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Tab 1

Diagnostic Laparoscopy

Diagnostic laparoscopy is a procedure that allows a doctor to look directly at the contents of the abdomen or pelvis.

How the Test is Performed

The procedure is usually done in the hospital or outpatient surgical center under general anesthesia (while you are asleep and pain-free).

The procedure is performed in the following way:

• The surgeon makes a small cut (incision) below the belly button.
• A needle or hollow tube called a trocar is inserted into the incision. Carbon dioxide gas is passed into the abdomen through the needle or tube. The gas helps expand the area, giving the surgeon more room to work, and helps the surgeon see the organs more clearly.
• A tiny video camera (laparoscope) is then placed through the trocar and is used to see the inside of your pelvis and abdomen. More small cuts may be made if other instruments are needed to get a better view of certain organs.
• If you are having gynecologic laparoscopy, dye may be injected into your cervix so the surgeon can view the fallopian tubes.
• After the exam, the gas, laparoscope, and instruments are removed, and the cuts are closed. You will have bandages over those areas.

How to Prepare for the Test

Follow instructions on not eating and drinking before surgery.

You may need to stop taking medicines, including narcotic pain relievers, on or before the day of the exam. DO NOT change or stop taking any medicines without first talking to your health care provider. Follow any other instructions for how to prepare for the procedure.

How the Test will Feel

You will feel no pain during the procedure. Afterward, the incisions may be sore. Your doctor may prescribe a pain reliever.

You may also have shoulder pain for a few days. The gas used during the procedure can irritate the diaphragm, which shares some of the same nerves as the shoulder. You may also have an increased urge to urinate, since the gas can put pressure on the bladder.

You will recover for a few hours at the hospital before going home. You will probably not stay overnight after a laparoscopy.

You will not be allowed to drive home. Someone should be available to take you home after the procedure.

Why the Test is Performed

Diagnostic laparoscopy is often done for the following:

• Find the cause of pain or a growth in the abdomen and pelvic area when x-ray or ultrasound results aren't clear.
• After an accident to see if there is injury to any organs in the abdomen.
• Before procedures to treat cancer to find out if the cancer has spread. If so, treatment will change.

Normal Results

The laparoscopy is normal if there is no blood in the abdomen, no hernias, no intestinal obstruction, and no cancer in any visible organs. The uterus, fallopian tubes, and ovaries are of normal size, shape, and color. The liver is normal.

What Abnormal Results Mean

Abnormal results may be due to a number of different conditions, including:

• Scar tissue inside the abdomen or pelvis (adhesions)
• Appendicitis
• Cells from inside the uterus growing in other areas (endometriosis)
• Inflammation of the gallbladder (cholecystitis)
• Ovarian cysts or cancer of the ovary
• Infection of the uterus, ovaries, or fallopian tubes (pelvic inflammatory disease)
• Signs of injury
• Spread of cancer
• Tumors
• Noncancerous tumors of the uterus such as fibroids


There is a risk for infection. You may get antibiotics to prevent this complication. There is a risk of puncturing an organ. This could cause the contents of the intestines to leak. There may also be bleeding into the abdominal cavity. These complications could lead to immediate open surgery (laparotomy).

Diagnostic laparoscopy may not be possible if you have a swollen bowel, fluid in the abdomen (ascites), or you have had a past surgery.

Tab 2


What is tubectomy? Tubectomy, also known as tubal sterilization, is a continual method of contraception in women. It is a healing process that blocks the fallopian tubes, through preventing the egg released by the ovary from reaching the uterus.

Implications for Tubectomy Tubectomy is shown when a woman who doesn’t wish to imagine in the future voluntarily requests this strong method of sterilization.

A woman counting permanent sterilization through the tubectomy ought to consider the following points: .Ideas for wanting to opt for permanent sterilization
.Whether tubal ligation is the most suitable option for her
.Side effects, dangers and difficulties associated with the system.
.Whether other methods of contraception might be further suitable

Technique Tubectomy is a main surgical method in which the fallopian tubes are cut open and trimmed or tied up to prevent the portion of the egg into the uterus.

Procedure Several small surgeries are made around the belly button. A telescopic tool known as a laparoscope is implanted through one of the cuts. There is a petite camera at the top of the laparoscope which broadcasts images to a screen, presenting the surgeon with a view of the interior organs. Guided by the images and going through the tiny holes, the surgeon injects special instruments to seal the devices by making parts of them or by checking them using clips.

Different methods Bipolar coagulation- Electric current is utilized to harden parts of the fallopian tubes.
Monopolar coagulation- The tubes are hardened using electric current. A radiating course is also used to further damage them.
Tubal clip- The fallopian tunnels are blocked by permanently cutting them or joining them together.
Tubal Ring- The tube is tied utilizing a band.
Fimbriectomy- In this method, a part of the fallopian tube is separated from the ovary. This forms a gap, impeding the capacity of the tube to take eggs and transport them to the uterus.

Recovery Patients will be discharged on the same day after the tubectomy.
However, after experiencing the surgery, one may expect:
Pain and illness in the first four to eight hours
Abdominal pain and cramps Fatigue Dizziness

Stitches are taken out regularly after a week or ten days. It is also important to understand the surgeon for a follow-up check-up after six weeks.

Care to be taken after tubectomy It is important to follow the surgeon’s opinion about keeping post-surgery. Some suggestions include:
Strenuous exercise should be evaded for about a week.
Work may be returned within a few days.
Abstain from sex for a week after the tubectomy.
Pain medicine can help manage pain.
Make sure to consult the doctor if you endure high fever, bleeding from the cut, fainting spells, etc.

Tubectomy is a significant surgery that’s constant and not without its set of risks. Hence it is necessary to receive aid and support the surgery of under-qualified doctors only at trusted gynecology hospitals.

Tab 3

Ovarian Cyst

Ovaries are the part of the female reproductive system which is located in the lower abdomen of the female body on both sides of the uterus. Women have two ovaries that produce eggs as well as the hormones known as estrogen and progesterone.

Sometimes we observe a fluid-filled sac known as a cyst that will develop on any one of the ovaries. Most of the women will develop at least one cyst during their lifetime. These cysts stay painless and have no indications.

Types of ovarian cysts

Follicle cyst During the women's menstrual cycle, at least one egg grows in a sac called a follicle. This is located inside the ovaries. In most of the cases, this follicle or sac breaks its shell or opens up to release an egg. But if the follicle does not break open, the fluid which presents inside the follicle can form a cyst on any of its ovary.

Corpus luteum cysts A follicle sac typically dissolves or melts after releasing its egg. But if the sac does not dissolve and then the opening of the follicle seals, then it this point additional fluid can develop inside the sac and this leads to accumulation of fluid which causes a corpus luteum cyst. Other types of ovarian cysts include:

Dermoid cysts: sac grows on the ovaries that can also contain hair, fat, and other tissues. Cystadenomas: noncancerous growths that can also develop on the outer surface of the ovaries Endometriomas: tissues that grow normally inside the uterus can also develop outside the uterus and attach to the ovaries which results in the formation of a cyst Some women can also suffer from a condition called polycystic ovary syndrome. This condition refers to ovaries that contain a large number of small cysts. It can cause the ovaries to enlarge from its initial size. If it is not treated at the beginning stage then those polycystic ovaries can cause infertility.

Ovarian cysts do not show any symptoms. But symptoms can appear when cyst starts growing. Those symptoms may include:
· abdominal bloating or swelling
· painful bowel movements
· pelvic pain throughout the menstrual cycle
· painful intercourse
· pain in the lower thighs
· breast tenderness
· nausea and vomiting
Intractable symptoms of an ovarian cyst that need immediate medical attention include:
· severe or sharp pelvic pain
· fever
· faintness or dizziness
· rapid breathing

Ovarian cyst complications Most of the ovarian cysts are naturally go away on their own without any treatment. But in a rare case, your doctor may detect some cancerous cystic ovarian mass during its routine examination.

Ovarian torsion is another rare complication of an ovarian cyst. This is when a large cyst creates an ovary to twist or leave from its original position. Blood supply to the ovary glands is cut off, and it can cause damage or death to ovarian tissue. Although the uncommon, the ovarian torsion accounts for almost 3 percent of emergency gynecologic surgeries. Ruptured cysts are also rare, which can cause intense pain and internal bleeding. This complication increases your risk of an infection and can be life-threatening if it is not treated well.

Diagnosing the ovarian cyst The doctor can detect an ovarian cyst during their routine pelvic examination. They may publish like a swelling one of your ovaries and order an ultrasound test to authenticate the presence of a cyst. An ultrasound test is an imaging test that uses a high-frequency sound wave to produce an image of your internal organs. Ultrasound tests help you to determine the size, location, shape, and composition of a cyst.

Imaging machines used to diagnose ovarian cysts include: CT scan: a body imaging device which is used to create cross-sectional images of internal organs
MRI: a test which uses magnetic fields to produce in-depth images of internal organs
Ultrasound device: an imaging device which is used to visualize the ovary

Treatment for an ovarian cyst Your doctor may recommend you for treatment to shrink or remove the cyst if it does not feed away on its own or if it grows larger.
· Birth control pills
· Laparoscopy
· Laparotomy

Ovarian cyst prevention Ovarian cysts cannot be prevented. However, routine gynecologic examinations can detect or determine ovarian cysts early.

Tab 4


Myomectomy is the surgical method to remove the uterine fibroids. These common noncancerous tumors appear in the uterus. Uterine fibroids normally develop while childbearing years, but they can also occur at any age.

The surgeon's main purpose during the myomectomy is to take out the symptom that is causing fibroids and reconstruct the uterus once again. Unlike hysterectomy, which will help in removing the entire uterus, a myomectomy removes only the fibroids and leaves your uterus and does not harm it.

Women who undergo myomectomy improves in fibroid symptoms, including a decrease in heavy menstrual bleeding and pelvic pressure.

Why is it done The doctor might recommend myomectomy for the fibroids causing symptoms that are painful or intervene with the normal activities also. If you need surgery, Below are reasons to choose a myomectomy
• You have to plan to bear children
• The doctor suspects uterine fibroids might be intervening with the fertility.

What can someone expect Depending upon the size, number and location of the fibroids, the surgeon might choose one of three surgical approaches to perform myomectomy. Abdominal myomectomy In this, the surgeon makes an open abdominal cut to access the uterus and remove the fibroids. The surgeon will generally prefer to make a low, horizontal cut, if possible. Vertical incisions are usually needed for larger uteruses.

Laparoscopic or robotic myomectomy In this, both minimally invasive procedures, the surgeon accesses and removes the fibroids through several small abdominal cuts. Compared with women who have laparotomy, women who undergo laparoscopy will have less blood loss, shorter hospital stays and faster recovery, and a low rate of complications and adhesion development after the surgery. There are limited comparisons between the laparoscopic and robotic myomectomy. Robotic surgery may take quite long and might be more costly, but otherwise there are few differences in outcomes that are reported.

Laparoscopic myomectomy. The surgeon makes only a small cut near the bellybutton. Then he or she inserts a laparoscope, a narrow tube fitted with the camera into the abdomen. The surgeon performs the surgery with instruments inserted through other small cuts in the abdominal wall.

Robotic myomectomy. The surgeon inserts instruments through the small cut similar to those in the laparoscopic myomectomy and then controls the movement of the instruments from the separate console. Few surgeons are now performing single cut laparoscopic and robotic myomectomies.

Hysteroscopic myomectomy To treat smaller fibroids that swell significantly into the uterus, the surgeon may suggest the hysteroscopic myomectomy.
A hysteroscopic myomectomy will follow this process:
• The surgeon will insert a small, lighted instrument through the vagina and cervix and into the uterus.
• A clear liquid that is a salt solution, is inserted into the uterus
• The surgeon shaves pieces from fibroid using the resectoscope, taking out the pieces from the uterus until the fibroid is eliminated. Sometimes large fibroids cannot be fully removed in one surgery, then the second surgery is needed.

• Symptom relief. After surgery, most women experience relief from bothersome symptoms, like excessive menstrual bleeding and pelvic pain and pressure.
• Fertility improvement. Women who undergo laparoscopy with or without robotic assistance will have good pregnancy outcomes within or about a year of surgery. After the myomectomy, the suggested waiting time is three to six months before attempting the conception to allow your uterus time to heal.

Tab 5

Ectopic Pregnancy

Generally Pregnancy starts by a fertilized egg. Normally, the fertilized egg connects to the wall of the uterus. An ectopic pregnancy occurs when a fertilized egg implants and develops outside the main cavity of the uterus.

An ectopic pregnancy most often transpires in a fallopian tube, which carries eggs from the ovaries to the uterus. This kind of ectopic pregnancy is also called tubal pregnancy. Sometimes, an ectopic pregnancy occurs in distinct areas of the body like in the ovary, abdominal cavity or the lower part of the uterus , which connects to the vagina.

An ectopic pregnancy can not proceed normally. The fertilized egg can not grow, and the developing tissue may cause life-threatening bleeding, if it is left untreated.

Causes The tubal pregnancy is the common type of ectopic pregnancy that happens when a fertilized egg gets attached on its way to the uterus, usually because the fallopian tube is destroyed by inflammation or is distorted. Hormonal imbalances or irregular development of the fertilized egg also might play a part.

Risk factors Fascinating Things that make you have an ectopic pregnancy are:

Inflammation or infection. Sexually transmitted germs, such as gonorrhea or chlamydia, can cause inflammation in the tubes and other nearby organs, and increase your risk of an ectopic pregnancy.

Fertility treatments. Some study recommends that women who have in vitro fertilization (IVF) or related treatments are more likely to have an ectopic pregnancy. Infertility itself may also inflate your risk.

Tubal surgery. Surgery to help in a closed or damaged fallopian tube can increase the risk of an ectopic pregnancy.

Choice of birth control. The chance of getting pregnant while using an intrauterine device (IUD) is unique. However, if you do get pregnant with an IUD in place, it's more apt to be ectopic. Tubal ligation, a continual method of birth control commonly known as "owning your tubes tied," also increases your risk, if you become pregnant after this procedure.

Smoking. Cigarette smoking before you become pregnant can grow the risk of an ectopic pregnancy. The more you smoke, then the greater will be the risk.

Complications An ectopic pregnancy can create a fallopian tube to burst open. Without the treatment, the ruptured tube can lead to life-threatening bleeding.

Prevention There is no way to block an ectopic pregnancy, but here are few ways to reduce your risk:

Restricting the number of sexual partners and utilizing a condom during sex supports to prevent sexually transferred infections and decrease the risk of pelvic inflammatory disease.
Don't smoke. If you do, stop before you strive to get pregnant.

Tab 6


Fallopian tube recanalization is the nonsurgical process to clear the blockages in fallopian tubes, part of the woman’s reproductive system. What are the fallopian tubes?

The fallopian tubes are essential for female fertility. They are the passageways for eggs to move from the ovaries to the uterus. During conception:
1. The ovary releases one egg, which will travel into the fallopian tube.
2. Sperm will go into the fallopian tubes to fertilize that perticular egg.
3. The resulting embryo is supported and moved to the uterus where the pregnancy resumes.

A common problem of female impotence is a blockage of the fallopian tubes, normally as the result of debris that has grown up. Occasionally, cutting from surgery or severe infection can lead to blockage as well.

Procedures Details Infertility is described as the inability of a couple to conceive after one year of unprotected sex. The other common cause of infertility is blocked in the fallopian tube. Till recent times this problem has required microsurgery and outcomes after the surgery was never good. Over recent times interventional radiology procedures have been increased to remove these blocks. The method is done below mild sedation and the patient is discharged after a few hours.

Fallopian tubes are fine tiny tubular structures that join the uterus to the ovary. Once the ovum is mature it travels along the fallopian tube and here that fertilization will take place. Thus the block in these tubes makes fertilization difficult.

These blocks can be secondary to an infection such as tuberculosis or mucous plug. If it is the mucous plug, then removing this block can be easily be achieved by passing the flexible soft wire through the blocked segment into it.

The procedure is usually performed on the eighth, ninth or the 10th day of a woman’s menstrual cycle. This is to allow the pregnancy to take place in the first cycle following the recanalization.

This procedure involves passing a small tube into the uterine cavity through the vagina. This may cause slight discomfort. Through the case another smaller tube is moved into the uterine cavity and the opening to the fallopian tube intubated with the help of the guidewire. A quick injection of variation is built into the opening to flush out the trash if present. If this procedure crashes then the blocked segment is gently manipulated with a guidewire and the block will be removed.

Recanalization of these tubes is successful in upto 90% of the patients who are present with corneal blocks. Blocks in the other parts of the fallopian tube are secondary to infection and cannot be cleared at all. It is also necessary to understand that fallopian tubes might have disease outer usually due to adhesions. These must be ruled out by the laparoscopy before the patient is taken up for fallopian tube recanalization.

Close to 40% of the patient’s who undergo the successful tubal recanalization conceive within the first 6 months only. However, it is important that the male partner is fully investigated and all the abnormalities are to be corrected before this procedure is taken up. Tubes that have been recanalized might close again also sometimes and then the procedure can be repeated again.

Following this procedure the patient may have light cramps and slight bleeding for a few days. But all the patients are encouraged to resume their normal activities and have a normal sexual relationship with the husband.

Tab 7


A hysterectomy is an advanced surgery to remove the woman's uterus (i.e., women’s womb). A uterus is a place in a woman's body where a baby grows when she is pregnant. During the process of surgery the whole uterus is completely removed and can also remove your fallopian tubes and ovaries. After the hysterectomy surgery, you no longer have your menstrual periods and cannot become pregnant in your lifetime.

Discuss with your doctor before ensuring the surgery and their options. For example, if both ovaries are entirely removed, you may have symptoms of menopause. Discuss with your doctor about the risks and benefits of removing ovaries. You may also look for an alternative to hysterectomy if you feel it risky, you can go with options like proper use of medicine or another type of treatment.


Uterine fibroids: These are noncancerous growths beside the wall of the uterus. In some women they can notice the cause of pain or heavy bleeding.
Heavy or unusual vaginal bleeding. Hormonal changes may cause infection, cancer, or fibroids can cause prolonged bleeding.
Uterine prolapse: this happens when the woman's uterus slips down from its place into the vagina. This is a common problem in women who had several vaginal births, but it can also be observed after menopause or because of being overweight or obesity. Prolapsed can lead to urinary and bowel problems according to pelvic pressure.
Endometriosis: This happens when the tissue that develops on the walls of the uterus grows outside of the uterus on the ovaries glands. This can cause severe pain and bleed at the time of periods.
Adenomyosis. This happens when the tissue that develops on the walls of the uterus grows outside of the uterus on the ovaries glands where it doesn't belong. The uterine walls turn thick and cause severe pain and heavy bleeding. Cancer of the uterus, ovary, cervix, or endometrium Hysterectomy may be the better option if you have cancer in one of these areas. Hysterectomy is major surgery. Discuss with your doctor about all the treatment alternatives.

DIFFERENT TYPES OF HYSTERECTOMIES: A complete hysterectomy eliminates the whole uterus, including the cervix. The ovaries and the fallopian tubes are not sure that it may be removed.
A partial or subtotal or supracervical hysterectomy eliminates just the upper part of the uterus.
A radical hysterectomy defeats the entire uterus, cervix, the tissue on both surfaces of the cervix, and the uppermost part of the vagina.