Gynaecological Malignancies

Gynaecological cancers include endometrial, ovarian, cervical, vaginal and vulval cancers. Laparoscopic management is done in endometrial cancers, early-stage cervical cancers and completion staging laparoscopy for lymphadenectomies in early ovarian malignancies.

Emergencies:

Well equipped 24 x 7 casualty and emergency theatre, with round the clock gynaecologist and anesthetist availability, blood bank and ICU services.

1.Torsion (when clicked following text should appear) :

Torsion is one the most common gynaecological emergencies. Torsion is the twisting of ovary around its pedicle leading to severe abdominal pain, with or without vomiting and fever. Early intervention is needed to preserve the ovary, to avoid gangrenous changes inturn causing loss of function. In the younger age group it is imperative that the ovary has to be preserved for reproductive function.

Ultrasound is an useful imaging modality to diagnose torsion. Emergency laparoscopic surgery is done to untwist the ovary and to anchor it to the uterus to prevent recurrence of torsion. The ovary may have an associated cyst, which will need to be removed along with the procedure.

2.Ectopic pregnancy:

When pregnancy occurs outside of the uterine cavity it is called ectopic pregnancy. Most common site is the fallopian tube (tubal pregnancy). Ectopic pregnancy is life threatening and needs emergency intervention. Tubal rupture may occur due to the growing embryo leading to bleeding inside the abdominal cavity and hemodynamic instability.

Patient may present with bleeding per vaginum following missed period, abdominal pain, giddiness or in an unconscious state. Diagnosis is by serum beta HCG and ultrasound. In certain cases medical management is tried. Most cases need Emergency diagnostic laparoscopy along with removal of tube (salphingectomy) or if possible tubal conservation (salphingostomy, milking) is done.

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