Hysterectomy with BSO in Bangkok, Thailand
Bilateral Salpingo-oophorectomy (BSO)
Hysterectomy and oophorectomy may be sought to reduce gender dysphoria are gynecological procedures which can be performed by laparoscopic surgery (minimally invasive surgery) or open technique (abdominal hysterectomy)
1. Laparoscopic technique:
The newest technique instead of a large incision to be a few tiny incisions are made through, which thin instruments are passed. This new technique significantly reduces scaring, pain, healing time, blood loss and duration of hospital stay when compare to open technique.
Picture 1 shows the scar of Laparoscopic Hysterectomy technique
2. Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy (BSO) or Open technique:
A transverse incision is made through the abdominal wall, usually above the pubic bone, as close to the upper hair line of the individual's lower pelvis as possible, similar to the incision made for a caesarean section approximately 4-5 cm long. This technique allows surgeon the greatest access to the reproductive structures and is normally done for removal of the entire reproductive complex. Abdominal hysterectomy is the most common method. The recovery time for an open hysterectomy is 4–6 weeks
Picture 2 shows the scar of Abdominal Hysterectomy or Open technique
3. Subsequently the vaginal or V technique:
Vaginal hysterectomy is performed entirely through the vaginal canal and has clear advantages over abdominal surgery such as less complications, shorter hospital stays and shorter healing time. When this technique has complications, a surgical exploration is required.
Risk and complication:
1. Wound complication, such as infection, abscess, disruption
2. Excessive bleeding.
3. Bladder, ureter or bowel injury
4. Tenporary abdominal distention due to transient decreased bowel movement.
4. Natural Orifice Transluminal Endoscopic Surgery Hysterectomy with Bilateral Salpingo-oophorectomy (BSO) & Oophorectomy (NOTES or Scarless Hysterectomy):
It is a new technique to remove uterus and ovaries, developed from total laparoscopic hysterectomy and transvaginal hysterectomy procedures, which provides more safety. During the operation, the surgeon inserts vaginal speculum into the vagina and inserts the shield into the vagina for protecting cervix. Then the surgical instrument is inserted into vagina. After dissection, both uterus and ovaries are removed from the vagina opening.
There are many advantages of NOTES, as follow;
- Less postoperative pain
- Shorter hospital stay and quick on return of bowel function
- Shorter recovery and quicker return to daily activities
- Less complication from bleeding during surgery, or reduce chance of injury in the abdomen.
Picture 3 shows the scarless of NOTES technique
Visit our gallery to view hysterectomy with BSO before and after photo: