In-theatre procedures consist of the following
Hysterectomy
A hysterectomy is a widely-executed surgical procedure that aims to remove the uterus for several reasons related to abnormal bleeding, painful menses, adenomyosis, endometriosis, gynaecologic cancers, fibroids and uterine prolapse. There are different ways to perform a hysterectomy, such as the following:
1. Total hysterectomy involves the resection of the uterus and cervix.
2. Partial ot subtotal hysterectomy is the surgical resection of the uterus only, leaving the cervix intact.
3. Radical hysterectomy which is usually performed for the treatment of cancer, entails the surgical resection of the uterus, cervix, tissues next to the cervix and upper part of the vagina.
1. Total hysterectomy involves the resection of the uterus and cervix.
2. Partial ot subtotal hysterectomy is the surgical resection of the uterus only, leaving the cervix intact.
3. Radical hysterectomy which is usually performed for the treatment of cancer, entails the surgical resection of the uterus, cervix, tissues next to the cervix and upper part of the vagina.
Salpingo-oophorectomy
A salpingo-oophorectomy is the surgical resection of the ovaries and fallopian tubes. It is perfomed as part of the treatment of ovarian and endometrial cancer. It is could also be performed separately, to treat ovarian masses or to decrease the risk of ovarian and fallopian tube cancer.
Cold knife cone, LLETZ/LEEP
Cold cone biopsy requires the administration of general anaesthetic and is advised for precancerous changes of the cervix. During the cold cone removal, a tissue sample in the shape of a small cone is extracted from the cervix. The sample is analysed under a microscope to check for signs of cancer. LLETZ/LEEP could also be performed in theatre and involves the use of a wire loop that’s extensively kept warm by electric current. The wire is used to excise a cone of abdnormal cervical tissue.
Diagnostic laparoscopy
A diagnostic laparoscopy is an investigative procedure to examine the inside of the stomach or pelvic region. The laparoscope is placed into the abdominal cavity to assess for gynaecologic disorders.
Diagnostic laparoscopy is a minimally invasive investigative technique that eradicates the need for expansive abdominal incisions and leads to a quicker recovery period.
Laparoscopy for ovarian cysts
Laparoscopic ovarian cystectomy is a medical procedure that resects a cyst from the ovary. Laparoscopy involves creating a few tiny incisions in the lower abdomen to prepare for the removal of the ovarian cysts. Surgical removal of these cysts could be required if the cysts are causing pain or discomfort or result in pelvic pain during menstruation or sexual intercourse.
Laparoscopic sterilization
Laparoscopic sterilisation, also referred to as bilateral tubal ligation (BTL), is a medical procedure and permanent method of birth control. It reduces the likelihood of a woman’s eggs from migrating through the fallopian tubes to prepare to be fertilised by sperm cells.
Hysteroscopy
Hysteroscopy is a detailed examination of the interior of the cervix and uterus. The procedure relies on the use of a slim, illuminated camera (hysteroscope) that’s carefully inserted through the vagina. A hysteroscopy is required to test and could also treat heavy menstrual bleeding, irregular uterine bleeding, spotting between menstrual cycles and bleeding following menopause.
Excision of the vulva, vaginal lesions and cancer
A vulvectomy is a surgical procedure that involves the resection of a portion of the vulva or a complete vulvectomy that entails the removal of the entire vulva. The extent of the surgical procedure depends on several key factors, such as the mass/size of the tumour, the location of the tumour on the vulva and the portion of the vulva affected by the tumour.
Surgeries pertaining to vulva, vaginal, cervix and ovarian cancer
The type of surgery selected depends on the size of the tumour, its location and staging. For example, surgery is performed for the following types of cancer:
- Surgery for vulval cancer:
Surgery is the most widely performed treatment for cancer of the vulva and in some cases of vulvar intraepithelial neoplasia (VIN). If the tumour is large, surgery to remove the entire vulva may be advised, which is a procedure referred to as a radical vulvectomy. - Surgery for vaginal cancer:
Primary vaginal cancer is rare and, if in the early stages, could be removed surgically. A wide excision involves removing the cancer along with a healthy, surrounding rim of tissue. - Surgery for cervical cancer:
Depending on the stage, a simple hysterectomy or radical hysterectomy could be the treatment for cervical cancer. Radical trachelectomy (radical cervicectomy) entails the removal of the upper portion of the vagina, surrounding tissue and lower part of the cervix. The surgeon may also have to remove the pelvic lymph nodes during any of these procedures. - Surgery for endometrial or uterine cancer:
Surgery for endometrial cancer involves removal of the uterus, cervix (total hysterectomy) and ovaries and fallopian tubes (salpingo-oophorectomy.) The procedure could be performed through keyhole surgery (laparoscopically) or through an open abdominal incision. The surgeon may also have to remove the pelvic lymph nodes. - Surgery for ovarian cancer:
The extent of surgery for ovarian cancer depends on where the cancer can be found and which areas it has spread to. Debulking is a process that involves removing cancerous regions, particularly when cancer has spread to parts of the pelvis and abdomen. Total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO) and omentectomy is a combination of the standard surgical procedures to treat ovarian cancer, which involves the resection of the fallopian tubes, ovaries, womb, cervix and omentum.
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