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Total Laparoscopic Hysterectomy proves to be a boon for the physically challenged lady

Our patient, Baljinder Kaur, who has been suffering from polio since childhood, leaving her severely physically disabled and an abnormally narrow pelvis, was suffering from heavy vaginal bleeding with clots and pain every month.

She was diagnosed to have large uterine fibroids. It was a distressing condition for her as she could not even lie down straight or move around on her own; leave aside take care of her painful heavy vaginal bleeding every month. She needed a hysterectomy.

Doing an abdominal hysterectomy would have led to a large abdominal incision with very difficult painful period of post operative care, besides chances of wound infection, incisional hernia development. She underwent Total Laparoscopic Hysterectomy at IVY Hospital, with tiny ½ to 1 cm incisions, and minimal post operative pain.

The Advanced laparoscopic surgery was performed by Dr. Raman Singla, Head, Deptt. Of Minimal Access Surgery and Dr. Rimmy Singla, Consultant Gynaecologist, IVY Hospital.

To quote another similar example from our series, Mrs. Sharma was miserable for last few years – heavy periods, lots of cramping. She had large multiple fibroids (largest measuring 10 cm) in her uterus, causing distressing bleeding and serious discomfort. She had earlier undergone Caesarean section. She needed a hysterectomy, she was told.

She had earlier been advised that abdominal hysterectomy was the best option — “so that one could see everything clearly,” she told. That involves a big incision in the abdomen, about five to seven days in the hospital, and nearly two months of recovery.

“I didn’t like the idea of abdominal surgery,” she says. “I am a house wife with a nuclear family, and a kid at home. I knew I needed to be up and about to take care of my home. I didn’t have time for the six- to eight-week recovery.” She had not forgotten the post operative agony of her previous Caesarean Section.

That’s when she got a second opinion, which resulted in a Total Laparoscopic Hysterectomy, by Dr. Raman Singla, at IVY Hospital. It left almost no scar, and she had minimal downtime.”One day later, I pretty much walked out of the hospital,” she says. “By the second day, I felt wonderful. I didn’t have the miserable pain.”

Laparoscopic Hysterectomies

Total Laparoscopic Hysterectomy is a form of minimally invasive surgery that allows the surgeon to view the internal organs through a camera attached to a telescope through very tiny incisions. Laparoscopic surgery is used in Gallbladder, Hernia and Appendectomy surgeries, and has been adapted to surgeries in other fields also.

While upwards of 80% of all hysterectomies are abdominal surgeries, they could well be done as laparoscopic hysterectomies, doctors say.

The trend is indeed moving in that direction – and the patient’s recovery is the biggest reason. There’s a shorter hospital stay and recovery, compared to abdominal surgery, so return to normal activity is much quicker.

Hysterectomy Recovery: A Quick Comparison

It’s easy to see why women opt for laparoscopic hysterectomy. Why suffer with a big incision if you don’t have to? Why have a month or more downtime if it’s not necessary? Compare the three options available:

* The standard abdominal hysterectomy is major surgery with a big belly incision, and a slow, painful recovery. Approximate recovery time: Six to eight weeks.

* The laparoscopic-assisted vaginal hysterectomy, or LAVH – Only women with a relatively small fibroid, small uterus, and no previous caesarean sections can have this. Approximate recovery time: Two weeks.

* The total laparoscopic hysterectomy, TLH – even in patients with large fibroids, previous Caesarean sections – involves only small “keyhole” incisions, often made in the navel or abdomen. Approximate recovery time: One to two weeks.

Earlier laparoscopic-assisted vaginal hysterectomy (LAVH), which debuted in the late 1990s, was the commonly performed procedure. But total laparoscopic hysterectomy is a much newer concept – with the first cases performed in 2005.

The Pros and Cons of Total Laparoscopic Hysterectomy

Nearly any woman is a good candidate for total laparoscopic hysterectomy – ones with larger uterus, whether she has had a caesarean section or not, patients with endometriosis, etc.

The incisions are smaller (1/2 to 1 cm) and much less uncomfortable than that of abdominal hysterectomy. Also, the hospital stay of 1-2 days and the ability to resume normal activity in about 2 weeks are substantially shorter than for abdominal hysterectomy.

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PCOS & Recurrent IVF Failure Evening Clinic

Research shows at least 1 in 10 females of reproductive age meet measures for the diagnosis of polycystic ovarian syndrome (PCOS), and many of them first progress signs in adolescence. The implications of this disease cover beyond the noticeable physical signs of increased body hair, acne and irregular menstrual cycles to include long-term risks of cardiometabolic disease and infertility.

Sensitive, multidisciplinary care at the Singla Mediclinic Evening PCOS Clinic

“We’re impending diagnosis and treatment from the Infertility perspective,” says Dr. Rimmi Singla (Senior Consultant Laparoscopic Gynaecologist & Obstetrician, IVF& Infertility Specialist)Director cum In charge –Ivy test Tube Baby Center, Ivy Hospital, Mohali.

An emphasis on nutrition is central since two-thirds of patients are overweight. “The importance is on a healthy diet — favoring vegetables, fruits, whole grains, and lean meats, decreasing sugar and junk foods — and working portion control as well as regular physical exercise,” Dr. Rimmi Singla says. It is now well documented that even in the nonappearance of obesity, women with PCOS are at increased risk of metabolic problems that can lead to infertility & cardiac disease. Thus, another significant factor of clinical care includes periodic screening for metabolic complications and age-appropriate treatment and preventive strategies. Unnecessary hair growth on face and body, carried on by excess androgen is a main concern for girls with PCOS. While moderating hormones through oral contraceptives, spironolactone, and metformin can decrease hair growth, they do not remove hair already on the face, chest, abdomen and back.

Woman/Girls with PCOS can suffer from low self-confidence as well as nervousness and depression due to the frustrating physical symptoms, excess weight, and long-term concerns for fertility and health.

To help minimal the effects of PCOS, try to:

  • Maintain a healthy weight. Reduce loss can reduce insulin and androgen levels and may reinstate ovulation. Ask your doctor about a weight-control program, and meet frequently with a dietitian for help in reaching weight-loss goals.
  • Eat less carbohydrates. Low-fat, high-carbohydrate diets might increase insulin levels. Your doctor can guide you about a low-carbohydrate diet if you have PCOS. Choose complex carbohydrates, which increase your blood sugar levels more slowly.
  • Be energetic. Workout helps lower blood sugar levels. Patient of  PCOS, joining in a regular exercise program may treat or even prevent insulin resistance and help you keep your weight under control and avoid emerging diabetes.

Finding it hard to see a doctor during the day. Visit our, evening clinic for the treatment of PCOS , treatment of recurrent miscarriage, Infertility on every Wednesday and Thursday at  #2747, sector 70 from 4pm to 6:30pm.
Let us solve your problem with our expertise. Dr. Rimmi Singla is a renowned and an eminent Gynaecologist, Infertility Specialist, laparoscopic surgeon. For queries contact on 9815500448 and 9815507974

You can also visit our website http://infertilitychandigarh.com and follow us on Google Plus, Instagram Facebook, Twitter and YouTube for the latest blog on fertility issues.

Categories  #ivf, IVF treatment, #ICSI,#IUI, #Surgical – Azoospermia / #TESA, #PESA, #MESA, #Micro #TESA, #Stem Cell Therapy

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Ensure Pregnancy through Egg-freezing

The role of the mother, giving birth to a child is considered a sense of completeness for many women in their life. In this regard, age plays a very important role in fertility and pregnancy. A woman’s fertility peaks in her early and mid-twenties, after which it starts declining.

 

Women are born with their unique life time supply of eggs, which is fixed and declines with age. When a woman reaches her late 30’s, the remaining eggs have less potential for fertilising and establishing a healthy pregnancy. The advanced egg age leads to increased risk of miscarriage and infertility. Beyond 35 years of age, a lot more eggs become genetically abnormal, leading to a failure of treatment, and hence there are high chances of abortion, congenital malformation.

A decline in fertility peaks at 20-25 years, it declines by 10% 25-30 years, by 30% at 30-35 and by 50% at 35-40 years.

 

The fecundity of women decreases gradually, but significantly from approximately 32 years and decreases more rapidly after 37 years, reflecting primarily as a decrease in egg quality.

 

An age increases, the risks of other disorders that may adversely affect fertility, such as leiomyomas, tubal disease, and endometriosis, also increases. Women with a history of prior ovarian surgery, chemotherapy, radiation therapy, severe endometriosis, smoking, pelvic infection, or a strong family history of early menopause may be at an increased risk of having a premature decrease in the size of their follicular pool, and hence a decline in fertility.

Education and enhanced awareness regarding the effect of age on fertility is essential in counselling patients who desire pregnancy. if there is need to delay child bearing, you can go for embryo egg freezing through fertility preservation. This will ensure that when you decide to become pregnant, their healthy eggs can be fertilised clinically. Otherwise once age sets in, you will have to rely on egg donation. It is important to remember that the biological clock cannot wait, and you need to take a wise decision regarding pregnancy before it is too late, considering the factor of age the resultant physiological condition of your body.

 

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You can also visit our website http://infertilitychandigarh.com and follow us on Google Plus, Instagram Facebook, Twitter and YouTube for the latest blog on fertility issues.

Categories  #ivf, IVF treatment, #ICSI,#IUI, #Surgical – Azoospermia / #TESA, #PESA, #MESA, #Micro #TESA, #Stem Cell Therapy