Surgery & procedures
Some common procedures that Michael carries out regularly include: laparoscopy, endometrial ablation, hysteroscopy, adiana, colposcopy, laser and loop excision of cervix, prolapse surgery and removal of pelvic tumours such as fibroids or ovarian cysts.
Laparoscopic surgery is used for both investigation and treatment purposes. It involves passing a small telescope through or just below the navel into the belly (abdomen) to provide a view of the pelvis.
This procedure enables investigation of pelvic pain, painful sex and painful periods. It can also be used to treat ovarian cysts, ectopic pregnancy, endometriosis, removal of ovaries, division of adhesions, tubal ligation (tying the tubes).
This procedure is used to treat heavy periods in women who have completed childbearing. It is usually preformed under general anaesthetic and involves passing a device into the cavity of the uterus to destroy the lining. A diathermy, novasure radio frequency or irrigation of fluid heated to a high temperature (thermablate) is used to perform this procedure.
Endometrial ablation is a day only procedure with up to 90% success in reducing or ceasing periods. This replaces the need for a hysterectomy in women.
A hysteroscopy involves passing a small telescope through the cervix into the uterine cavity. It is used to further investigate abnormal uterine bleeding, infertility and post-menopausal bleeding. It can also be used to remove polyps, resect fibroids, ablate the lining of the uterus or divide adhesions.
A hysteroscopy can also be used in conjunction with Adiana (to block the fallopian tubes) to provide a permanent contraception without the need for a laparoscopy.
Colposcopy is the first step after the diagnosis of an abnormal pap smear from low to high grade SIL (squamous intraepithelial lesion). In this procedure, a speculum is inserted into the vagina (also known as a pap smear) and the cervix is visualised by an external colposcope (telescope). If an abnormal area is identified, a biopsy (small tissue sample) may be retrieve for analysis by a pathologist. To find out more about colposcopy, visit www.csp.nsw.gov.au
- Ablation – laser, diathermy or cryosurgery can be used on the abnormal area. This process is normally used for low grade SIL.
- Excision – wire loop excision removes the abnormal area. An analysis by a pathologist will determine if the excision is complete. This procedure is generally used for high grade SIL.
Prolapse is the descent of the pelvic organs from their original position due to childbirth, obesity, hereditary tendency, and post-menopausal women. Surgery is usually performed through the vagina.
Surgery for pelvic tumours can either be performed by laparoscopy (keyhole surgery) or as an open procedure if the tumour is large.