Endoscopic surgery, which is described as closed operations, is also used extensively in gynecological diseases. Gynecology and Obstetrics Specialist Prof. Dr. Gazi Yıldırım said that closed operations are preferred with patients because they have more advantages compared to open surgeries and provide more comfort for the patients as well.

Closed methods are used in many problems and treatments, from fibroids, which are very common among women, to cancers of female reproductive organs, from ovarian cysts to infertility treatment. Moreover, the advantages of these procedures make closed operations the primary preference in the treatment of problems that require surgical intervention.

According to the information provided by Prof. Dr. Gazi Yıldırım, Yeditepe University Kozyatağı Hospital Gynecology and Obstetrics Specialist, endoscopic surgeries in women are generally divided into two categories as laparoscopy and hysteroscopy. In laparoscopy, surgery is performed by observing the inside of the abdomen with a camera inserted through a 1 cm cut on the navel, or two or three incisions of 0,5 cm on the lower abdomen, without the need for larger incisions.

LAPAROSCOPY IS THE FIRST OPTION FOR MANY OPERATIONS

Prof. Dr. Gazi Yıldırım explained about the areas where laparoscopy can be applied: “Laparoscopy is the primary choice in the treatment of chronical abdominal pain as well as opening or tying the tubes that carry eggs from female reproductive organs, removal of ovarian cysts (ovarian cyst surgeries) or ectopic pregnancy surgeries. In addition, for the treatment of female infertility and chocolate cyst disease (endometriosis), endoscopical methods are the primary choice for cleaning chocolate cysts and endometriosis nodules. Removal of myomas, which are benign tumors of the uterus, or removal of the uterus and ovaries, prolapse of the uterus, bladder and the sagging of the rectum from the vagina, which we call pelvic organ prolapse, as well as stress urinary incontinence operations can also be successfully performed using closed techniques. Being the most extreme case in this field, for cancer surgeries in female reproductive organs, endoscopical methods are now the first choice for the operation.”

Gazi Yıldırım continued his words: "With laparoscopy, surgeries to be performed by opening the abdomen can now be conducted, so laparoscopy is a much more preferred method due to being less risky". Prof. Dr. Gazi Yıldırım continued his words as follows: “The gains of this method result from the much smaller incisions in the skin. Major surgeries including cancer and uterus can be performed through the small holes opened.” Stating that while there was a belief in the past that a great surgeon would make a big incision, this perception has been reversed today, Prof. Dr. Gazi Yıldırım claimed that it is possible to achieve great results with a small incision as a result of special education. Reporting that the operational scale of endoscopical operations is the same with open surgeries, Prof. Dr. Yıldırım emphasized the importance of the following regarding the gains of the patient: “Following this procedure, the patient experiences less pain, stays in the hospital for a less time, goes back to his job earlier and it is considerably advantageous in an aesthetic sense. With the daily developments in technology, smaller and pliable telescopes are started to be used in endoscopical surgeries and this enabled us to conduct surgeries without anaesthesia.”

 

HISTEROSCOPY IS USED FOR BOTH DIAGNOSIS AND TREATMENT

Hysteroscopy is the evaluation of the part of the uterus and tubes opening into the uterus, called the ostium, by entering through the cervix with a millimeter-thick optical system mounted as a diagnostic or therapeutic camera. This procedure can be performed for both diagnosis (diagnostic hysteroscopy) and treatment (operative hysteroscopy) of intrauterine anomalies. The doctor prescribes open or closed surgery according to his patient’s needs. Informing that anyone whose general condition is suitable for operation can be performed laparoscopy and hysteroscopy, Prof. Dr. Gazi Yıldırım said, “Laparoscopy may not be preferred for those who have a heart or lung condition that would posess a problem for the procedure, as the patient is in a headfirst position during the procedure. Closed operations are also not preferred for those with diaphragm and hernia problems, those with very large and multiple fibroids, and for women with ovarian cancer.”

FASTER HEALING

Emphasizing once again that recovery in closed surgeries can be faster than open surgeries, Yeditepe University Hospital Gynecology and Obstetrics Specialist Professor Dr. Gazi Yıldırım continued his words as follows after stating that the patient is taken to his room after observing the patient until the effects of anaesthesia wears off: “For about 4-6 hours nothing is given orally and serum treatment is applied. It would be appropriate to have a catheter in the urinary tract for 4-6 hours until standing up. The patient stays in the hospital for 1, sometimes 2 days. "

TIMING IS IMPORTANT IN ENDOSCOPIC OPERATIONS

Emphasizing that the timing is critical for endoschopic surgeries, Prof. Dr. Gazi Yıldırım also said, “If our patient is in the fertile age, the appropriate time for the procedure is the period just after the end of the order and before the ovulation time. Timing is very important in order for the image taken during hysteroscopy to be accurate. For those who are in climacterium, the action can be carried out any time”.

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