Shannon Medical Center | Health Beat | Fall 2018

4 HEALTH BEAT F rom heavy menstrual periods to chronic pelvic pain, the symptoms of some gynecological conditions can cause major disruptions in a woman’s daily life. If you’ve recently been diagnosed with such a condition, you may be looking for solutions. Medicines and other treatments can help. But if they don’t work, there may be a surgical fix—and one that comes with small incisions and faster healing times. It’s known as laparoscopic or minimally invasive surgery. You’re probably familiar with open surgery for gynecological conditions— the way surgery has been done for years and still is sometimes. With open surgery, an incision is made in the abdomen that is several inches long. With laparoscopic surgery, however, the incisions are very small (less than ½ an inch). One cut is made in the belly.The surgeon inserts a laparoscope, a thin tube with a video camera, through that incision.The camera lets the surgeon see the pelvic or- gans on a screen.The doctor then inserts other instruments through the incision, or through additional small incisions, to do the surgery. Because the incisions are small, less tissue is damaged. So healing can be faster. Other benefits of laparoscopic surgery, compared to open surgery, may include: • Less pain after surgery. • Shorter hospital stays—in many cases, you can go home the same day. • A quicker recovery. • Smaller scars. • Lower risk of infection. • Less blood loss. What follows are three common gynecological conditions that can be treated—and sometimes even diagnosed—with laparoscopic surgery. 1. Endometriosis. In this condition, tissue that normally lines the uterus grows outside the uterus in places where it shouldn’t, such as in the ovaries or fallopian tubes. Women with endometriosis may have symptoms that include pelvic pain, heavy menstrual bleeding, pain during sex, and painful bowel movements.They may also have trouble getting pregnant. Sometimes a doctor can feel the rogue endometrial tissue during a rectal or pelvic exam. But the only way to truly diagnose endometriosis is with a visual inspection of the pelvic organs, which is done using laparoscopic surgery. A doctor may also remove the endometriosis tissue at the same time. 2. Ovarian cysts. These fluid- or tissue-filled sacs form in or on an ovary. Most cysts are painless—they’re found during a routine pelvic exam. And they of- ten go away on their own. But some cysts can grow large and become very painful. Some may even burst, which can cause sudden severe pain. When ovarian cysts need to be removed, laparoscopic surgery may be an option. Surgery to remove just the cysts and spare the ovary is called a cystectomy. 3. Fibroids. These growths form in the wall of the uterus. Most are small and don’t need to be treated. However, if a fibroid grows large and causes problems, such as pelvic pain or heavy periods that trigger anemia, then treatment may be necessary. Drug therapy is an option for some women with a bothersome fibroid. So is surgically removing the fibroid and leaving the uterus intact, called a myomectomy, which can often be done laparoscopically. If child-bearing is no longer desired, hysterectomy is often an option, and can again usually be done laparoscopically. Hysterectomy—surgery to remove the uterus and sometimes the cervix— is used to treat many gynecological conditions, including endometrio- sis, fibroids, and cancers of the cervix, uterus, fallopian tubes and ovaries. A hysterectomy can be done in different ways, including laparoscopically. With laparoscopic surgery, the uterus may be removed through the vagina, or if too large, may be removed in pieces through the um- bilical incision. Although laparoscopic surgery has many benefits and can be success- fully used for most gynecological conditions, open surgery is some- times still the best solution. Discuss with your doctor the pros and cons of each type of surgery. Which one is right for you will depend on your current and past medical conditions. Source: American College of Obstetrics and Gynecology Treating gynecological conditions with small incisions 3 CONDITIONS WITH A MINIMAL SOLUTION A DIFFERENT TYPE OF SURGERY HELP WITH HYSTERECTOMIES TOO Less MORE NO SINGLE BEST CHOICE Women’s health