Gynecologic Laparoscopy
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Gynecologic Laparoscopy
Information, Resources & Education for Husbands

What is Gynecologic Laparoscopy?

Gynecologic laparoscopy is performed by a gynecologist or uro-gynecologist and is a group of minimally invasive surgical procedures on the female reproductive organs, that involves the use of a small camera, which is used for the doctor to observe the woman's reproductive organs as well as perform surgical procedures. Gynecologic laparoscopy is performed as an alternative to open surgery, which usually involves greater risk for complications.

How is the Gynecologic Laparoscopy procedure performed?

Gynecologic laparoscopy is usually performed in the hospital and under general anesthesia. A small catheter is inserted through the woman's urethra into the bladder. A small incision is made either above or below her navel to allow the insertion of a tube called a trocar, which allows for the passage of the tiny video camera, which is placed where the doctor needs to observe her, uterus, fallopian tube(s), ovary/ovaries, bladder, or otther pelvic organs he needs to observe.  Before the insertion of the trocar, a needle is inserted into the incision and carbon dioxide gas is injected to elevate the abdominal wall, which creates a larger space for the doctor to work in, and allows for easier viewing and manipulation of the female reproductive organs.

The laparoscope is then inserted so that the organs of the pelvis and abdomen can be examined. Additional small incisions are made for instruments that allow the surgeon to move organs, cut tissue, suture, and staple structures as needed to safely and effectively perform the procedure.

Following the examination, the laparoscope is then removed, the incisions are closed with sutures, and bandages are applied. Depending upon the operation performed, a drain may be left through one of the incisions to allow for drainage of accumulated fluid.

How to prepare for the Gynecologic Laparoscopy procedure:

Always follow your doctor's specific directions. This usually includes the following:

You are not to eat or drink for 8-12 hours before the procedure.

How the Gynecologic Laparoscopy will feel:

You will probably be under general anesthesia, and won't feel anything while the procedure in taking place.  After the procedure, the incisions may be slightly painful, and your doctor will provide you with a pain reliever.  

If your doctor prefers to perform the Gynecologic Laparoscopy using local anesthesia, as opposed to general anesthesia, you may feel a prick and/or a burning sensation when the anesthetic is given. 

After the procedure, there may be some pain at the incision site(s) after the procedure. The carbon dioxide gas used to inflate your pelvic area may cause irritation in your diaphragm, which shares some of the same nerves as the shoulder. You may also experience an increased urge to urinate, since the carbon dioxide gas may place pressure on your bladder.

Depending on the type of gynecologic laparoscopy being performed, your doctor may advise you to avoid eating and drinking for a period of time after the procedure. There is usually one or more follow-up doctor visits for the doctor to observe your incision(s) and determine how you feel and whether the gynecologic laparoscopy procedure was successful. 

What is Gynecologic Oncology?

Gynecologic oncology is an area of medicine and oncology that specializes in cancers of the cervix, fallopian tubes, ovaries, uterus, vagina, and vulva (including the labia.

What is Vulvar Cancer?

Vulvar cancer is cancer that is found in and on the vulva. 

Estimated new cases and deaths from vulvar cancer in the United States in 2006 are: 

New cases: 3,740.
Deaths: 880.

Vulvar cancer is primarily a disease of elderly women but has been observed in premenopausal women as well. It is most commonly squamous cell carcinoma in type, although other histologic types do occur. Vulvar cancer is highly curable when diagnosed in an early stage.

Survival is most dependent on the pathologic status of the inguinal nodes. In patients with operable disease without nodal involvement, the overall survival rate is 90%; however, in patients with nodal involvement, the overall 5-year survival rate is approximately 50% to 60%.

Risk factors for node metastasis are clinical node status, age, degree of differentiation, tumor stage, tumor thickness, depth of stromal invasion, and presence of capillary-lymphatic space invasion.

Overall, about 30% of patients with operable disease have nodal spread. A multifactorial analysis of risk factors in squamous vulvar cancer demonstrated that nodal status and primary lesion diameter, when considered together, were the only variables associated with prognosis. Patients with negative inguinal nodes and lesions no more than 2 cm had a 98% 5-year survival rate, while those with any size lesion with 3 or more unilateral nodes or 2 or more bilateral nodes had a 29% 5-year survival rate. Intermediate groups with intermediate survival were also identified. These discriminants were most useful within FIGO stage III disease. 

In many cases, the development of vulvar cancer is preceded by condyloma or squamous dysplasias. The prevailing evidence favors human papillomavirus (HPV) as a causative factor in genital tract carcinomas. The labia majora is the most common site of involvement and accounts for about 50% of cases. The labia minora accounts for 15% to 20% of cases. The clitoris and Bartholin’s glands are less frequently involved.

The pattern of spread is influenced by the histology. Well-differentiated lesions tend to spread along the surface with minimal invasion, while anaplastic lesions are more likely to be deeply invasive. Spread beyond the vulva is either to adjacent organs such as the vagina, urethra, and anus, or via the lymphatics to the inguinal and femoral lymph nodes, followed by the deep pelvic nodes. Hematogenous spread appears to be uncommon. 

What is Vulvar Vestibulitis?

Vulvar Vestibulitis is a condition which causes redness and pain of the vestibule. Vulvar Vestibulitis is an inflammation of this skin and the mucous secreting glands found in the skin. The mucous secreting glands are called the lesser vestibular glands.  

Vulvar Vestibulitis may include all the area around the opening of the vagina but is normally seen in the lower part of the vaginal opening.

Vulvar Vestibulitis occurs in women of all ages. It can occur in women who are sexually active and also in women who have never been sexually active.  

Many women with this problem have suffered physically and emotionally for months or years, have seen a number of physicians, and have tried many unsuccessful treatments in search of relief.  

What are the signs and symptoms of Vulvar Vestibulitis?

*  Severe pain with pressure (for example: biking, exercise, tight fitting clothes ).

*  Vaginal entry such as tampon use or intercourse. 

*  Burning, stinging, irritation, or raw sensation within the vestibular area.

* Vestibular redness 

*  The urge to urinate frequently or suddenly.   

Your doctor or health care provider will examine the vulva and vestibule to identify the common skin changes seen with Vulvar Vestibulitis. Pain is usually felt if the vestibule area is touched with a cotton tipped applicator. A sample of your vaginal discharge is collected and tested to rule out infection.

What causes Vulvar Vestibulitis? 

The exact cause is unknown, but many studies are being conducted to determine the cause of Vulvar Vestibulitis.  

The following factors have been associated with Vulvar Vestibulitis:

*  HPV (Human Papilloma Virus)
*  Chronic Yeast Infections
*  Chronic bacterial infections 
*  Chronic changes of pH (acid-base balance in the vagina)
*  Chronic use of chemicals/irritants such as detergents, soaps, spermicides or lubricants.

What is the treatment for Vulvar Vestibulitis?  

Treatment may include any of the following:  

*  Follow the Guidelines for Vulvar Skin Care
*  Steroid Ointments 

How it is used: A thin layer is applied to the vulvovaginal areas. 

How it Works: Decreases redness, irritation, and burning. Caution: Use only as prescribed by your doctor. Overuse may result in thinning of the skin which will make your problem worse rather than helping it.

*  Trichloroacetic Acid (TCA) may be used in some cases as determined by the severity of the symptoms you have. TCA is a chemical that is used to destroy small areas of the irritated skin allowing new healthy skin to grow in its place. 

*  Interferon Injections are used to increase your body's response to infection. 

Helpful treatment hints for Vulvar Vestibulitis:

*  Vitamin A and D Ointment  How it is used: Apply to the areas of discomfort.
How it Works: Protects the skin, decreases irritation, heals, and soothes.

*  Lidocaine Gel may be prescribed after initial treatment. 
How it is used: Apply lidocaine gel to the vulvovaginal areas of discomfort. 
How it Works: Numbs areas before intercourse.
Caution: After applying, wait until area becomes less sensitive before intercourse. Burning may occur for a short time ( 5 to 10 mins.) after the gel is applied.

*  Witch Hazel Pads (TUCS Pads) How it is used: Apply to the vulvovaginal areas of discomfort. 
How it Works: Decreases burning and irritation after intercourse and urinating.

*  Cleansing Bottle - Pour plain luke-warm water over the vulva after urinating to remove urine from irritated area.  

*  Calcium Citrate Tablets- How it is used: Take orally 1200-1800mg. elemental calcium every day. How it Works: Thought to decrease certain crystals in the urine which may cause burning. 

*  Cranberry Juice  How it is used: Drink an 8oz. glass every day. 
How it Works: Increases the acid content of the urine to decrease bladder irritation. 

*  Limit High Oxalate Foods - May decrease amount of oxalate crystals in urine. Oxalate crystals cause urinary symptoms such as the urge to urinate frequently or suddenly. 

What is a Vaginal Vault Prolapse?

The vaginal vault is the area at the top of the vagina, next to and adjacent to the cervix. It can only “fall” or descend downwards toward the introitus, or the entrance of the vagina, after a woman's womb has been removed (hysterectomy). Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine prolapse, and in about 1% of women who have had a hysterectomy for other reasons.

What is Pelvic Organ Prolapse?

Pelvic Organ Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation, pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What is Pelvic Prolapse?

Pelvic Prolapse is another term used for "pelvic organ prolapse."  Pelvic prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown. 

Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall prolapse.

What is a Prolapsed Uterus?

A Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis. 

A Prolapsed Uterus may be one of three types, depending on the severity:

• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.

• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.

• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.

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Gynecology and Gynecological Health"

Adhesiolysis     Birth Control Sponge     Cervical Cancer     Cervical Mucus Method     Clitoral Adhesions

Depression Help     Essential Trace Minerals     Female Sexual Health    Feminine Deodorant  

Feminine Hygiene     Feminine Itching     Feminine Odor     Feminine Wipes 

Gynecology for Guys    Labial Adhesions     Menarche     Menstrual Disorders     Menstrual Hygiene 

Menstruation    Natural Hormone Cream     Natural Progesterone Cream     Organic Cotton Tampons  

Organic For Life    Organic Trace Minerals     Painful Periods     Pelvic Adhesions     Pelvic Floor Dysfunction 

Pelvic Floor Reconstruction    Pelvic Inflammatory Disease     Pelvic Laparoscopy     Pelvic Prolapse  

Pelvic Reconstructive Surgery    Period Protection     Polycystic Ovary Syndrome     Pregnancy and Childbirth 

Premature Ovarian Failure     Premenstrual Syndrome     Prolapsed Uterus     Puberty     Reconstructive Pelvic Surgery 

Tampon Safety    Toxic Shock Syndrome     Urinary Tract Infections     Uro-Gynecology 

Vaginal Birth After Cesarean    Vaginal Dryness     Vaginal Hygiene     Vaginal Moisturizers    Vaginal Odor

Vaginal Relaxation     Vaginal Sponge     Vaginal Vault Prolapse     Vaginal Yeast Infection     Vulva Health     

Vulvar Diseases     Vulvar Vestibulitis     Vulvovaginal     Vulvovaginitis

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