Gynecologic surgery

Removal of the uterus: hysterectomy

Hysterectomy involves the removal of the uterus when it carries fibroids that greatly hinder the patient through pain and/or bleeding. This radical solution is often proposed for patients who no longer wish to have children.

Hysterectomy is also proposed for the treatment of cervical, endometrial and certain forms of ovarian cancer.

How is the surgery performed?

It can be carried out:

• through the natural ways, which leaves no apparent scar;
• by coelioscopy, through the wall of the abdomen (without visible scars);
• by laparotomy.

Is this a painful procedure?

Thanks to a powerful analgesic treatment (Lyrica®), the aftermath is generally comfortable. With current surgical techniques, the procedure is no longer known to be very painful.

Myomectomy

It is the surgical removal of uterine fibroids, leaving the uterus in place, by coelioscopy or through the abdomen.

What is a fibroid?

Fibroids are benign tumors that develop in the wall of the uterus. In the majority of cases, they do not cause any discomfort or symptoms, so they remain “silent” until menopause.

In other cases, they can lead to heavy periods, bleeding between periods, pain in the lower abdomen, more frequent urination, difficulty in getting pregnant or special risks for pregnancy.

How can fibroids be treated?

The choice of treatment depends on many factors: the importance of symptoms, the number and location of fibroids, the desire for pregnancy, age, etc.

Coelioscopy

It is a surgical technique that allows surgeons to operate inside the belly through small incisions. It is preferred for surgery inside the abdomen.

How is a coelioscopy performed?

Under general anesthesia, tubes are passed through small incisions in the skin. Through these tubes, all kinds of instruments can be passed:

• a camera that allows you to see on a screen what is inside the belly;
• scissors, pliers, needle holders and spreaders.

What is the difference between diagnostic and surgical coelioscopy?

Diagnostic coelioscopy makes it possible to look for an abnormality that cannot be detected by other means. As its name indicates, this procedure is only diagnostic.

Surgical coelioscopy is used in particular for the treatment of:

• an extra-uterine pregnancy;
• an ovarian cyst;
• endometriosis.

Why is coelioscopy preferred to the classic opening of the belly?

• Aesthetic advantage.
• Precision of the gesture.
• Less painful procedure.
• Simpler post-operative course.
• More limited infectious risks.

Hysteroscopy

Hysteroscopy consists in exploring the interior of the uterus using an endoscope. The uterine cavity is dilated with physiological serum.

Diagnostic hysteroscopy

It makes it possible to visualize the uterine cavity and take samples. The small size of the device used makes it possible, most often, to perform this examination without anesthesia.

You can follow the exam on a control screen. The hysteroscope is introduced by natural means, without a speculum. There is no need to fast. The exam lasts less than 10 minutes and a sample of the mucosa can be taken.

Surgical hysteroscopy

It is a surgical procedure that makes it possible to treat, using tiny instruments, abnormalities located inside the uterus (polyps, fibroids, adhesions called synechiae, mucosal abnormalities, malformations, etc.).

Organ descent surgery (prolapse cure)

What is an organ descent?

A genital prolapse (or organ descent) is an abnormal downward displacement of one or more organs of the pelvis. There are several kinds of organ descent depending on the organ(s) affected.

What are the causes?

It is favored by vaginal births and certain personal predispositions, but also by everything that significantly increases the pressure in the abdomen: jobs where you often carry heavy loads, constipation, etc.

What are the operating techniques?

Three approaches can be used: opening the abdomen (laparotomy), coelioscopy and through the vagina (vaginal approach). In some cases, prostheses can be used.