Reproductive surgery

In females, reproductive surgery mainly employs two minimally invasive techniques, laparoscopy and hysteroscopy, though open surgery might be needed in some cases. The decision to choose laparoscopy over non-surgical treatment or abdominal surgery is made on a case-by-case basis. It requires an in-depth consultation between the patient and the treating physician and risk/benefit analysis. Sometimes, even though some surgical interventions could be performed laparoscopically, open surgery is the better option (for example, treating an endometriotic lesion involving the bowel). In other cases, laparoscopy is the preferred technique (for example, tubal reconstruction). Your treating consultant will decide which approach works best in your case.

Laparoscopy is an inspection of the abdominal cavity, which is done to diagnose or treat many conditions of various organs, including pelvic organs such as the ovaries, the uterus and the fallopian tubes. If, however, an inspection of the inside of the uterus is required, a hysteroscopy needs to be done. Both techniques can be combined in one session if necessary.

Office hysteroscopy and laser office hysteroscopy are also available at Nadezhda hospital. Office hysteroscopy is a minimally invasive procedure carried out in an outpatient setting without anaesthesia, which uses a mini-camera to inspect the female genital tract – vagina, cervix, cervical channel, uterine cavity, as well as tubal patency.

Besides diagnosis, the technique is also used for surgical treatment in various indications such as polyp or myoma removal, adenomyosis, or biopsy in suspect malignant findings in the uterine cavity.

Laser office hysteroscopy is also a minimally invasive procedure, employing a diode laser to remove uterine polyps and fibroids surgically. Diode laser in minimally invasive surgery has numerous advantages for the patient – less pain, less blood loss, faster recovery, and no complications risk. The procedure is done in the office setting, without general anaesthesia.

In the males, reproductive surgery is considered when there are no spermatozoa in the ejaculate. Possible methods include TESE – testicular sperm extraction and PESA – percutaneous epididymal sperm aspiration.