Enodoscopic Surgery

Dr.Abhilasha Kumar is one of the best laparoscopic endometriosis treatment or laparoscopic removal of a chocolate cyst in Kolkata West Bengal India.
She is performing Laparoscopic & Hysteroscopic surgeries over last 20 years.

Endometriosis:

Endometriosis (chocolate cysts) is a gynecological condition in which cells from the lining of the uterus (endometrium) appear and flourish outside the uterine cavity, most commonly on the membrane which lines the abdominal cavity, the peritoneum. The uterine cavity is lined by endometrial cells, which are under the influence of female hormones. Endometrial cells in areas outside the uterus are also influenced by hormonal changes and respond in a way that is similar to the cells found inside the uterus. Symptoms of endometriosis are pain and infertility. The pain often is worse with the menstrual cycle and is the most common cause of secondary dysmenorrhea.

Endometriosis is typically seen during the reproductive years; it has been estimated that endometriosis occurs in roughly 6–10% of women. Symptoms may depend on the site of active endometriosis. Its main but not universal symptom is a pelvic pain in various manifestations. Endometriosis is a common finding in women with infertility. Consult with Dr.Abhilasha Kumar Endometriosis specialist in Kolkata for best Laparoscopic Endometriosis treatment in Kolkata India.

 

Signs and symptoms

1) Pelvic pain
• dysmenorrhea – painful, sometimes disabling cramps during menses; pain may get worse over time (progressive pain), also lower back pains linked to the pelvis
• chronic pelvic pain – typically accompanied by lower back pain or abdominal pain
• dyspareunia – painful sex
• dysuria – urinary urgency, frequency, and sometimes painful voiding

2) Infertility
Many women with infertility may have endometriosis. As endometriosis can lead to anatomical distortions and adhesions (the fibrous bands that form between tissues and organs following recovery from an injury), the causality may be easy to understand; however, the link between infertility and endometriosis remains enigmatic when the extent of endometriosis is limited. Infertility specialist in Kolkata may advise Endometriosis surgery in the case of infertility.

3) Other Symptoms

• pain with ovulation
• pain associated with adhesions
• pain caused by inflammation in the pelvic cavity
• pain during bowel movements and urination
• during general bodily movement like exercise
• pain from standing or walking,
• pain with intercourse
• pain is usually with menstruation

Endometriosis is found:

  • Ovaries (the most common site)
    • Fallopian tubes
    • The back of the uterus and the posterior cul-de-sac
    • The front of the uterus and the anterior cul-de-sac
    • Uterine ligaments such as the broad or round ligament of the uterus
    • Pelvic and back wall
    • Intestines, most commonly the rectosigmoid
    • Urinary bladder and ureters

Types of endometriosis

  • Subtle
    • Typical
    • Cystic Ovarian
    • Deep

 

Chocolate cysts of the ovary

Complications of endometriosis:

Infertility
Ruptured cyst

Ruptured cyst

• internal scarring
• adhesions
• pelvic cysts,
• chocolate cyst of ovaries
• ruptured cysts
• bowel and ureteral obstruction resulting from pelvic adhesions
• Infertility

Treatment of endometriosis

Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used first in patients with pelvic pain, particularly if the diagnosis of endometriosis has not been definitively (excision and biopsy) established. The goal of directed medical treatment is to achieve an anovulatory state. Typically, this is achieved initially using hormonal contraception. This can also be accomplished with progestational agents (i.e., medroxyprogesterone), danazol, gestrinone, or gonadotropin-releasing hormone agonists (GnRH), as well as other less well-known agents. These agents are generally used if oral contraceptives and NSAIDs are ineffective. GnRH can be combined with estrogen and progestogen (add-back therapy) without loss of efficacy but with fewer hypoestrogenic symptoms. These medications are often ineffective in treating endometriomas and any relief is short lived while taking the medications. Hormonal treatment has a large number of sometimes permanent side effects, such as hot flushes, loss of bone mass, deepening of the voice, weight gain, and facial hair growth.

Peritoneal endometriosis

Laparoscopic surgical approaches include excision of ovarian adhesions and of endometriomas. Laparoscopic Endometriosis surgery in Kolkata is highly recommended to get rid of the disease and pain relief. This is the surgical removal of Endometriomas. Surgery can sometimes have the effect of improving fertility but can have the adverse effect of leading to increases in cycle day 2 or 3 FSH for many patients. Laser surgery and cauterization are considered to be far less effective and only burn the top layer of endometrial tissue, allowing for the endometrioma and endometriosis to grow back quickly. Likewise, endometrioma drainage or sclerotherapy is a somewhat controversial technique for removing endometriomas with varying degrees of success. Conservative surgery can be performed to preserve fertility in younger patients but as earlier stated can have the effect of raising FSH values and making the ovaries less productive, especially if the functional ovarian tissue is removed in the surgical process. Operative laparoscopic surgery can provide pain relief and improved fertility. Radical surgical options could include singular or bilateral oophorectomy. Radical surgery can be done by an advanced laparoscopic surgeon in Kolkata.Treatment of endometrioma(chocolate cysts of the ovary) is very important for treatment of infertility.early lesions of endometriosis is one of a common cause of unexplained infertility.Diagnostic laparoscopy is the mainstay for confirmation of diagnosis in early lesions for the treatment of endometriosis. Dr. Dr.Abhilasha Kumar can give best infertility solutions in Kolkata.

Hysterectomy

Dr. Abhilasha Kumar is one of the best laparoscopic hysterectomy surgeons in Kolkata and attached with top laparoscopic hospitals in Kolkata West Bengal India.

Dr. Abhilasha Kumar accomplished his Master’s degree (MS) in 1993 from Patna University. Dr. Abhilasha Kumar is also a renowned hysterectomy surgeon in Kolkata. He performs Hysterectomy for fibroids, adenomyosis, & DUB in best laparoscopy hospitals in Kolkata at an affordable cost. He is one of the best laparoscopic hysterectomy surgeons in Kolkata India. He is very expert in doing a laparoscopic hysterectomy in cases like big fibroids, severe endometriosis & difficult hysterectomy cases. He has done more than 1000 hysterectomy cases in different renowned hospitals in Kolkata. He has very good track record in laparoscopic surgery in Kolkata.”

What is Hysterectomy?

Hysterectomy is a procedure (operation) performed for removal of the uterus (womb) It is the most common surgery performed by gynecologists. Hysterectomy can only be performed when future childbearing is not desired by the patient. If you have more question consult with Hysterectomy surgeon in Kolkata Dr. Abhilasha Kumar. What are the indications [reasons] for performing this procedure? This procedure can be performed for women with any of the below-mentioned problems like

 

Hysteretomy
Uterine Fibroids
Hysteretomy

Fibroid uterus: Fibroids can be symptomatic leading to excessive periods or pressure symptoms.If not treated fibroids can become very big and can lead to ureter (tubes carrying urine from kidney to bladder) & kidney damage.

Adenomyosis: This condition leads to heavy prolonged periods and severe pain during periods.

DUB: This condition leads to heavy prolonged or irregular menstrual problems which if not responsive to tablets (drug treatment) or other small surgical procedures like TCRE and may then need a hysterectomy. According to the condition, the doctor may advise Hysterectomy for fibroids, adenomyosis, & DUB in Kolkata.

Prolapse of the uterus: This condition is very commonly present in our Indian population. The uterus descends down into the vagina and is felt as a mass vaginally.

Pelvic Inflammatory Disease / Chronic Pelvic Pain: These conditions are present as a result of repeated infections and these conditions may also need a hysterectomy.

Uterine / Cervical / Ovarian Cancer: Cancers are now becoming increasingly common but the life expectancy and quality of life can both be improved when a complete surgical removal of these cancers is done with minimal cancer tissue being left behind. In several studies, it is now proved that a complete removal of cancer tissue is done when the surgery is performed through Laparoscopic hysterectomy in Kolkata.

Which route of hysterectomy should a patient choose?

There are 3 Routes by which a hysterectomy can be performed

1) Abdominal 2) Vaginal 3) Laparoscopic

1) Open Abdominal Hysterectomy is now considered to be an obsolete procedure which should be abandoned.

2) Vaginal hysterectomy is chosen for patients who have a prolapse of the uterus. In places where facilities for a laparoscopic surgery are not available a vaginal hysterectomy can be performed.

Laparoscopic Hysterectomy: – This is the most preferred route for performing this surgery, the entire abdomen can be inspected with the laparoscope and any other pathology (diseases) present can be handled at the same time Also the availability of new equipment like Harmonic Scalpel has made this surgery a very quick and painless surgery. There is minimal blood loss (less than 50ml) during this procedure, there is minimal pain following this procedure, hospital stay for this procedure is only for 1 day, and also patient can return to work within 3-4 days, postoperative problems like pain during intercourse, are less with this procedure, there is less chance of formation of a hernia after this procedure since a very small scar (1cm) is formed after this procedure. You want to know more about Laparoscopic Hysterectomy you can ask laparoscopic hysterectomy surgeon in Kolkata Dr. Abhilasha Kumar for further explanations.

Myth Buster Myth

Ovaries are routinely removed at the time of hysterectomy leading to menopausal symptoms and weak bones (Osteoporosis) after hysterectomy.

Fact

Ovaries are not removed at the time of hysterectomy unless
1) Any ovarian disease is present along with the uterine disease for which hysterectomy is being performed.
2) Or if a family history of ovarian or breast cancer is present in the patient’s family.

Myomectomy

Dr.Abhilasha kumar famous for Myomectomy surgery in Kolkata. Specialist in the Laparoscopic removal of uterine leiomyomas, also known as fibroids.

 

“Dr.Abhilasha kumar is one of the leading Infertility & fibroid specialist performing Myomectomy surgery in Kolkata. If you are looking for fibroid treatment in Kolkata, contact Dr. Abhilasha kumar to get relief from your sufferings. Dr.Abhilasha kumar provides the best uterine fibroid treatment and Fibroid uterus surgery in Kolkata for every patient.”

Myomectomy, sometimes also fibroidectomy, refers to the surgical removal of uterine leiomyomas, also known as fibroids. In contrast to a hysterectomy, the uterus remains preserved and the woman retains her reproductive potential. When Myomectomy is required: The presence of a fibroid does not mean that it needs to be removed. Myomectomy surgery is necessary when the fibroid causes pain or pressure, abnormal bleeding, or interferes with reproduction. The fibroids needed to be removed are typically large in size or growing at certain locations such as bulging into the endometrial cavity causing significant cavity distortion. Patients have many options in uterine fibroids treatment in Kolkata, including observation, medical therapy (such a GNRH agonists), Laparoscopic hysterectomy in Kolkata, uterine artery embolization, and high-intensity focused ultrasound ablation. Despite these many options, the surgical approach of selected fibroid removal remains an important choice for those women who want or need to preserve the uterus.

Methods of Myomectomy
  • Hysteroscopy, which involves inserting a lighted viewing instrument through the vagina and into the uterus.
  • Laparoscopy, which uses a lighted viewing instrument and one or more small cuts (incisions) in the abdomen.
  • Laparotomy, which uses a larger incision in the abdomen.

Dr.Abhilasha kumar Myomectomy surgeon in Kolkata can explain if you want to know more.
Myomectomy surgeries are done by Dr.Abhilasha kumar

Methods of Myomectomy depend on:

  • Size
    • Location
    • Number of fibroids
    • Hysteroscopy can be used to remove fibroids on the inner wall of the uterus that has not grown deep into the uterine wall.
    • Laparoscopy is usually reserved for removing one or two fibroids, up to about 2 in. (5.1 cm) across, that are growing on the outside of the uterus.
    • Laparotomy is used to remove large fibroids, many fibroids, or fibroids that have grown deep into the uterine wall.
    • Need to correct urinary or bowel problems. To repair these problems without causing organ damage, laparotomy is usually needed.

After Surgery: The length of time you may spend in the hospital varies.

  • Hysteroscopy is an outpatient procedure.
    • Laparoscopy may be an outpatient procedure or may require a stay of 1 day.
    • Laparotomy requires an average stay of 1 to 4 days.
    • Recovery time depends on the method used for the myomectomy: • Hysteroscopy requires from a few days to 2 weeks to recover.
    • Laparoscopy requires 1 to 2 weeks.
    • Laparotomy requires 4 to 6 weeks.

Why it is Done:

Myomectomy surgery in Kolkata preserves the uterus while treating fibroids. It may be a reasonable treatment option if you have:
• Anemia that is not relieved by treatment with medicine.
• Pain or pressure that is not relieved by treatment with medicine.
• A fibroid that has changed the wall of the uterus. This can sometimes cause infertility or repeat miscarriages. Before an in vitro fertilization, myomectomy is often done to improve the chances of pregnancy.

How well it works:

Myomectomy surgery decreases pelvic pain and bleeding from fibroids.

Pregnancy:

Myomectomy is the only fibroid treatment that may improve your chances of having a baby. It is known to help with a certain kind of fibroid called a submucosal fibroid. But it does not seem to improve pregnancy chances with any other kind of fibroid.2 After myomectomy, a cesarean section may be needed for delivery. This depends in part on where and how big the myomectomy incision is.

Uterine Fibroids

Fibroids return after surgery in 10 to 50 out of 100 women, depending on the original fibroid problem. Fibroids that were larger and more numerous are most likely to recur.3 Talk to your doctor about whether your type of fibroid is likely to grow back.

Risks may include the following:

  • Infection of the uterus, fallopian tubes, or ovaries (pelvic infection) may occur.
  • Removal of fibroids in the uterine muscle (intramural fibroids camera.gif) may cause scar tissue.
  • In rare cases, scarring from the uterine incision may cause infertility.
  • In rare cases, injuries to the bladder or bowel, such as a bowel obstruction, may occur.
  • In rare cases, uterine scars may break open (rupture) in late pregnancy or during delivery.
  • In rare cases, a hysterectomy may be required during a Myomectomy.

This may happen if removing the fibroid causes heavy bleeding that cannot be stopped without doing a hysterectomy surgery in Kolkata.

Hysteroscopy Surgery

Dr, Abhilasha Kumar best Hysteroscopy surgeon in Kolkata West Bengal India. Specialist in treatment of Hysteroscopic Surgery both Diagnostic and Surgical.
“Dr, Abhilasha Kumar is the member of Indian Association of Gynaecological Laparoscopists (IAGE) and provides Infertility treatment for blocked fallopian tube (Hysteroscopic tubal cannulation) and Hysteroscopic polyp, myoma septum resection in Kolkata for patients suffering from Polyps and fibroids, Septums and Abnormal bleeding”
Hysteroscopy is a procedure that allows gynecologist in Kolkata to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

Diagnostic hysteroscopy is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG). HSG is an X-ray dye test used to check the uterus and fallopian tubes. Diagnostic hysteroscopy can many times be done in an office setting.

Additionally, hysteroscopy can be used with other procedures, such as laparoscopy, or before procedures such as dilation and curettage (D&C). In laparoscopy, Gynaecology doctor in Kolkata Dr, Abhilasha Kumar will insert an endoscope (a slender tube fitted with a fiber optic camera) into your abdomen to view the outside of your uterus, ovaries and fallopian tubes. The endoscope is inserted through an incision made through or below your navel.

What is operative hysteroscopy?

Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.

When is operative hysteroscopy used?

 

Senior gynecologist in Kolkata Dr, Abhilasha Kumar may perform a hysteroscopy to correct the following uterine conditions:

Polyps and fibroids — Hysteroscopy is used to remove these non-cancerous growths found in the uterus.

Adhesions — Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions.

Septums — Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth.

Abnormal bleeding — Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.

Polyphysteroscopy

What are the benefits of hysteroscopy?

Compared with other, more invasive procedures, hysteroscopy may provide the following advantages:

  • Shorter hospital stay
    • Shorter recovery time
    • Less pain medication needed after surgery
    • Avoidance of hysterectomy
    • Possible avoidance of “open” abdominal surgery

How safe is hysteroscopy?

Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1 percent of cases and can include:

  • Risks associated with anesthesia
    • Infection
    • Heavy bleeding
    • Injury to the cervix, uterus, bowel or bladder
    • Intrauterine scarring
    • Reaction to the substance used to expand the uterus

When should the procedure be performed?

Famous gynecologist in Kolkata Dr, Abhilasha Kumar may recommend scheduling the hysteroscopy for the first week after your menstrual period. This timing will provide the gynecology doctor in India Dr, Abhilasha Kumar the best view of the inside of your uterus. Hysteroscopy is also performed to determine the cause of unexplained bleeding or spotting in postmenopausal women.

What type of anesthesia is used for hysteroscopy?

Anesthesia for hysteroscopy may be local, regional, or general:
Local anesthesia –the numbing of only a part of the body for a short time
Regional anesthesia –the numbing of a larger portion of the body for a few hours
General anesthesia –the numbing of the entire body for the entire time of the surgery
The type of anesthesia used is determined by where the hysteroscopy is to be performed (hospital or doctor’s office) and whether other procedures will be done at the same time. If you are having general anesthesia, you will be told not to eat or drink for a certain amount of time before the hysteroscopy.

How is hysteroscopy performed?

Prior to the procedure, Obstetrician doctor in Kolkata may prescribe a sedative to help you relax. You will then be prepared for anesthesia. The procedure itself takes place in the following order:

Renowned gynecologist in Kolkata Dr, Abhilasha Kumar will dilate (widen) your cervix to allow the hysteroscopy to be inserted. The hysteroscopy is inserted through your vagina and cervix into the uterus.

Carbon dioxide gas or a liquid solution is then inserted into the uterus, through the hysteroscopy, to expand it and to clear away any blood or mucus.

Next, a light shone through the hysteroscope allows your doctor to see your uterus and the openings of the fallopian tubes into the uterine cavity.
Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.

The time it takes to perform hysteroscopy can range from less than 5 minutes to more than an hour. The length of the procedure depends on whether it is diagnostic or operative and whether an additional procedure, such as laparoscopy, is done at the same time. In general, however, diagnostic hysteroscopy takes less time than operative.

What can I expect after the procedure?

If regional or general anesthesia is used during your procedure, you may have to be observed for several hours before going home. After the procedure, you may have some cramping or slight vaginal bleeding for one to two days. In addition, you may feel shoulder pain if gas was used during your hysteroscopy. It is also not unusual to feel somewhat faint or sick. However, if you experience any of the following symptoms, be sure to contact best gynecologist doctor in Kolkata:

  • Fever
    • Severe abdominal pain
    • Heavy vaginal bleeding or discharge

Will I have to stay in the hospital overnight?

Hysteroscopy is considered minor surgery and usually does not require an overnight stay in the hospital. However, in certain circumstances, such as if your doctor is concerned about your reaction to anesthesia; an overnight stay may be required.

Who is a candidate for this procedure?

Although there are many benefits associated with hysteroscopy, it may not be appropriate for some patients. Gynecological surgeon in Kolkata will consult with your primary care physician to determine whether it is appropriate for you.