doctor, obstetrician-gynecologist, MD
I have experience of 30 years work, in 1997 I was the first surgeon in Armenia that performed laparoscopic hysterectomy(remove of uterus). I perform such laparoscopic procedures, as limphadenectomy, colpopoesis, hysteropexy, I was the first person who performed these procedures in Armenia. I perform 500 surgical procedures every year, 300-350 of all procedures are performed laparoscopic.
Gynecologic surgical procedures can be done by laparoscopic, vaginal and traditional laparotomic routes.Intrauterine surgery is also called hysteroscopy and hysteroresectoscopy. Nowadays about 95 % of all surgical procedures are performed by laparoscopic route, details of this route we will discuss in other section.
In every case surgical route is being discussed individually,
Laparoscopic route can be used during following pathologies
Infertility-diagnostic laparoscopy,and after pathology detection appropriate intervention is done-adhesiolysis,tubal surgery or endometriosis treatment.
Extra-uterine pregnancy- gestational sac removing with uterine tube preservation, or tubectomy( removing of fallopian tube)
Ovarian cysts- cystectomy( removing only cyst with ovarian tissue preservation, ovarian resection( removing part of ovary with cyst)
Uterine myoma-myomectomy, hysterectomy, despite of uterine size( even uterus is reached 24 weeks of pregnancy)
Adenomyosis-hysterectomy, removing of adenomyosis nodule
Genital prolapse-hysterpexy( uretus fixation to the sacrum with graft using)
Chronic pelvic pain, algomenorrhea-diagnostic laparoscopy, LUNA( uterine nerve ablation)
Uterine tubes sterilisation
PCOS-cauterisation, ovarian resection
Unknown diagnosis- diagnostic laparoscopy
Genital malformations- neovagina creation in cases of absent of vagina
Genital cancer- ovarian, endometrial , cervical cancer – hysterectomy,or organ preservating operations with lymphadenectomy
Abdominal cerclage-laparoscopic correction of cervical insufficiency
Vaginal route is using during following conditions
Genital prolapse- vaginal plastic surgical procedures with or without grafts using(Prolift and other), Le-For procedure( colpocleisis)
Urine stress incontinence- TVT-O;TOT
Vulvar, vaginal pathology(condillomas, vaginal cysts, bartolinitis,imperforate hymen),
Aesthetic vaginal surgery - aesthetic surgery to improve the appearance of the external vaginal and vulvar structures.
By hysteroscopy following conditions can be treated
Endometrial polyps, endometrial hyperplasy-removing of polyps, endometrial
Submucosal uterine myoma-removing of myoma
Intrauterine septum- septum dissection
Intrauterine adhesions( Asherman disease)- adhesiolysis
Removing of products of conception or foreign bodies
Cervical surgical procedures
dysplasia- LEEP, conization
cervical insufficiency-cervical cerclage