Uterine inversion is a condition where the uterus literally turns inside out. This occurs following delivery and is an extremely dangerous and life threatening condition. We performed a laparoscopic surgery where by the uterus along with the cervix (mouth of the uterus) was cut vertically, the uterus reverted back to its normal position and the cut wall of the uterus sutured with absorbable sutures. A repeat endoscopy performed three months later revealed a normal cavity of the uterus and a normal uterus in the pelvis. The woman conceived subsequently and delivered by a cesarean section. This was the first ever reported endoscopic procedure of its kind and was published in American Journal of Minimally Invasive Gynecology in 2009.
Shirodkar’s sling is a surgery performed for treatment of pelvic organ prolapse. Occasionally, the genitofemoral nerve, a nerve passing along the side wall of the pelvis, may get entrapped in the tape used for the sling.This causes excruciating pain with difficulty in using that leg. We were referred a woman who had such a complication. Via laparoscopy, we released the nerve from the tape, cut the tape and placed a new tape at a different position to prevent recurrence of the prolapse. The woman recovered completely from her symptoms. This was the first ever reported case of its kind. It was presented at a national conference and is to be published a national journal shortly.
Occasionally, following hysterectomy or myomectomy, fibroid tissue (tumor of the uterine muscle) may implant inside the abdomen on the intestine, ovary, peritoneum or bladder and grow. We managed a rare case of a fibroid growing into the urinary bladder. We enucleated the fibroid completely from the bladder and the woman recovered completely from her urinary symptoms.
A scar ectopic pregnancy is a pregnancy which implants into the uterus at the site of a cesarean section scar. The pregnancy can invade the uterine wall and into the urinary bladder. Life threatening bleeding can occur. Hysterectomy is often necessary. We managed a case of scar ectopic pregnancy by laparoscopy. We first ligated the major blood vessels supplying the pelvis (internal iliac arteries), excised the ectopic pregnancy and repaired the cut in the uterus by absorbable sutures. The uterus could thus be saved with the hope for future fertility.