Gynecological Surgery at Goldenes Kreuz Private Hospital
There are two types of surgical procedures in gynecology: the so-called laparoscopic surgery and hysteroscopic surgery (inside the uterine cavity).
Laparoscopic surgeries are usually performed under general anesthesia. Through the 5 to 10 mm incision below navel, the abdominal cavity is inflated with carbon dioxide gas so that the abdominal wall is separated from the internal organs.
Thus, the doctor can obtain a clearer view of the field of intervention. A laparoscope with attached video camera and a source of light are inserted through the hollow tube introduced through the navel (the so-called trocar). This way the abdominal image is broadcast directly to the monitor. The surgery is performed in an inclined position with the pelvis raised and the head end of the operating table lowered (the so-called Trendelenburg position). This position allows intestinal loops and omentum to move to the upper abdominal cavity and the pelvic organs become clearly visible to the surgeon. Through 2-3 additional small incisions in the abdomen (5 to 20 mm each), additional trocars are inserted for introduction of endoscopic instruments (scissors, forceps, conductive forceps or instruments used to cut tissues, ultrasonic scissors, etc.). Thus, various gynecological surgeries can be performed, from diagnostic interventions on the fallopian tubes, ovaries, and uterus to the treatment of complex diseases such as endometriosis, female urinary incontinence, and some cancer related surgeries.
Indications for gynecological laparoscopy include
- Benign uterine disorders- myomas
- Ovarian cysts
- Fallopian tube surgeries
- Postoperative adhesions removal
- Diagnosis and treatment of fertility problems
- Pelvic inflammatory diseases
- Tubal pregnancy
- Pelvic organ prolapse and urinary incontinence
- Hysterectomy (complete or partial and supracervical)
- Endometrial carcinoma
- Cervical carcinoma
Hysteroscopy is a technique that requires a lot of training and experience. It is performed by inserting a 2-4 millimeter hysteroscope into the uterine cavity through natural access (through the vagina and cervix). The uterine cavity is a virtual cavity, which dilates after being filled with fluid (saline or sugar and alcohol-based solutions). This allows to fully visualize the uterus. Similar to laparoscopy, the image of the uterine cavity is broadcast to the monitor using a video camera with an attached source of light. Diagnostic operations can be performed at an outpatient basis using thin optical hysteroscopes without the need for general anesthesia. The so-called outpatient or office hysteroscopy is most often used to diagnose infertility problems.
Indications for hysteroscopic operations under general anesthesia include
- Polyps removal
- Myomas removal
- Intrauterine adhesions (Asherman's syndrome)
- Complete removal of the endometrium due to a heavy menstrual bleeding (the so-called endometrial ablation)
In addition to the existing advantages of minimally invasive surgical techniques, the patient’s desire to for use of the organ-sparing methods is a priority. Today, myomas can be removed conservatively to preserve anatomical integrity of the uterus, and cysts on the ovaries are removed in a targeted manner in order to preserve the ovarian function.
In summary, we can say that minimally invasive surgery or gynecological endoscopy have proven to be the most important surgical techniques in gynecology. Major abdominal surgeries are no longer in demand, and patients fairly require organ sparing surgeries performed through small incisions. This motto is consistent with the self-consciousness of modern women and women who care for their health.
Goldenes Kreuz Private Hospital
For 100 years, Goldenes Kreuz Private Hospital has been one of Austria’s most renowned private hospitals, located in close proximity of the Vienna University Hospital (AKH). It has distinguished itself through its high standards of medical safety and its dedication to patients’ comfort.
Goldenes Kreuz is the premier provider of gynecological care. It operates the most popular and largest private obstetric clinic in Austria, as well as an internationally certified Breast Health Center.
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