COMMON DIAGNOSTIC PROCEDURES

1. Laparoscopy: Is also known as keyhole surgery. Laparoscopy is an exploratory operation performed under general anesthetic which allows the gynecologist to inspect woman's pelvic organs: the uterus, ovaries and fallopian tubes.

Why is Laparoscopy required?

Laparoscopy may be performed to identify a cause or symptom, which cannot be diagnosed by ordinary questioning and examination.

This may apply when there is:

• Pelvic pain
  
• Infertility
  
• Suspected ectopic pregnancy
  
• Endometriosis

Laparoscopy may also be used in performing operations such as:

• Removal of ovarian cysts
  
• Excision of fallopian tubes
  
• Treatment (with diathermy or laser) of endometriosis lesions
  
• Excision of fibroids (certain types)

Pre-Operative operation

The usual pre-operative preparation for this surgery includes fasting and no smoking. For some surgery you may be required to take bowel preoparative medication to empty your bowels. You will be advised if this is required.

The operation

Laparoscopy is performed under a general anestheasia. The operation starts by performing a small cut below the bellybutton. A needle will be inserted through this cut and your abdomen will be inflated with carbon dioxide gas. This makes it easier for the gynecologist to view your pelvic organs. A telescope (laparoscope) with a video attached to it is then inserted inside the abdomen. Other instruments may be inserted through small holes, made just above the pubic hairline. At the end of the operation all these instruments are removed, the gas is expelled and the skin cuts are closed using tapes, sutures or clips.

Complications

No surgery is without risk, but the risks associated with this kind of surgery are relatively rare. The risk is greater for woman who smoke, are significantly overweight or have other problems.

Some of the complications that may occur are:

• Bleeding
  
• Damage to the bowel, bladder, blood vessels or other organs
  
• Infection

What happens afterwards:

After your surgery you may feel:

• Some degree of nausea
  
• Discomfort and fatigue are common for up to five days
  
• Pain were the cuts were made
  
• Pain of the shoulder tip and rib cage. This is due to small amounts of gas remaining under the diaphragm
  
• Period type pain and a few days of vaginal bleeding or discharge.

Painkillers may be taken if required.

Once the symptoms have settled and you feel better you can restart your usual physical and sexual activity. If the symptoms do not settle, you should contact your doctor.

The results of the laparoscopy will be discussed with you prior to your discharge from Hospital and if is necessary further treatment will be arranged.

If you have sutures or clips, they will be removed 3 days after your operation.

2. Hysteroscopy: Is a procedure, which allows the gynecologist to have a look inside the uterus (womb). Hysteroscopic procedure may be used for either diagnosis or treatment.

The hysteroscope, which is similar to a narrow telescope, is inserted through the cervix into the uterine cavity. Carbon dioxide gas or liquid is inserted to separate the walls of the uterus and reveal the uterine cavity. At the end of the procedure a sample of the lining of the uterus (endometrium) may be taken and sent for examination.

Some indications of Hysteroscopy are:

For diagnosis

• To investigate infertility factors
  
• To investigate heavy or irregular periods
  
• To investigate bleeding after menopause
  
• To investigate recurrent miscarriages
  
• To find intrauterine devices

For treatment

• To remove or cauterize the lining of the womb in the procedure called endometrial ablation
  
• To remove fibroids or polyps
  
• To remove lost intrauterine devices
  
• To divide and remove intrauterine adhesions

Complications

No surgery is without risk, but the risks associated with hysteroscopy are very rare.

Some complications that may be occur are:

• Bleeding
  
• Perforation of the uterine wall
  
• Infection

Recovery

Following the procedure some symptoms may be experienced including:

• Fainting
  
• Cramps similar to period pains
  
• Mild bleeding
  
• Nausea or fatigue