GYNECOLOGY

MINIMALLY INVASIVE SURGERY OR LAPAROSCOPIC SURGERY

Also called Microsurgery in the layman's term 1 inch cut made at umbilicus and lower abdomen, 3 -4 in number and the entire surgery is done by specialised instruments and laparoscope camera.

DIAGNOSTIC LAPAROSCOPY

Diagnostic Laparoscopy is done to only visualise the abdominal cavity directly to determine cause of chronic abdominal pain, abdominal distension where no other cause can be found through investigations

Operative Laparoscopy

The common surgeries are...

Laparoscopic Hysterectomy

Removal of uterus, Laparoscopic Salpingo oophorectomy (removal of fallopian tubes and ovary) Laparoscopic Ovarian Cystectomy (removal of ovarian cyst)

Laparoscopic Colposuspension surgery

Laparoscopic colposuspension is a procedure to help treat the stress urinary incontinence by lifting and supporting the base of the bladder with stitches.

Laparoscopic Myomectomy

Laparoscopic myomectomy is minimally invasive treatment for patients suffering from fibroids, especially those wishing to maintain their fertility sparing potential.

Excision of Ectopic Pregnancy

Laparoscopic Excision of Ectopic Pregnancy (removal of abnormal pregnancy from fallopian tube)

Benefits of Laparoscopic Surgery

Disadvantage of Laparoscopic Surgery

Disadvantage is that it may require conversion to open surgery if any problems are encountered during Lap surgery like difficulty in visualisation due to adhesions (intestines and other organs adhering to each other) or presence of excessive blood or fluid in abdominal cavity.

HYSTEROSCOPIC SURGERY

A form of Minimally Invasive Surgery where a hysteroscope camera is inserted through the vagina into the uterus to visualise and treat problems inside the uterine cavity.

Diagnostic Hysteroscopy is done in case of heavy or prolonged periods where other tests are inconclusive, to detect any septum , polyp or tumours inside uterus
Operative Hysteroscopy is done to remove any tumour, polyp, septum inside uterus
Hysteroscopic Polypectomy (Removal of Uterine Polyp)
Hysteroscopic Septoplasty (Removal of Uterine Septum)
Hysteroscopic Myomectomy (Excision of Uterine Fibroid)

OPEN GYNAECOLOGICAL SURGERY

Done where laparoscopic surgery is not possible due to type of disease, medical condition of patient.

Common surgeries are...

Abdominal Hysterectomy
Salpingo oophorectomy
Vaginal Hysterectomy
Pelvic Floor Repair
Excision of Tubo ovarian mass
Endometriosis
Ovarian Cystectomy
Myomectomy
Excision of Ectopic Pregnancy
Surgery for Urinary Incontinence (urine leakage)
Gynecological Oncology (Surgery for Carcinoma of uterus, cervix or ovary)

Benefits is that any type of surgery in any type of patient can be done by open technique.

Disadvantages are scarring, more pain, delay in resuming activities and work, chances of hernia

MEDICAL GYNAECOLOGY

A broad term encompassing the Gynecological conditions a woman faces in her lifetime which can be treated medically, some are diseases and others are normal physiological changes.

Common physiological conditions are…

Adolescent Gynecology
Perimenopause,
Post menopausal conditions
Common diseases are PID (Pelvic Inflammatory Diseases or infection of reproductive organs)
DUB (Dysfunctional Uterine Bleeding or Problems with menstrual periods),
PCOS (Poly Cystic Ovarian Syndrome or hormonal disbalance causing tiny cysts in ovary)
Endometriosis

Image GALLERY

TWISTED OVARIAN CYST

It is a complication of Ovarian Cyst where the pedicle (stalk) of the cyst had twisted forming a knot and resulted in necrosis (death) of ovarian tissue and subsequent blackish discolouration of tissue.

DERMOID CYST

A type of ovarian cyst containing hair, teeth. Usually occurs in children and young adults.

OVARIAN CYST

A large ovarian cyst measuring 10cm by 10cm weighing 1.5 kg

ADENOMYOSIS OF UTERUS WITH SIMPLE OVARIAN CYST

A large Adenomyotic uterus with a large simple Ovarian Cyst.

LARGE FIBROID OF UTERUS

UNDERWENT MYOMECTOMY - A large fibroid(tumour) of uterus causing swelling of the abdomen. The fibroid was removed keeping the uterus intact for future pregnancy.

ECTOPIC PREGNANCY

Abnormal pregnancy occurring in left tube with impending rupture. It is an acute Emergency situation needing urgent surgery to remove the ectopic pregnancy. If rupture occurs - the patient may collapse due to severe internal haemorrhage.

LARGE CERVICAL FIBROID

LARGE CERVICAL FIBROID AT LOWER PART OF UTERUS - Underwent Hysterectomy because patient suffered from excessive pain and bleeding.

OVARIAN TUMOR

OVARIAN TUMOR WITH ELONGATED CERVIX WITH PROLAPSED UTERUS - The patient was an elderly lady of 75 years age.

FIBROID POLYP - ENDOSCOPIC VIEW

FIBROID POLYP - Was removed hysteroscopically.

ENDOMETRIAL POLYP - ENDOSCOPIC VIEW

Removed hysteroscopically. This is an important cause of prolonged and heavy flow.

SUBMUCOUS FIBROID

SUBMUCOUS FIBROID OF UTERUS SEEN DURING HYSTEROSCOPY. The opening of the Fallopian tube into the uterus is also seen.

ENDOMETRIOTIC CYST

ENDOMETRIOTIC CYST or CHOCOLATE CYST OF OVARY - containing old blood

EXCISION OF ENDOMETRIOTIC CYST

LAPAROSCOPIC EXCISION OF ENDOMETRIOTIC CYST or CHOCOLATE CYST - Part of the uterus, Fallopian tube and intestines can also be seen.

LAPAROSCOPIC MYOMECTOMY

Removal of fibroid tumor of uterus preserving the uterus. Both tubes and both ovaries are also seen.

LAPAROSCOPIC HYSTERECTOMY

LAPAROSCOPIC HYSTERECTOMY - for fibroid uterus. The uterus with fibroids, part of left ovary and intestines are also seen.

CHAMBERS

KKM LAP LASER SURGICAL CENTER, KOLKATA

Nandan Kanan, Ward Number 109, Opposite Metro Cash & Carry, Beside SBI Branch, Kolkata - 700099
KKM CLINIC, BARDHAMAN

The Arogya, Opposite Bardhaman Nursing Home, 168, R C Das Road, Bardhaman

Appointment

Dr Kajari Mukherjee

Consultant Obstetrician & Gynecologist