CONSERVATIVE SURGERY OF THE REPRODUCTIVE TRACT

FEMALE

1. Fibroids - Fibroids are generally non malignant overgrowths of the uterine muscle and are sometimes known to cause infertility because of their sheer size, number or location. Such patients may require surgery to remove the fibroids.Endoscopic removal of fibroids is always recommended for superior results.

2. Ovarian cysts - A large fluid filled cyst in the ovary will not only cause pressure symptoms but also hamper normal function of the ovaries which can cause fertility problems, necessitating surgical removal of the cyst, laparoscopic removal again being the method of choice.

3. Polycystic ovaries - In some women, the follicle (egg) manages to grow but is unable to rupture leading to formation of small grape like cysts within the ovary. These cysts contain androgenic hormones impairing fertility. While rupture of the eggs can be induced in some of the women, a segment of these woman may be resistant to the drugs(thick capsule).These women may need surgical drilling of the ovary, where puncture holes are made in both ovaries using monopolar current through the endoscope. Good results are seen following this surgery.

4. Tubal anastomosis - Some women who have bilateral blocked tubes may require a bypass of the block which is done by anastomosing the healthy part of the tube on either side of the block. Using microsurgical techniques always gives better results ,but overall results of anastamosis are poor and with availability of IVF, which give superior results, has led to decline in this surgery.

5. Endometriosis adhesiolysis - Some unfortunate women are prone to a condition called endometriosis where some part of the menstrual blood with the lining of the uterus is pushed into the abdominal cavity. This fluid is highly irritant and causes formation of dense adhesions between the various pelvic organs leading to severe pain during menstruation ,as also pain during sexual intercourse. Extensive endometriosis leads to fertility problems with a poor prognosis for conception. Adhesiolysis ,whereby all the stuck internal organs are separated and anatomic position of the structures restored can temporarily help these patients, but overall results in endometriosis are poor. IVF offers slightly better results for these couples.

6. Uterine septum / Adhesions - Hysteroscopic surgery has transformed the prognosis of patients having intrauterine adhesions and septum's in the uterus. These conditions can now be treated completely with good results for fertility.

7. Canulation of blocked tubes - Sometimes the fallopian tubes may be blocked ,which prevents the meeting of sperm with the egg. Passing a small canula throught the tube under hysteroscopic vision can now be done for such patients with good results, especially in patients with isolated blocks.

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Hysterectomy-Surgery for removal of uterus.

Besides facility services ,we offer all gynaecological endoscopic surgery including total laparoscopic hysterectomy (uterus removal surgery)at our center. Total laparascopic hysterectomy has the advantages (over open surgery ) of shorter hospital stay, faster recovery from surgery and reduced post surgery pain.

We also offer sutureless vaginal hysterectomy and we can proudly say that we are the first center in the country offering this procedure.

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