Gynecological surgery

Advanced gynaecological surgery can be the recommended treatment option

For women suffering from certain physiological problems, medication alone may not be sufficient to achieve the desired results. Gynecological surgery can be another treatment option. Before gynecological surgery, doctors will conduct gynecological examinations and/ or imaging examinations (including pelvic ultrasound, abdominal MRI, etc.) to determine the and the patient’s physical condition, thereby choosing the most suitable surgery. Women may assume that surgery is always necessary, worrying not only about the success rate or potential damage to the body, but also about whether the wound will leave a permanent scar. , women are relatively more concerned about their personal appearance; for example, wearing a bikini at the beach or pool would not look good if a surgical scar s visible on the abdomen! In fact, gynecological surgeries are now quite diverse, with cure rates better postoperative . Even open surgeries avoid leaving noticeable scars. ynecological surgeries are not limited to traditional open surgeries; there are also minimally invasive gynecological surgeries. These surgeries only require extremely small incisions to insert , and the incisions are less noticeable. invasive surgerythat leave no abdominal wounds.

Each type of gynecological surgery has its own advantages

With the continuous advancement of medical technology, many types of gynecological surgeries are now available. Doctors will choose the most suitable procedure based on the patient's condition, physical state, and wishes. The most commonly used gynecological surgical procedures and examination methods generally include the following:

Traditional open surgery

The doctor will make an incision in the patient's abdomen to treat specific areas, then will remove and repair the diseased orangs and structures through the incision. After the surgery, the incision site will be sutured with needles and sutures. Open surgery may be necessary in cases of larger uterine fibroids, ovarian cysts, or cancer. This traditional gynaecological surgery is relatively more affordable than minimally invasive surgery, and patients with a budget may consider this option. However, open surgery always results in a larger incision, more postoperative pain , a longer recovery time , and a noticeable scar. However even with a larger incision, for women who wish to have children, open surgery for fibroid removal actually carries the lower risk of uterine rupture than minimal invasive gynaecological surgery. Also, open surgery for severe endometriosis may be associated with reduce chance of complications.

Coloscop

If pap smear or HPV DNA test results are abnormal, gynaecologist recommends a colposcopy to determine the cause. This examination method can clearly identify whether there are precancerous cervical lesions, allowing for targeted treatment. The doctor will use a colposcope to thoroughly examine the cervix and vagina for any lesions and perform a biopsy to determine the severity of the lesions. No anaesthesia is required in most of the cases.

Minimally Invasive Surgery

Minimal invasive gynaecological surgery involves making several tiny incisions in the patient's abdomen. Instruments equipped with lenses and camera are then inserted through these incisions to allow for detailed observation and ensure precise and accurate treatment, achieving the desired therapeutic effect. Minimally invasive gynaecological surgery is generally used to treat or examine the uterus, fallopian tubes, ovaries, and surrounding tissues. In most cases, gynaecologists recommend it because the smaller incisions accelerate recovery, reduce pain, and shorten hospital stays.

Suction

This gynaecological procedure is performed when a patient needs to terminate a pregnancy due to physical or mental conditions. Medical abortion is another feasible and safe non-surgical method.

Hysteroscopy

This technique is used to examine abnormal vaginal bleeding and gynaecologist recommends hysteroscopy for women with abnormal uterine bleeding or suspicious ultrasound finding. It is used to diagnose uterine fibroids, endometrial polyps, and cancer-related conditions. The entire diagnostic and examination process is relatively simple, and patients can usually be discharged on the same day after the procedure. In most cases, hysteroscopy does not necessarily require general anaesthesia.

If necessary, during hysteroscopy, curettage or endometrial biopsy will be performed to obtain endometrial tissue for testing, thereby diagnosing any gynaecological problems. Therapeutic procedures like polypectomy, myomectomy can be performed in the same occasion.

Non-invasive uterine fibroid surgery — High-intensity focused ultrasound

High-intensity focused ultrasound ablation of fibroids (HIFU) is suitable for selected patients with uterine fibroids and without abdominal scars. It is performed at a day center, no hospitalization or general anaesthesia required.

Our clinic offers a variety of suitable medical technologies and surgical procedures. Our doctors will first each patient's condition, then provide a detailed explanation and recommend the most suitable surgical approach for optimal treatment outcomes. understanding reduces anxiety, which positively impacts the treatment process.

Detailed Explanation of Three-Port and Transvaginal Minimally Invasive Gynecological Surgery

The aforementioned minimally invasive gynecological surgeries involve making three to four small incisions in the patient's abdomen to facilitate the insertion of instruments with into the body for examination and treatment. Both methods are recommended by gynecological surgeons due to their advantages. So, what are the differences between three-incision and single-incision minimally invasive surgeries? The following is a detailed explanation:

Three-port minimally invasive surgery

This minimally invasive gynecological surgery involves three small incisions: one around the navel and two to three more in the lower abdomen. of these are about 10 mm in diameter, while the others are only about 5 mm. Surgical instruments are then inserted through these incisions to perform the treatment. As it is considered minimally invasive, it causes less trauma and bleeding, resulting in faster recovery and less hospitalization. Furthermore, the surgical instruments allow for precise manipulation and clear visualization of the internal organs, reducing risks. This technique and method are suitable for common gynecological surgeries, such as myomectomy and ovarian cyst removal.

Transvaginal minimally invasive surgery

All instruments are inserted into the body through the vagina, leaving no abdominal wounds. However, this method is not suitable for everyone and depends on whether the woman has previously undergone abdominal surgery, the reason for the surgery, and the size of the tumor or cyst.

Traditional abdominal surgery: The doctor makes an incision in the patient's abdomen, and then sutures the wound with needles and thread. This type of surgery isexpensive, but it creates a larger wound, takes a long time to heal, and leaves an unsightly scar. However, sometimes, due to large uterine fibroids, ovarian cysts, or severe endometriosis, abdominal surgery is the only option.

Frequently Asked Questions about Gynecological Surgery

1. What are the main types of common gynaecological surgical procedures?

The common gynaecological surgical procedures today include the following:

Traditional open abdominal surgery: The doctor makes an incision in the patient's abdomen, and then sutures the wound with needles and thread. This type of surgery is less expensive, but it creates a larger wound, takes a longer time to heal, and leaves an unsightly scar. However, sometimes, due to large uterine fibroids, ovarian cysts, or severe endometriosis, abdominal surgery is the only option.
Minimally invasive laparoscopic surgery: In this minimally invasive gynaecological surgery, the doctor will make three to four small incisions in the patient's abdomen, and then insert an instrument with a camera into the body through the small incisions. This method can be used to treat or examine the uterus, fallopian tubes, ovaries and nearby tissues.
Hysteroscopy: Gynaecologist recommends hysteroscopy for examination in cases of abnormal vaginal bleeding. It can diagnose conditions such as uterine fibroids, endometrial polyps, and even cancer. The procedure is very simple, and patients are usually discharged the same day. If necessary, a curettage or endometrial biopsy may be performed simultaneously for testing to diagnose endometrial hyperplasia or cancer.
Colposcopy: If a patient's Pap smear or HPV DNA test results are abnormal after examination, the gynaecologist recommends that the patient undergo colposcopy to further determine whether there are any precancerous cervical cell lesions.
Vacuum aspiration for abortion: This gynaecological surgical procedure is used when a woman needs to terminate a pregnancy due to physical or mental problems. Medical abortion is another feasible and safe non-surgical method.
Uterine fibroids can also be treated with non-invasive surgery — high-intensity focused ultrasound ablation of uterine fibroid.

As can be seen from the above, doctors will decide which gynaecological surgical method to use based on the patient's physical condition and the illness they suffer from.

2. What preparations should patients make before undergoing surgery, such as minimally invasive gynecological surgery?

Before undergoing minimally invasive gynaecological surgery or similar treatments, patients typically need to abstain from food for at least 6 hours prior to the procedure. Additionally, any jewelry or cosmetics worn by the patient, such as rings, bracelets, necklaces, earrings, contact lenses, hair clips, dentures, and any nail polish, toenail polish, or lipstick, must be removed and wiped off. Furthermore, the patient must remove all clothing, including underwear and bra, and then put on a surgical gown, surgical cap, and surgical stockings. If the patient has valuables, they should be entrusted to a family member or friend for safekeeping, or their belongings should be locked away. Before the actual surgery, the patient should empty their bladder.

Of course, the preparations required for different types of gynaecological surgeries may vary slightly, so you should consult your doctor before undergoing any surgery.

3. After undergoing gynecological surgery, are there any postoperative care procedures or other precautions required?

Yes, it is necessary. After surgery, the wound needs careful care. The dressing should be kept clean and dry, and strenuous exercise and lifting heavy objects should be avoided, as these can affect wound healing. If the surgery involved the removal of uterine fibroids, hysteroscopy, or colposcopy, vaginal bleeding may occur, which is normal and nothing to worry about. However, if you experience severe abdominal pain, wound suppuration, heavy vaginal bleeding or discharge with a strong odor, or fever after surgery, you should not attempt to manage the bleeding yourself and should seek medical attention immediately.

In addition to following the postoperative wound care methods as gynaecologist recommended, daily diet also needs adjustment, focusing on balanced nutrition. For example, consuming foods rich in protein has a positive impact on wound healing, and eating plenty of fruits and vegetables helps with bowel movements. However, foods containing hormones, such as bird's nest, should be avoided, especially for those with a history of tumors, as consuming them may stimulate tumor growth. Furthermore, if the patient has had their uterus or ovaries removed, they must follow the doctor's instructions for hormone therapy and undergo regular gynaecological examinations to monitor the condition and prevent recurrence.

4. If I have uterine fibroids, is gynecological surgery always necessary?

No. Surgery is not required in most of the cases. The need for surgery for uterine fibroids or not depends not only on the size and number of fibroids. The doctor will first conduct a thorough examination and determine the need for surgery based on the patient's specific symptoms. Most fibroids are benign and asymptomatic, therefore surgery is generally not required. Medication can be used to reduce menstrual flow and alleviate menstrual cramps, and the fibroids usually shrink after menopause.

However, if medication is ineffective, such as in cases of excessive menstrual bleeding, severe menstrual cramps, or if the fibroids are too large, affecting daily life, fertility, or even posing a risk of malignant transformation, then open surgery or minimally invasive removal of the fibroids should be considered. If the patient no longer plans to have children, a complete hysterectomy may also be considered to prevent recurrence.

In cases where the risk of malignant transformation is low, non-invasive surgical treatment — high-intensity focused ultrasound ablation of uterine fibroid (HIFU) is another option. You should discuss with your doctor regarding the most suitable treatment options.

5. Based on the above, are there any risks associated with gynecological surgery to remove uterine fibroids?

Indeed, undergoing this type of gynaecological surgery carries certain risks and potential complications. Patients should discuss the procedure in detail with their doctor before deciding whether to proceed, ensuring a comprehensive understanding of the associated risks. The risks and potential complications are roughly as follows:

Complications of anaesthesia: Some patients may experience sequelae due to intolerance to the administration of anaesthetic drugs.
Damage to nearby organs: Surgery may injure nearby organs, such as the ovaries, bladder, ureters, or even the intestines. However, doctors will assess the feasibility before the surgery, and this risk is not necessarily too great.
Massive bleeding: There may be significant bleeding during surgery, which may require a blood transfusion.
Pelvic infection: This postoperative risk can potentially affect a patient's fertility.
Incomplete removal: In case of adenomyosis or the fibroid is too small or too deep, complete removal may not be possible.
Deep vein thrombosis: Deep vein thrombosis may occur after surgery.
Wound complications: Surgery may lead to wound complications, including infection, haematoma, inguinal hernia, and thick scarring.
Uterine rupture: Even if pregnancy is possible after surgery, there is a risk of uterine rupture.
Caesarean section: After this surgery, a caesarean section may be necessary in the future.
Endometrial adhesions: After surgery, endometrial adhesions may occur, which can affect fertility.
Hysterectomy required: This is very rare complication, with about 1-2% of unsuccessful cases requiring hysterectomy.
Fibroid recurrence: After surgery, uterine fibroids may grow back. Approximately 30% of patients will require further treatment due to recurrence in 10 years.
Infertility: This risk is possible, but rare.

6. In summary, what conditions are gynecological minimally invasive surgeries primarily used for appropriate treatment?

Today, minimally invasive gynaecological surgery is widely used in Hong Kong, offering diverse treatment and diagnostic applications and is recommended by gynaecologists. Procedures such as oophorectomy, ovarian cyst removal, polycystic ovary syndrome drilling, salpingectomy, salpingostomy, total hysterectomy, myomectomy, endometriosis removal, and diagnostic laparoscopy all leverage the advantages of minimally invasive gynaecological surgery.

7. If a hysterectomy is performed via minimally invasive gynecological surgery, is it permissible to shower on the same day after the procedure?

Gynecologists recommend that patients shower aftera minimally invasive gynecological surgery, once the anesthesia has worn off. However, only showering is permitted; bathing is not recommended because the surgical wound is still healing nfection. Even when showering, it is essential to take precautions to keep the abdominal incision area waterproof.

9. If a woman has urinary incontinence, can it be treated with minimally invasive gynecological surgery?

Yes, it's possible. For severe urinary incontinence in women, a small incision can be made to insert an artificial sling into the tissue below the mid-urethra, thus supporting the pubourethral ligament. This minimally invasive gynecological treatment greatly reduces the chance of bladder damage and rarely results in postoperative problems.

10. Approximately how much do you charge for minimally invasive gynecological surgery?

Depending on the specific condition being treated, the fees for our various gynecological surgeries, including minimally invasive gynecological surgeries, will vary. Please contact us for details.