The advantage of surgery outside the operating room lies in its ability to be much less distressing for patients. Performed in consultation without recourse to general or locoregional anesthesia, this approach is intended to be reassuring.
- Heavy periods, accompanied by fatigue, discomfort, possible anemia and a reduction in quality of life, are not inevitable. There are now solutions adapted to each woman: progesterone IUD, hormonal treatment, surgery.
- Under local anesthesia, outside the operating room and without hospitalization, these minimally invasive procedures can resolve the problem of heavy periods and metrorrhagia.
- To date, several hundred patients in France have benefited from these procedures carried out outside the operating room and under local anesthesia, by experienced teams including Dr. Vincent Villefranque.
Abnormal bleeding is the leading cause of emergency consultation among patients in the 30/40 age group.These pathologies are linked to pathologies that are easily identified, whether it is a polyp, a fibroid, endometriosis of the uterus, or a hormonal imbalance. The latter is quite common, especially after the age of 45, but we have different therapeutic solutions,” explains Dr. Vincent Villefranque, head of the gynecology department of the Eaubonne-Montmorency hospital group (Val d’Oise).
“Hysterectomy is always a bad experience for patients.”
For a long time, hysterectomy was almost inevitable for the majority of patients.Before, if a patient had a bleeding problem, it ended up in the operating room with the uterus removed. Hysterectomy is always a bad experience for patients. It is a mutilation, a loss of femininity, a loss of the ability to give life. It is always complicated: it is a hospitalization, a month off work, etc. It is a major surgical procedure and if we have to go back a second time for something else, it will be much more complicated.”
“Target the lesion without removing the uterus”!
The idea is therefore to carry out relevant explorations for a precise diagnosis, thus making it possible to effectively target the treatment and increase the chances of preserving the uterus. According to Dr. Villefranque, the clinical examination is essential and is based on simple procedures such as ultrasound. If necessary, a hysteroscopy can be performed: a small camera is introduced into the uterus to precisely determine the origin of the bleeding.
It is crucial to identify the lesion in order to refine the treatment strategy as best as possible so that it is as minimal as possible.The philosophy of these treatments is to target the lesion without removing the uterus, thus solving the problem of bleeding without resorting to mutilating surgery. The most common pathologies are polyps and fibroids. A significant advance in this field is hysteroscopic morcellation, which has greatly improved treatment techniques“, the surgeon explained during a press conference organized by theThe National College of French Gynecologists and Obstetricians (CNGOF).
“These are patients who come alone with their car and leave alone with their car.”
Hysteroscopic morcellation is a surgical technique used to remove abnormal tissue, such as polyps or fibroids, from the uterus. This method is done via a hysteroscope, a thin, tubular instrument with a camera, which is inserted into the uterus through the vagina.The advantage is that there is no electric current, which means that in terms of tolerance it is very little painful.“Once in place, specialized instruments are used to morcellate, that is, cut into small pieces, the abnormal tissue. “It is a surgery that generally lasts 1 minute 30. There is very little post-operative pain. These are patients who come alone with their car and leave alone with their car.”
Masking and hypnosis techniques are used and are very effective in helping patients to “disconnect during the intervention“. In addition, this method does not impact family life, which allows for an almost immediate return to work. Patients who have used this technique express “great satisfaction with their experience and quick recovery“.
