Information about uterine fibroids
Minimally Invasive Therapy Unit & Endoscopy Training Centre
University Department of Obstetrics and Gynaecology
Royal Free Hospital
Pond Street
London NW3 2QG, UK


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A new website for gynaecologists interested in the surgical management of fibroids is now on line.

Vaginal hysterectomy

Vaginal hysterectomy, as the name suggests, is done through the vagina and leaves no external scars. It is a common misconception that this type of hysterectomy is done using "suction"! It is not. Vaginal hysterectomy is carried out using the same surgical principles as abdominal hysterectomy, the difference being that the surgery starts around the cervix in the vagina rather than the abdomen.

Surgery takes about the same time as abdominal hysterectomy, and the ovaries can be removed if indicated. In contrast, recovery as judged by hospital stay and return to normal activities is generally much faster. In the USA, some gynaecologists are even doing vaginal hysterectomy as a day case procedure!

No external scars
Less chance of complications than laparoscopic hysterectomy
Relatively quick recovery

Not suitable if fibroids are very large
Usually contra-indicated if there is an ovarian cysts, adhesions (scar tissue) or co-existing endometriosis
Subtotal hysterectomy may not be possible

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Laparoscopy is direct visual examination of the inside of the abdomen, using a viewing device that can be passed through a small cut in the abdominal wall. The device, called a laparoscope, usually has fibre-optic illumination and viewing channels. A miniature camera is usually attached to allow the procedure to be monitored on a colour screen.

Laparoscopy can be used by any specialist concerned with disease of the abdominal organs. It is used for diagnosis by general surgeons, and by gynaecologists for the investigation of disorders of the female reproductive organs in the pelvis. It can help to diagnose conditions that are difficult to identify with certainty in any other way short of an exploratory abdominal operation, such as endometriosis and adhesions. With the use of small instruments, laparoscopy can also be used to perform surgery formally done by laparotomy (large incision).