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    Interventional procedure overview of vaginal transluminal endoscopic hysterectomy and adnexal surgery for benign gynaecological conditions

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    Indications and current treatment

    Benign gynaecological conditions refer to non-cancerous conditions affecting the female reproductive systems. These include chronic pelvic pain, uterine prolapse, fibroids and abnormal vaginal bleeding. The causes of these types of conditions are not always known but can be linked to periods, hormones and genetics. Left untreated, these conditions can lead to severe and prolonged pain, infections, and reduced quality of life.

    The typical treatments for these vaginal conditions are medications (such as antibiotics, painkillers and hormonal medicines), physiotherapy (such as pelvic floor exercises to relieve pain), and surgical intervention (such as hysterectomy).

    The focus of this overview is on selected surgical interventions, namely hysterectomy, adnexectomy and myomectomy.

    • Conventional hysterectomy is done through a cut in the abdomen or via the vagina. There are also laparoscopic approaches. A vaginal hysterectomy is usually preferred over an abdominal or laparoscopic hysterectomy because it's less invasive and involves a shorter stay in hospital. Limitations of vaginal hysterectomy includes poor visualisation and the limited space for manipulation.

    • Adnexectomy is a surgical procedure which removes part of the adnexal tissue of the uterus and can be done with a hysterectomy or in isolation. Adnexectomies include the removal of one or both of the fallopian tubes (salpingectomy), the removal of one or both of the ovaries (oophorectomy) or the removal of ligaments that support the uterus and ovaries.

    • A myomectomy is the surgical removal of fibroids that develop in or around the womb. These surgeries can be done as either keyhole or open surgeries depending on the size and position the fibroids.