For information about Gynaecology, laparoscopy, hysterectomy, Gynaecologists

Traditional gynaecological surgery has relied on the use of large abdominal incisions for gynaecologists to perform "open" surgery. Unfortunately this may result in complications such as wound infections and significant post-operative pain. As a result there may be a delay in recovery from surgery, a prolonged hospital stay and hence a delay in return to your normal activities and work.

Laparoscopic surgery (otherwise known as "Minimal Access Surgery" or "keyhole" surgery) avoids these large abdominal incisions. "Keyhole" incisions are used instead for the gynaecologist to insert a telescope to visualise organs and other instruments are then also inserted to perform the surgery.  Consequently, laparoscopic surgery is associated with fewer major complications, less pain and faster or enhanced recovery for the patient. For the gynaecologist it also has the advantage of better visualisation of pelvic and abdominal organs. 

In some cases laparoscopic surgery may not be feasible.

• This includes the presence of significant pathology which cannot be managed by "keyhole" techniques, such as some very large cysts with solid features or a high risk of underlying malignancy.

• There may be some sort of hindrance to laparoscopic surgery in some cases, because of significant adhesions or disruption and distortion of the normal anatomy e.g. by previous surgery or by the condition itself (for instance, some cases of advanced endometriosis).

• In other cases, your gynaecologist may not be able to perform the laparoscopic surgery because it is not of a type that they routinely perform or because they have not been trained in that procedure.

Much advanced laparoscopic surgery requires technical skills and co-ordination by the gynaecologist, obtained from extensive training, practice and repetition of a particular type of procedure. While most gynaecologists in England will perform certain simple laparoscopic procedures, such as diagnostic procedures or management of ectopic pregancies, only a minority routinely perform advanced laparoscopic procedures. As a result, they become more familiar with the techniques involved, can make any adjustments required and can then give adequate information about whether a condition can or should be treated by laparoscopic surgery.

We are a group of gynaecologists based in the northeast of England, whose usual NHS surgical practice includes a substantial volume of cases treated by "keyhole" methods. This includes management of a number of benign gynaecological conditions, including urogynaecology, subfertility, endometriosis, menstrual disorders, uterine conditions (fibroids, polyps, uterine septum), presumed benign pelvic cysts and chronic pelvic pain. We also manage cases related to gynaecological cancer, such as hysterectomy for endometrial cancer and prophylactic genetic cancer-risk reducing surgery (as well as some advanced gynaecological cancers).

Each gynaecologist in this group has their own specific range of practice and will not treat all conditions - however they will be able to advise you regarding gynaecologists and clinicians who can manage a particular disease or condition. Consequently you will be able to make a more informed judgement regarding any recommended surgical or non-surgical treatment. 

We present here (on the following pages) some useful information to help you make informed choices regarding your options for treatment.