In the context of surgery, experts can be defined as “experienced surgeons with consistently better outcomes”, demonstrating superior performance in multiple skills compared to non-experts.
Minimally invasive surgery (MIS) continues to play an important role in gynaecology as an alternative to traditional open surgery and laparoscopic techniques. The field of surgery continues to see advancements and innovations to provide better outcomes for patients – from large scars on the abdomen to minimal holes, and now we are in the era of hole-less surgery through natural openings with minimal instrumentation.
Minimally invasive vaginal surgeries, from simple episiotomy to giant fibroid, any pelvic pathology can be treated and operated on this way, which is a state of the art, with the right case selection.
Vaginal surgeries lead to advancement in gynaecology and curiosity to perform the new techniques with newer technologies that perform the procedure effortlessly.
Apart from benign indications for hysterectomy like fibroids, abnormal uterine bleeding, pelvic pain, cervical dysplasia and uterine prolapse. Other surgeries, from basic McDonald Cerclage to high cervical cerclage and beyond, such as permanent sterilisation, ectopic pregnancy, scar repair for ectopic pregnancy to adnexal removal, sacrospinous fixation, high uterosacral ligament suspension and forgotten skills of electrosurgical snare removal and more.
The recovery time for a vaginal procedure is shorter and less painful. There is no abdominal incision, eliminating the risk of wound infections, hernias, pain and unsightly scars. The surgeon has more comfortable ergonomics than traditional laparoscopy, and blood loss is minimal.
Because vaginal procedures have a minimal learning curve compared with laparoscopic or robotic procedures, they should be preferred whenever possible because of their well-documented benefits and lower complication rates.
But the question arises, how many of us think of a vaginal approach when we see pelvic pathology, are we confident enough to perform vaginal surgery or make decisions when it comes to other pathologies, aside from traditional pelvic organ prolapse surgery.
This should be included in the training programme of obstetricians and gynaecologists to gain expertise in vaginal surgeries with a minimum of instrumentation rather than the expensive laparoscopic surgeries with their longstanding intraoperative and postoperative complications.
In this glamorous world of laparoscopy, definitely we should have a complete knowledge of it but the focus should be on the art and beauty of vaginal surgeries that require a simple setup with minimal instrumentation and a good power device compared to expensive instruments.
The brain adapts to what we see and observe, so we are here with many video demonstrations on a variety of vaginal surgeries. Join our community of StudyVaginalSurgery for daily updates with daily activities, case discussions, journal updates on recent advances, and recordings of surgical video clips to make vaginal surgery easy. Connect with us on WhatsApp for registration. Click Here
Richa Patel Narkhede
Asst Course Director