vaginal opening.
Tubal Surgery
Surgeries related to the fallopian tubes are often aimed at treating blockages or other conditions that may affect fertility.
- Tubal Recanalization: Reopening blocked fallopian tubes, often after a prior tubal ligation, to restore fertility.
- Fimbrioplasty: Surgery to repair or reconstruct the fimbriae (the finger-like ends of the fallopian tubes) when they are damaged or absent.
Vulvar and Vaginal Reconstruction
These procedures are used to treat congenital conditions, trauma, or diseases such as cancer affecting the vulva or vagina.
- Vulvar Reconstruction: Surgical reconstruction of the vulva after cancer, trauma, or other conditions.
- Vaginal Reconstruction: Surgery to repair or reconstruct the vagina after trauma, cancer, or congenital absence of the vagina.
Urinary Incontinence Surgery
Some gynecological surgeries are focused on correcting urinary incontinence (loss of bladder control), which is a common issue after childbirth or due to pelvic floor weakness.
- Sling Surgery (Midurethral Sling): Involves placing a synthetic mesh or tissue sling around the urethra to treat stress urinary incontinence.
- Bladder Suspension Surgery: Repositions the bladder to treat incontinence caused by pelvic organ prolapse.
Ovarian Cancer and Gynecologic Oncology Surgery
Surgical treatments for cancers of the female reproductive organs, including ovarian, uterine, cervical, and vulvar cancers.
- Oophorectomy: Removal of one or both ovaries, often as part of the treatment for ovarian cancer.
- Hysterectomy with Oophorectomy: Removal of the uterus, cervix, and ovaries, often for endometrial or ovarian cancer.
- Radical Surgery for Cancer: Extensive removal of the uterus, cervix, vagina, and surrounding tissues in cases of advanced cancer.
Ectopic Pregnancy Surgery
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in a fallopian tube.
- Laparoscopic Removal of Ectopic Pregnancy: Surgical removal of an ectopic pregnancy, usually via laparoscopy.
- Salpingectomy: Removal of the fallopian tube that is affected by an ectopic pregnancy.
Fertility Preservation and IVF-Related Surgery
Some gynecological surgeries are performed in conjunction with fertility treatments.
- Oocyte (Egg) Retrieval: Surgery to collect eggs from the ovaries for in vitro fertilization (IVF).
- Endometrial Biopsy: Removal of a small sample of the lining of the uterus, often done to evaluate fertility or investigate abnormal bleeding.
Gynecological surgery includes a broad spectrum of procedures designed to address conditions affecting the female reproductive system, with options that can be tailored to specific needs, ranging from fertility concerns to cancer treatment. The choice of surgery often depends on the condition, patient health, and reproductive goals.
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