A hysterectomy is a surgical technique that involves the removal of the uterus. The uterus may be removed entirely, including the cervix (total hysterectomy) or leaving the cervix intact (partial hysterectomy).
There are different ways a hysterectomy can be performed:
- Vaginally: surgery is performed through the vagina
- Laparotomically: open surgery by performing either a partial or segmental incision (like a caesarean), depending on the disease.
The way the procedure is performed is based on the disease. A hysterectomy is indicated in women with polimiomatosos uterus, uterine prolapse, polimenorreas, endometrial pathology, etc.
This is a uterine-conserving surgical technique that involves resection of uterine fibroids. The uterus is left intact and this surgery is normally performed on patients who still want to become pregnant or on those patients who have submucosal fibroids that can be resectioned by hysteroscopy.
There are different ways a myomectomy can be performed:
- Hysteroscopically: for submucosal fibroids (those located inside the uterus, the endometrium)
The way the procedure is performed is based on the type of fibroid, number, location and size.
This is an ovary-conserving surgical technique for adnexal masses.
There are different ways a cystectomy can be performed:
The most commonly used procedure is a laparoscopy. It involves the excision of different types of cysts located on the ovaries, leaving most of the ovary intact and functioning. The inside of the ovary is drained and aspirated through an incision in its surface, identify the cyst wall and separating it from the ovarian cortex using forceps. If bleeding is observed during surgery it will be coagulated with bipolar forceps. Laparoscopy is a surgical technique in which the abdominal cavity is filled with CO2 and a trocar is inserted into a 1 cm umbilical incision through which a camera and accessory trocars placed in the iliac fossa will be introduced to perform the procedure.
Tubal occlusion is a permanent contraceptive technique performed on women.
There are two possible procedures:
- Laparoscopic tubal ligation: where we can perform a tubal coagulation and resection or a salpingectomy (excision of the entire fallopian tube)
- Hysteroscopically by using the ESSURE method (a device is inserted vaginally and placed at the entrance of the fallopian to form a barrier)
Uterine prolapse is a condition that significantly affects the quality of life of women and can affect more than 50% of women who have had multiple births. It is the most common reason women have surgery for a benign disease, and it is estimated that the annual incidence of prolapse surgery ranges from 1.5 to 4.9 cases per 1,000 women/year. Prolapse is when the walls of the vagina, bladder, rectum, uterus or all of them together slip forward or down towards the vulva.
Prolapse surgery aims at keeping the organs in their proper position inside the pelvis. The type of surgery will depend on the prolapse itself. Depending on the degree of prolapse we can implant mesh to prevent recurrence.
There are different ways this surgery can be performed:
Many women suffer from urinary incontinence. In Spain it occurs in about 10% of patients aged 25 to 64 years and in over 50% of patients 65 and older. It is defined as the involuntary and frequent loss of urine, enough that the person with this problem suffers social and health issues.
Surgical treatment is usually performed in cases of stress urinary incontinence, and new techniques like transobturator suburethral bands and minislings (Needleless) make it possible to perform this surgery on an outpatient basis.
Retropubic suburethral bands or adjustable devices (Remeex-type slings) may be placed in recurring or more complicated cases.
The cone biopsy is a simple surgical technique that involves removing a cone-shaped sample of abnormal tissue from the cervix using laser or loop diathermy. It is performed as a treatment for precancerous lesions or to obtain a definitive diagnosis in cases of cytohistological discrepancy. It is usually performed under local anaesthesia or sedation. Certain measures must be taken after surgery (relative rest, no bathing) to prevent bleeding and ensure the treated area heals properly.