An ovarian cyst is a common finding in women of all age groups. They may present as abdominal pain, abdominal mass or may be asymptomatic. They are evaluated by clinical examination, imaging, blood investigations such as tumour markers. Age is also an important factor in management.
Cysts can be benign or malignant. There are many varieties of a cyst-like simple cyst, chocolate cyst(endometriotic), and dermoid cyst. Simple small cysts require only to follow up. If the cyst is present with torsion or rupture then they require emergency surgery. If the cyst appears borderline or malignant on evaluation then they may require radical surgery. Cystectomy is performed in those who wish to retain their ovaries/young age when there is no suspicion of malignancy.
TLH is a major surgical procedure which involves removal of the uterus, cervix using keyhole (laparoscopic) surgery. Fallopian tubes are also removed to reduce the risk of future development of ovarian cancer. Ovaries may be removed depending on the menopausal status. We usually preserve the ovary for maintaining hormonal function if there is no associated ovarian pathology.
Hysterectomy can be performed vaginaly, transabdominally, laparoscopically or as a combination of these. Laparoscopic methods reduce hospital stay, postoperative pain and blood loss. You will be able to walk, take oral clear fluids after 6 hours of surgery.
Indications to perform TLH- abnormal uterine bleeding not responding to medical management, large symptomatic fibroid uterus, adenomyosis, postmenopausal bleeding with a precancerous lesion, endometriosis, endometrial cancer, early stage of cervical cancer, pelvic organ prolapse.
During this assessment, we will check your fitness for general anaesthesia and surgery. This will include full medical history, blood investigations, imaging and cardiac fitness. Depending on your medical condition, you may require additional investigations.
Patients will be counselled regarding surgical procedure & expected the duration of surgery. TLH is carried out under general anaesthesia.