Laparoscopic gynaecological surgery

Laparoscopic Gynaecology
At woom, you can count on our gynaecologists to help you with fibroid treatment. If you need surgery for endometriosis, then our specialists can help you with the diagnosis and with a personalised treatment plan.
Laparoscopic gynaecological surgery
Laparoscopic gynaecological surgery
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Laparoscopic gynaecological surgery Perth

Gynaecological surgeries:
an overview
Gynaecological surgery is one of the key services here at Woom. We offer a vast combined expertise in women’s health and assist our patients in Perth with the following surgical procedures:

At woom, it’s not just about the symptoms and the surgery. We see you as the whole person that you are, and we will always discuss your fears or concerns, as well as answer the questions that you may have.

Dr Tamara Hunter - WOOM
Dr Tamara Hunter

Gynaecologist Perth

We believe that you deserve to be well informed as you prepare for surgery and our team is here to help and support you.

Laparoscopic endometriosis surgery Perth

Surgery for endometriosis

Endometriosis is a chronic inflammation around the uterus. It occurs when tissue similar to your uterus lining is found outside your uterus and the chronic inflammation is dependent on your oestrogen balance. If your GP suggests that you may have it, it’s good to know that up to 1 in 10 Australian women of reproductive age have it at some point in their lives, mostly before the age of 44.

Endometriosis is represented in higher percentages in subfertile patients (up to 1 in 2) and in patients with chronic pelvic pain (up to almost 9 in 10 women).

Laparoscopic gynaecological surgery
Laparoscopic gynaecological surgery

The challenge for you as a woman might be linked to the long list of possible symptoms:

In other situations you would have zero symptoms but you would not fall pregnant when trying to conceive.

There is no correlation between the severity of the pain and the extent of the disease.

In other words: you can have endometriosis and present with no symptoms at all. Or you can have period pain, fatigue and bloating and yet not be diagnosed with endometriosis.

Dr Tamara Hunter - WOOM
Dr Tamara Hunter

Perth gynaecologist

Your specialist will tell you that endometriosis can not be ‘cured’. The good news is that we have treatment options to improve your quality of life and your potential to have children.

Some of the treatment methods work by suppressing ovulation (eg COCP or Combined Oral Contraceptive Pills). Other treatments slow down the development of endometriosis by changing your progesterone levels, dampening the effect of endometriosis at a cellular level.

If other medical treatments fail, or if you want to increase your chances of falling pregnant, we may suggest a laparoscopy. The procedure gives a reliable visual and in the same procedure the laparoscopic surgeon can cut out (excise) or burn (ablate) the endometriosis areas.

Dr Tamara Hunter - WOOM
Dr Tamara Hunter

Gynaecologist Perth

One of the things to be aware of, is the possibility of pain even after the endometriosis has been removed. It happens in some patients and it is due to the hot-wiring of the nervous system. This is why your GP may recommend seeking the help of a women’s health specialist early on, to stop the transition from painful periods to chronic pelvic pain. Ideally, the aim is to have the surgery early on and to then maximise the medical treatment to avoid unnecessary repeat surgical procedures for endometriosis.

At Woom, our focus will always be on the bigger picture of your life. We believe that women’s health is not just about the treatment of symptoms and conditions. You deserve a team of experts who listen and who make sure that you understand the long term plan to improve your health.

Laparoscopic fibroids surgery Perth

Surgery for fibroids
Your specialists at Woom can also help you if you need laparoscopic surgery for fibroids. Fibroids are benign ‘growths’ in the muscle of your uterus. If your doctor mentions that you may have fibroids, it is good to know that they are very common. By the age of 50, up to to 8 in 10 women will have had at least one.

The exact causes of fibroids are unknown. Symptoms include abnormal uterine bleeding, pelvic pressure or pain and a delay when you are trying to conceive (subfertility). In some cases, there are no symptoms.

Dr Tamara Hunter - WOOM
Dr Tamara Hunter

Perth gynaecologist

Fibroids are hormone dependent and can continue to grow until the age of the menopause. Normally they are slow growing. Some fibroids grow rapidly, especially in high hormone states such as pregnancy. At times, if growth is too rapid, they can outgrow their blood supply and die (degenerate), which causes acute pain. After the menopause, shrinkage normally occurs. The treatment for fibroids can be medical or surgical and should be discussed with your doctor.

At Woom we offer the expertise of some of Perth’s leading gynaecologists to organise your fibroids treatment, and to make sure that you are comfortable before, during and after your surgery.

Laparoscopic gynaecological surgery Perth

Why laparoscopy for
gynaecological issues such as
endometriosis and fibroids?

You will have heard this before: Laparoscopic surgery or keyhole surgery is the gold standard for diagnosis and treatment of endometriosis, as well as other gynaecological conditions.

At Woom, our first concern is to look at the bigger picture in women’s health. It’s not just about treating your symptoms; it’s about looking at giving you the best outcomes and about keeping an eye on your quality of life. Shorter hospital stays, less dependency on pain relief, less blood loss, better cosmetic outcomes and a faster recovery. These benefits of laparoscopy for gynaecological conditions make it the gold standard approach.

Laparoscopic surgery is not only indicated for the treatment of endometriosis, but also for other gynaecological conditions including fibroids.

Dr Tamara Hunter - WOOM
Dr Tamara Hunter

Perth gynaecologist

It’s important to know that although we call it keyhole surgery, laparoscopy is also often used for both diagnosis and therapy. It is very reasonable to try non-surgical (medical) options first. But if symptoms persist or if fertility is desired, then your gynaecologist will probably suggest a laparoscopy, for the treatment of fibroids or to manage endometriosis.

The laparoscopy helps your specialist doctor get a clear visual on the areas that suffer from endometriosis. And at the same time, laparoscopic surgery for endometriosis may include the removal of unwanted tissue. It is then sent to the laboratory for analysis to confirm your diagnosis.

Laparoscopic gynaecological surgery Perth

Does laparoscopy guarantee I will no longer
have Endo or fibroids?

In short: not really.

Ideally, tissue is removed, but it is important to be aware of the ‘recurrence rates’: the chances of needing more treatment in the years after your endometriosis surgery.

The aim of laparoscopic diagnosis and treatment is to visualise endometriotic lesions.

And, when possible, the surgery also removes those lesions. In ideal situations, the endometriomas or chocolate cysts are ‘stripped’ from your ovary. That reduces the risk of recurrence and it improves your fertility.

Frequently in ‘deep’ endometriosis, pelvic structures are ‘fixed’ by fibrotic plaques (scarring) and normal pelvic anatomy needs to be restored prior to surgical excision.

So what are your chances of needing more treatment for endometriosis, perhaps another surgery? Recent studies have shown that the recurrence rate of endometriosis is 20-40% within 5 years following primary surgery.

Remember that there is not always a connection between the pain you feel and the severity of the condition. It is important to avoid repeated endometriosis surgery as this can make the pain worse.

Dr Tamara Hunter - WOOM
Dr Tamara Hunter

Perth gynaecologist

Although the recurrence of pain may indicate that the endometriosis has recurred, it is important to avoid repeated surgical procedures as this can exacerbate the pain. Repeat surgery will also not improve your fertility. If you would experience pain but your images wouldn’t show anything abnormal, then your gynaecologist will propose an endometriosis management plan. It may include suppression of ovulation, pain relief, and the incorporation of other disciplines such as psychology or women’s health physiotherapy. In the long term, our patients tell us that this type of management plan works really well for them and gives them a higher quality of life.

If you need surgery for fibroids, the laparoscopic excision can be to the outer aspect of the womb (we call that subserosal), or within the wall of the womb (called intramural). Another type of fibroids surgery happens on the inner wall (submucosal) or in the cavity and consists of a hysteroscopic resection of the fibroids.

Laparoscopic gynaecology surgeon Perth

I always wanted children. Will laparoscopy
surgery for endometriosis
increase my chances?

It is perfectly normal that you would ask this very clear and straightforward question, when told that endometriosis could be one of the factors affecting your fertility. With modern medicine, it is easy to look for simple ‘yes’ and ‘no’ answers, but in this case, your specialist will really look at your personal situation. The American Society for Reproductive Medicine performed research on this topic in 2012. And this is probably the most important thing to remember: The treatment of endometriosis in the setting of infertility raises a number of complex clinical questions that do not have simple answers.

That is why, at Woom, you can count on the combined expertise of laparoscopic surgeons and gynaecologists, as well as your experienced CREI-certified fertility specialist.

The full article is available here: Endometriosis and infertility: A committee opinion. Fertility and Sterility, 98(3): 591–598.

Laparoscopic gynaecological surgery
Laparoscopic gynaecological surgery

Laparoscopic gynaecology surgeon Perth

Doctors / Specialists at woom
available to help with Laparoscopic Gynaecology?

Shital Julania
Dr Shital Julania

Laparoscopic gynaecologist

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