Surgical Procedures/Operations

Abdominal Surgery

Abdominal surgery is a surgical operation that is performed via the abdominal wall on the organs that are found in the abdomen. The surgery may be on any of these organs like stomach, gallbladder, small intestine, etc. Abdominal surgery is performed because of infection, appendicitis, tumours, hernia repairs, or inflammatory bowel and is usually done under general anaesthetic. There two types of abdominal surgeries, the open incision (longer wound) and laparoscopic surgery (small wound) little telescope with a camera attached.

Hernia repairs

A hernia is a defect in a structure through which its contents may protrude Hernia repair is a surgical operation for the correction of a hernia (a bulging of internal organ or tissues through a defect in the wall of a body cavity, more often the abdomen).

Indirect Hernia;

            A congenital defect in that a person is born with it

            May not appear to be present for many years

Direct Hernia;

Usually acquired

Common types of Hernias;

            Inguinal hernia, femoral hernia, umbilical hernia or the site of a previous operation

            May not appear to be present for many years

Incidents;

2/3 are Indirect

1/3 are Direct

20% are bilateral (both sides)

Males, 20:1 Females

60% on the right side, 20% on the left side

Surgical treatment of hernias (Open or Laparoscopic);

Tension-free repair using mesh products

Suture in flat pieces of special polypropylene mesh

Suture in a special polypropylene mesh plug

Surgical Procedures/Operations

Women specific Surgical procedures

Common Gynaecological surgeries (Open or Laparoscopic)

Hysterectomy

A hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries, fallopian tubes and other surrounding structures. It can be performed via the vagina of via the abdomen.

A hysterectomy may be total, removing the body, fundus, and cervix of the uterus or partial, removal of the uterine body only.

Oophorectomy (removal of ovaries) is frequently done in addition to the hysterectomy to decrease the risk ovarian cancer. However, recent studies have shown that prophylactic oophorectomy without an urgent medical indication decreases a woman's long-term survival rates substantially and has other serious adverse effects.1 This effect is not limited to pre-menopausal women; even women who have already entered menopause were shown to have experienced a decrease in long-term survivability post-oophorectomy.2

1."Prophylactic oophorectomy in premenopausal women and long-term health". Menopause International 14 (3): 111–116.doi:10.1258/mi.2008.008016. PMC 2585770. PMID 18714076

2.Shoupe, D.; Parker, W. H.; Broder, M. S.; Liu, Z.; Farquhar, C.; Berek, J. S. (2007). "Elective oophorectomy for benign gynecological disorders". Menopause 14 (Suppl. 1): 580–585.doi:10.1097/gme.0b013e31803c56a4

Vaginal/Pelvic Floor Repairs

A vaginal repair is a surgical procedure for women who have a prolapse of one or both vaginal walls. A prolapse is a protuberance in the vagina caused by a weakness in its supporting structures (when the sling of muscles that supports your bladder, bowel and vagina has slipped or descended). It may involve the uterus alone, the vagina alone, or both the uterus and the vagina.

It is occasionally performed to treat stress incontinence when there is significant prolapse. This procedure is done by making an incision in the vaginal wall and suturing the tissue supporting the vagina closer together to decrease the protrusion in the vaginal wall.

There are three common types of vaginal prolapse: cystocele (protrusion in front wall), rectocele (protrusion in back wall) and enterocele (the small intestine protrudes through the rectum). The type of prolapse will determine the type of procedure required.

Vaginal surgery is performed for prolapse or urinary incontinence or both. The mode of repair will use either the patient’s own tissues or Mesh or both. Mesh is used to strengthen the repair and reduce the risk of your prolapse recurring. This mesh generally provides a longer lasting repair. It’s a flexible, lightweight synthetic material used for this purpose and also in hernia repairs. It has many holes to allow your own tissues to grow into it. It offers a framework for support of the organ or organs that have prolapsed.

Reference

Journal of the American Medical Association
Source reference: Iglesia CB "Pelvic organ prolapse surgery: Long-term outcomes and implications for shared decision making" JAMA 2013; 309(19): 2045-2046