Description

Watch this advanced gynecological surgical demonstration by Prof. Dr. R. K. Mishra at World Laparoscopy Hospital, featuring the management of two different gynecological conditions during one minimally invasive surgical treatment: bilateral ovarian endometriomas and a submucous uterine fibroid. This procedure highlights the role of laparoscopic and hysteroscopic techniques in addressing complex gynecological problems while aiming to preserve healthy reproductive organs whenever clinically appropriate. The surgical approach combines laparoscopic management of ovarian endometriotic cysts with hysteroscopic removal of a fibroid projecting into the uterine cavity. It offers an educational overview of operative planning, pelvic anatomy, tissue handling, adhesiolysis, ovarian preservation, and intrauterine fibroid treatment. Understanding the Two Gynecological Conditions 1. Bilateral Ovarian Endometriomas Endometriomas are ovarian cysts associated with endometriosis. They commonly contain thick, old blood and are sometimes referred to as chocolate cysts. They may occur in one or both ovaries and can be associated with pelvic pain, painful menstruation, painful intercourse, adhesions, and fertility-related concerns. Bilateral endometriomas require careful assessment because both ovaries may be affected. Surgical planning must consider cyst size, ovarian reserve, symptoms, previous operations, fertility goals, and the extent of associated endometriosis. 2. Submucous Uterine Fibroid A submucous fibroid is a benign growth arising from the muscular wall of the uterus and projecting into the uterine cavity. Depending on its size and position, it may contribute to heavy menstrual bleeding, prolonged periods, anemia, reproductive difficulties, or other symptoms. Hysteroscopic myomectomy allows selected submucous fibroids to be removed through the natural cervical opening, avoiding an abdominal incision. The suitability of this approach depends on fibroid size, depth of myometrial involvement, location, and the patient's clinical circumstances.