Gynecological Surgery: What is it?

What is Gynecological Surgery?

Before we jump into the nitty-gritties of the various surgical procedures discussed under the collective heading of the term gynecological surgery, we must define the term first. Gynecological surgery, in simpler words, refers to surgical procedures performed on female reproductive system parts[i]. Parts, here, refer to the vagina, cervix, uterus, fallopian tubes, and ovaries. However, gynecological surgeries are a little more complex than the simplified version of events that you just read. More often than not, gynecological surgeries involve procedures on a female’s urinary tract as well.

We are cognizant of the fact that while this introduction does help in familiarizing one with the concept of gynecological surgery, it is nowhere near enough in terms of adequacy. Hence, to cover all the important aspects related to these surgeries, we are going to discuss them one by one in the following sections.

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Preparation 

Preoperative preparations vary, concerning different surgeries of gynecological surgeries. However, there are a few preparatory activities common to every surgery of this nature, and is these that we briefly talk about in this section. Well, the first step in this chain of events is, of course, the consultation with the gynecologist. Then, a general examination is ordered, followed by a series of blood and urine tests. Consultation with specialists is the next step, which is important since how the surgery should be conducted is decided in this consultation. Risk evaluation is the final step before things move towards the OT. Anesthesia, antibiotic therapy are the key procedures to be taken care of before initiating the surgery itself[ii].

How is it done?

A question for which answer differs from one surgery to another! However, mostly, gynecological surgeries are laparoscopic surgeries by nature. What does that mean? It means that the surgeon can use a laparoscope to examine the internal situation, and then, perform the required surgical procedure without opening up the body. A laparoscope is a surgical instrument through which abdominal and pelvic structures can be observed[iii]. To insert a laparoscope, a small incision is made in the abdomen. These incisions are still smaller in diameter as compared to the ones made during open surgery. Hence, because of lower infection risk and a faster recovery rate, laparoscopic surgeries are preferred over open surgeries. Other surgeries have their own set of protocols to be followed.

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Common gynecological surgeries

In the following sections of this discussion, we are going to talk about some common gynecological surgeries, briefly.

1-Colposcopy

Colposcopy is a procedure used to view the uterus and vaginal opening. Magnification of images is the primary goal of colposcopy. If tissue samples are taken for examination in the lab, then the procedure is termed as a cervical biopsy. Colposcopy is mostly prescribed to assist in the treatment of polyps, genital warts, and DES[iv].

2-D&C

This is an abbreviation for dilation and curettage, a surgical procedure used to remove abnormal tissues found in the uterus region. As you might have guessed from the term, the first step in this surgical procedure is that of dilation of the cervix. In the next step, your surgeon will use a spoon-shaped tool to scrape out the endometrium. Endometrium, in case you are not aware, is the medical term used for uterus lining. Alternatively, D&C suction can also be used to remove the abnormal contents[v].

3-Hysteroscopy

This is a gynecological surgery type in which the uterus is removed. However, the scope of the surgery is not limited to the uterus only. Ovaries as well as fallopian tubes can also be removed through a hysterectomy. The reasons because a hysterectomy might be prescribed are numerous. Some common reasons for this gynecological surgery are fibroids, endometriosis, uterine bleeding, and uterine prolapse.

4-Trachlectomy

This is a surgical procedure in which a part of the cervix but not the entire uterus is removed. In the radical version of the surgery, surrounding tissues are removed as well[vi].

5-Colporrhaphy

In this type of gynecological surgery, the vaginal wall is repaired surgically. It is one of the more common gynecological surgeries since the procedure is an effective one in the treatment of hernias.

Benefits 

Specific benefits of gynecological surgeries vary with the type, but one doesn’t need to jump into the nitty-gritties of every gynecological surgery to understand the benefits on offer. Firstly, gynecological surgeries are super effective in preventing the spread of tumors and cancers. Secondly, these surgical procedures are also effective in alleviating pain, as well as in the treatment of conditions like urinary incontinence. And lastly, laparoscopic procedures are quite a handful, when it comes to the diagnosis of gynecological issues.

Side effects

It is important to discuss the risks involved in gynecological surgery as well. Yes, there is an element of risk involved as well! The major risk is, of course, bleeding. However, that is not all. Damage to the uterine wall, urinary tract, an allergic reaction because of the anesthesia, and risk of infection are equally important concerns. Preoperative and postoperative minor discomforts like nausea, bellyache, and difficulty in going to the bathroom cannot be ignored also.

Follow-up

It is becoming a bit of a redundant answer, but the follow-up treatment of each surgical procedure is quite different. For example, if gynecological surgery is aimed at removing a tumor of cancerous nature, then chemotherapy will be the most probable route to follow. It is the physician’s word that matters the most, so we will not waste your time with the details that don’t matter at this point for you.  

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Conclusion

Even though these surgeries are effective, gynecological surgeries should be the last option in the list of choices. A gynecological surgery will be prescribed only when the conservative treatment options have been exhausted. The word surgery is fearful for many, hence, exploring other treatment options first is essential. But if one is left with a surgical option only, then there are a couple of important points that must be kept in mind. One, you should still not ignore the risks. And second, choose the best surgeon in the town only! 

References

[i] https://www.sciencedirect.com/topics/medicine-and-dentistry/gynecological-surgery

[ii] https://publisher.medfak.ni.ac.rs/AFMN_1/2011/2-2011/9.pdf

[iii] https://www.healthline.com/health/laparoscopy

[iv] https://www.urmc.rochester.edu/ob-gyn/gynecology/procedures.aspx

[v] https://www.urmc.rochester.edu/ob-gyn/gynecology/procedures.aspx

[vi] https://emedicine.medscape.com/article/2046552-overview