Gynecologic surgery

The Gynecologic Surgery service offers all the surgical procedures that can be performed on an outpatient basis. The service is closely connected to the clinic’s Gynecology department, which is aimed to identify the causes of pelvic pain or abnormal uterine bleeding and directs the patient to surgery when necessary.

Surgery

MediClinic Gynaecological Surgery adopts the best minimally invasive techniques, which allow the health-care provider to cause the least possible pain and discomfort the patient. Generally, the discharge is expected after 4-6 hours from the surgery and the resumption of normal activities within 7-15 days.

Laparoscopic myomectomy

Fibroids or myomas are solid, nodular, benign formations of the muscular wall of the uterus; they are very frequent in women of perimenopausal age. Removal is recommended when symptoms such as uterine bleeding, signs of compression on neighbouring organs, abdominal swelling and persistent pelvic pain are present.

The surgery consists in introducing an optical probe (surgeon’s eye) through a small incision at the navel level and then another 2-3 skin incisions, between 0.5-1 cm, to introduce mini surgical instruments. Subsequently, the section of the myometrial tissue overlying the myoma is performed, until the myomatous node is found and thus enucleated. The uterus is sutured and finally the nodular tissue fragments are extracted. Duration of the surgery: 60-90 minutes.

Ovarian cyst

It is a common benign pathology in women: in fertile age, only the cyst is removed, while in menopausal age, the entire pathological ovary is removed.

Once the laparoscopic optic has been introduced, the surgery consists in delicately incising the ovarian tissue right above the cyst, which is then exported. The residual ovarian tissue is sutured while preserving the ovarian reserve as much as possible.

Endometriotic ovarian cyst

Endometriosis is an inflammation of the endometrium, a mucous membrane that covers the uterine wall, and is accompanied by significant pain. The endometriotic lesion is surgically removed only in cases of the woman’s infertility or pelvic pain resistant to the hormonal or anti-inflammatory therapy.

Removal of the endometrioma restores the normal functionality of the ovary, leads to a considerable relief of pelvic pain and the success rate of a future pregnancy is over 55%. After the cyst is removed, the ovarian bed is sutured and laparoscopic cromosalpingography is then performed to check the morphology, patency and functionality of the salpinges. Mobilising the ovary is sometimes necessary, as is finding the underlying ureter and performing an ureterolysis (less than 1% of the cases).

Pelvic adhesions

Surgery is the only solution to the adherence syndrome: at MediClinic a laparoscopic adhesiolysis is performed, which allows sectioning the adhesions and unblocking the bowel obstruction. The instruments for the surgery are introduced through 2-3 abdominal mini-incisions, which are useful to explore the abdominal cavity in detail and, finally, to section the adhesions. In 1/3 of the patients the post-surgical adhesions are particularly significant with intestinal occlusion and need therefore a re-hospitalization. The aim is to restore an anatomical-functional environment of the genital organs as normal as possible.

Female infertility

A woman is unfertile when she is unable to conceive or has had repeated abortions. A hysteroscopy is preferred to investigate the causes of this clinical condition. It allows examining the internal environment of the uterus to exclude lesions such as polyps, myomas, uterine septa, or other inflammatory lesions. It also enables the morphological evaluation of the tubal hosts. This investigation is always followed by an endometrial biopsy to evaluate the inflammation of the mucosa.

At the same time, the laparoscopy, together with the cromosalpingography, is performed to explore the internal genital organs and evaluate the morphology and functionality of both the ovaries and the salpinges. The surgery is performed under general anaesthesia and it lasts about 15-30 minutes.

Hysteroscopy

Hysteroscopy is a diagnostic technique performed in an outpatient basis without the need of anaesthesia. The hysteroscope is an instrument equipped with a camera that allows exploring the uterine cavity accurately which is inserted into the vaginal cavity. Thanks to a jet of water and saline that helps relaxing the uterine canal, it is able to reach the cavity and transmit images on a high definition screen. About 1-3 minutes are sufficient for the investigation.

Through the so-called “operative” hysteroscopy – for which the patient needs to be sedated – it is also possible to carry out surgical procedures such as the removal of uterine neoformations: fibroids or submucous myomas, polyps, intrauterine adhesions and uterus septa. Duration of the surgery: 5-20 minutes. The newly removed neoformations can then be examined at the MediClinic Analysis Laboratory, which will provide the histopathological diagnosis in a few days.

Laparoscopy

When the endoscopic access does not guarantee excellent surgical results, procedures can be performed laparoscopically, through some incisions in the abdomen. Laparoscopic access allows the specialist to reach the internal organs of the pelvic area with ease and reducing traumas of the superficial tissues, therefore it is considered a very effective minimally invasive approach. However, not all laparoscopies can be performed on an outpatient basis. From time to time, the surgeon will consider the opportunity to undergo laparoscopic surgery at the clinic, provided that discharge within a few hours of surgery without overnight stay does not present a risk for the patient. Whenever possible, this method is certainly effective and safe, especially if performed by competent and higly experienced surgeons.

Urinary incontinence treatment

Urinary incontinence treatment has evolved a lot in recent years, thanks to an integrated approach that includes medical therapy, physiotherapy and surgery. MediClinic offers the most effective procedures currently available for the resolution of stress urinary incontinence, which according to recent statistics, is successful in 90% of cases. This minimally invasive procedure lasts about 30 minutes and is performed under local anesthesia. The surgeon performs some incisions at the level of the inguinal fold or, according to a new technique, a single incision at the vaginal level. A small biocompatible prosthesis is positioned through the holes to support the urethra during the physical effort that causes incontinence. The effectiveness of the procedure is proven, in addition, patients can resume normal work approximately one week after surgery.

Diagnostics

Before surgery, the MediClinic specialists might request the patient to undergo to an in-depth diagnostic analysis, performed according to the principles of minimal invasiveness and maximum accuracy. The timeliness and correctness of the diagnosis are in fact the first step for overcoming or correctly managing the condition also from the surgical point of view. MediClinic provides patients with the most modern investigation techniques and technologies available.

• In this context, the Gynecology clinic offers the following services:
• Gynecological and obstetric consult
• Pelvic ultrasound (transabdominal and transvaginal)
• Vaginal cytology (Pap-smear)
• Colposcopy
• Sonohysterogram
• Diagnostic hysteroscopy

Why choose MediClinic?

The facility provides state-of-the-art diagnostic equipment. Specialists apply the most effective techniques for the diagnosis and treatment, based on the latest and most solid scientific evidence.

MediClinic is equipped with two modern operating theaters of about 40 square meters provided with the most sophisticated equipment. Thanks to the innovative use of technology and the adoption of modern organizational protocols, patient safety is maximized.

The operating block is also provided with a special preparation and awakening room, where the patient is followed by dedicated personnel and monitored in the immediate post-surgery period before being transferred from the operating block to the post-operative observation area.
The post-operative area has four postoperative observation rooms and a room with two armchairs for patients undergoing day hospital procedures that do not require prolonged postoperative assistance.

The organizational model of the facility encourages the collaboration between professionals, so that patients are followed as accurately as possible. For those who face gynecological conditions and undergo surgical procedures, a variety of professionals are available, from the Psychologist to the Dietician, who can concretely help the patient to promptly achieve a state of well-being.