Assuta Hospital - the oldest hospital of Israel, which since its founding in 1934, plays a crucial role in the development of the country's health system. For decades, the center of true to the principles laid down by its founders: quality patient care and scientifically proven effectiveness of treatment. Assuta - the first Israeli hospital, received the 2011 JCI certificate (International healthcare accreditation) according to international standards of medical pomoschi.a
Today, the clinic is considered to be an innovative medical center in the Middle East, in which patients are guaranteed to receive the most modern treatment. The priority of a surgery, it is the most developed in the Assuta. Dozens of prominent experts on women's reproductive health, and this problem is solved mainly by doctors gynecological department.
Assuta Hospital gynecology department
A large number of women in the search for a reliable and trusted specialists give preference to Israeli doctors - and they are not mistaken in their choice. Every year Israeli gynecologists treat hundreds of patients who are desperate to find a qualified specialist at home.
Assuta Hospital gynecology department equipped with the latest medical technology. Diagnosis and treatment of diseases affecting women engaged in talented doctors who have huge experience of practical activities. Gynecologists Assuta - the real masters of their craft, known not only in Israel, but throughout the world.
Ovarian Cysts - a frequent problem in women of childbearing age. The basis of this disease are both physiological and pathological factors. Correct assessment of the causes that led to the emergence of a cyst, is the key to effective treatment.
Typically, ovarian cysts does not manifest itself and is found during examination for another reason. However, various symptoms may occur in some women, such as:
- Discomfort in the abdomen.
- Drawing pain.
- The sensation round the tumor below the navel or on either side of him.
- Frequent urination.
The diagnosis of ovarian cysts are established on the basis of ultrasound examination of the pelvic organs (as the traditional ultrasound and transvaginal). This method allows the study to ascertain the presence of tumors, but says nothing about its structure, which is directly related to its benign or malignant. This requires histological examination of body fragments. The easiest way to do this after the operation.
On the structure and size of the brush depends on the further therapeutic tactics. For small formations caused by failures in the endocrine system, shown conservative treatments, including in the form of hormone replacement therapy. But if the process is moving too quickly, causing suspicion of a malignant growth pattern, and is accompanied by unpleasant symptoms require surgery.
The operation to remove a cyst on the ovary
In this disease, there are two types of surgical access - open (through an incision in the abdominal wall) and laparoscopic. Each of them has its own advantages and disadvantages. Abdominal surgery to remove a cyst on the ovary is optimal for large size tumors and complex anatomy of the pelvic organs. Also, it is selected in malignant nature of the process with invasion into the surrounding tissue and metastasis to regional lymph nodes, since open access allows the surgeon to hold and manipulate freely without any restrictions.
Preparation for surgery to remove an ovarian cyst
Before surgery, each patient passes thorough physical examination to identify possible contraindications. Minimum study include:
- Complete blood count (estimate hemoglobin level, early detection of infectious and inflammatory diseases).
- Biochemical blood test (evaluation of the liver, kidney and other internal organs).
- Coagulation (clotting definition of functions and anticoagulative blood systems).
- Determination of blood type and Rh factor (the case of need for transfusion).
- Urinalysis (exception renal pathology).
- Magnetic resonance imaging (MRI) of the pelvic organs.
The patient necessarily consulting physician, and in case of extragenital - other specialists. It is necessary for the timely detection of contraindications for surgery, because if any surgical intervention may be extremely hazardous.
On the day before the operation, the patient should drink a special solution laxatives to cleanse the bowel. For additional emptying the rectum for a few hours before surgery is done enema.
Contraindications to Step
There are several contraindications to surgery in ovarian cysts. Some of them are relative, that requires the surgeon utmost caution, and some absolute, that is, strictly prohibit the operation.
Make it illegal in the following cases:
- Chronic heart failure decompensation (heart can not withstand such a load).
- Decompensated diabetes (high risk of divergence sutures and surgical wound suppuration followed sepsis).
- Disorders of blood clotting - thrombocytopenia, haemophilia or other coagulopathy (this is an imminent threat of deadly bleeding during surgery).
- Acute infectious diseases.
- Acute myocardial infarction.
- Shock that in gynecological practice often caused massive bleeding from the genital tract.
course of the operation
Just before surgery the patient is carried premedication - injection of medications, which will remove the agitation and anxiety, as well as prevent the development of adverse events during and after the operation.
Surgical intervention is performed under general anesthesia, which means without any feelings. Action anesthesia can be compared to the state of sleep. Awakening comes in intensive care, and the patient does not remember anything that happened to her during the operation.
The course of surgical intervention as follows:
- Initially, the surgeon will treat the surgical field - the lower abdomen - an antiseptic solution to prevent penetration into the abdominal cavity of pathogenic bacteria.
- Then, layer by layer, step by step, are cut skin, subcutaneous fat, muscle, fascia and peritoneum with. Most carried lower midline laparotomy - a longitudinal section along the center line extending from the navel to the pubic area. Less commonly used cross-sectional view of Pfannenstiel above the pubic area where the abdominal crease is a natural (such as an incision is made, eg, cesarean section).
- After dilution of the wound edges surgeon inspects the pelvic organs for the presence or absence of pathological processes that might not be visible on ultrasound.
- The main stage of the operation - removal of ovarian cysts. With a small amount formation is carried ovary resection - removal of the affected organ cyst fragment. If the pathological process is expressed, and the ovary is almost completely substituted by a cyst, it shows oophorectomy - the complete removal of the ovary.
- The final stage of the operation - layer suturing of the wound with the mandatory installation of temporary drainage.
Typically, surgery lasts not more than 2 hours. However, suspected malignant cysts may require extended operation involving removal of the fallopian tube on the affected side, as well as regional lymph nodes. Surgical approach the doctor will determine in each individual case.
The postoperative period after removal of ovarian cysts
The postoperative period lasts on average 1-2 weeks. The first 2-3 days the patient spends in the intensive care unit, as at this time there is always a risk of early complications, such as:
- Internal bleeding.
- Suppuration of postoperative wounds.
- Pulmonary embolism.
Fortunately, this is extremely rare due to the use of modern equipment and medicines with proven efficacy.
On the first day the patient may be concerned about such unpleasant sensations such as pain in the surgical wound, discomfort in the throat, chilliness. This is perfectly normal and does not require any special treatment. It is very important after abdominal surgery observe calm and do not make unnecessary movements for at least 1-2 days to wound edges could slightly grow together.
Sutures require careful and regular care that there was no inflammation and even fester. Every day, the surgeon examines the postoperative wound and nurse changes the bandages and antiseptic wound handles. These simple actions provide protection from dangerous complications.
After the transfer of the patient to the general ward comes a period of rehabilitation. load should be gradually increased in the abdominal muscles, but in any case not to overdo it. It is fraught with the development of postoperative hernia that will require further surgery.
Frequently asked questions and their answers
How do surgery to remove an ovarian cyst?
When carried out as ovarian cyst abdominal or laparoscopic surgery. The first is made more often in large cysts, suspicious of malignancy, the second - for the removal of small cysts.
Abdominal surgery performed under general anesthesia in several stages. Initially, the surgeon secures access to the problem area through an incision in the lower abdomen. The second main step - removing most cysts. Depending on its size, and the malignant potential ovarian resection may be performed (by him "cut" cyst), oophorectomy (removal of the entire ovary) adnexectomy (oophorectomy together with tubal) and dissection (excision of regional lymph nodes). At the final stage the doctor sets the abdominal cavity drainage and sutures the incision.
Laparoscopic surgery is also performed under general anesthesia. On the front wall of the abdomen is a few small holes through which is injected into the body the necessary tools. Then, the abdominal cavity is fed gas to push the viscera from each other and provide the surgeon greater field of view. Further actions are similar to those of a doctor abdominal surgery.
How long does the surgery to remove an ovarian cyst?
Typically, surgery lasts not more than 2 hours. In the event of complications, and in the case of large cysts and its suspected malignancy, surgery may be delayed until 3-4 hours.
How to lie in the hospital when you remove an ovarian cyst?
Preparation takes an average of 2-3 days. The postoperative period when open surgery is 1-2 weeks. Thus, the total duration of treatment of ovarian cyst is not more than 2 weeks. It averaged figures - the length of stay in hospital are determined individually in each case.
What are the consequences of the removal of ovarian cysts?
On the first day after surgery, the following symptoms are perfectly normal:
- Drowsiness, lethargy, vomiting, due to the residual effect of the anesthesia.
- Sore throat from the anesthetic tube.
- Discomfort in the postoperative wound.
With combat sleepiness is not necessary - if the patient wants to sleep, then it is better to rest. Sore throat takes place during the day, but if it does not, then we can recommend a warm drink and gargling with antiseptic solution. During chill enough to hide a warm blanket or a blanket to keep warm.
After operation possible disturbances of the menstrual cycle. Menstruation can come back the next day, and could be out for 1-2 months. All this is due to some hormonal shifts, but over time the cycle is usually restored.
Within 2-3 days after the operation should comply with bed rest and not to make any unnecessary movements. If this is not done, there is a great risk of a divergence of seams and development of a postoperative hernia.
Whether pregnancy is possible after removal of ovarian cysts?
Yes, it is possible. Should not be considered such as the sterilization operation - it is absolutely not the case. Hundreds of thousands of women were able to give birth to normal children after this surgery.
But we must bear in mind that pregnancy will not come immediately. Due to the direct effect on the ovary during surgery for 2-3 months after the operation may be interrupted in the hormonal background, which is manifested by irregular menses. Once the cycle is restored, you can think about planning a pregnancy.
How much is the removal of ovarian cysts in your clinic?
Medical tactic is determined individually in each case, as in all women the disease occurs in different ways. Consequently, the estimated cost of surgery ranges from $ 7000 to $ 14000.
Hundreds of women have entrusted their health professionals clinic Assuta, and have not regretted it. Thanks to the numerous positive reviews we can be proud of the professionalism of our doctors - truly the best gynecologists in Israel.