Gynaecology Endoscopic Surgery: A Technological Boon in Obstetrics and Gynecology

Endoscopy is the direct observation of an organ or cavity by inserting an endoscope through natural orifices or small incisions. Endoscopy allows obtaining a more reliable and accurate information compared to other techniques. Gynaecology Endoscopy is a surgical discipline that is specially designed to see & treat the most frequently occurring female disorders and pathologies. It is state of the art investigation for evaluation and management of female infertility viz., assessment of tubal status, cysts, endometrioma, chronic pelvic infection, and adhesions. Intrauterine polyp, submucous fibroids, septum of uterus can be managed easily by hysteroscopy as day care procedure. Similarly, ectopic pregnancies can easily be handled by Gynaecology Endoscopy as day care procedure. The Gynaecology Endoscopy uses optical instruments and employs hysteroscopy and laparoscopy for these purposes.

Technical advances, coupled with sophistication and miniaturization of the equipment have made Gynaecology Endoscopy a possibility now-a-days. Moreover, the modern anaesthetic medicine has also played a significant role in developing these surgical procedures.

What are the uses of Gynaecology Endoscopic Surgery?

The endoscopic surgery makes it possible to treat most of the gynaecological pathologies as day care procedure avoiding major operations requiring prolonged hospitalization. It is useful in tubal recanalization, endometrioma operation, dermoid operation, myomectomy, total laparoscopic hysterectomy, ectopic pregnancy management, searching for pelvic pathologies causing infertility and recurrent abortions.

Hysteroscopy helps in discerning between: endometrial alterations (atrophies or hyperplasia); endometrial adhesion; myomas (benign tumours); endometrial polyps; and uterine septa or malformations.

Through the Gynaecological Endoscopic Surgery, the need for a major operation in cases of endometriosis and ovarian tumours is prevented. Moreover, the Gynaecological Endoscopic Surgery is the fastest way of carrying out tubal ligation. It is also effective for diagnosing causes of infertility.

What are the advantages of Gynaecology Endoscopic Surgery?

The advantages of Gynaecology Endoscopic Surgery are:

• Faster recovery compared to classical surgery cases.
• Post-operational infections are less probable to occur compared to conventional surgery.

It is worth mentioning here that these modern surgical techniques are meticulous, while the anaesthetic procedures allow for a fast recovery. The side-effects are almost non-existent.

What are the types of Endoscopic Surgery in Gynaecology?

Laparoscopy and Hysteroscopy are the two types of endoscopic surgery used in gynaecology.

With technological advancement, laparoscopic surgery has been rapidly replacing the conventional surgery, except in the most difficult cases. The patients with chronic pelvic pain, infertility, adhesions and endometriosis, and an adjunct in grading of gynaecological cancers are assessed through diagnostic laparoscopy. In fact, the laparoscopic approach has now become the preferred method for treating endometriosis, myoma uteri, ectopic pregnancy, ovarian tumours, inflammatory masses, and infertility.

Hysteroscopy is used to assess patients with abnormal uterine bleeding, post-menopausal bleeding, recurrent pregnancy loss and infertility. During hysteroscopy the uterine cavity is dilated with liquid and after that a resectoscope or hysteroscope is used. The main indications for hysteroscopic surgery are uterine anomalies, submucous myoma uteri, and Asherman syndrome. Using various mechanical occlusive devices or plugs, female sterilization can also be performed through hysteroscopy.