“Use of inpatient closed surgery in gynecological conditions is increasing”

Noting that closed surgeries such as minimally invasive surgery, endoscopic surgery, laparoscopy, hysteroscopy, robotic surgery, which are increasingly used today, especially in gynecological surgeries, shorten the length of stay of patients and increase the rate of recovery across the country, Dr. . Instructor U. Mert Yesiladalı pointed out that these results are important benefits for patients. Stating that especially fast recovery and shortening of the hospitalization period, patients who avoid surgery due to fear of surgery also help them overcome this fear, Dr. Instructor U. Yeşiladalı said, “With the rapid recovery process due to the absence of a large incision, the patient comes to the point where he/she can perform his/her daily tasks the next day. In addition to less bleeding and fewer infections, a much shorter infection time is also a significant benefit for the patient.


Referring to a study of 5554 patients in the US, Dr. Instructor U. Mert Yesiladalı said:

“In the related research; It has been reported that the discharge of the women whose uterus was removed using the closed method of surgery on the same day without overnight hospitalization caused no problems, and even a decrease in some complications. In laparoscopic operations we perform the closed method in our own practice, sometimes we are discharged the same day and sometimes the next day. In fact, we discharge our patient 2 hours after the procedure in hysteroscopy operations performed without incisions and requested removal of fibroids and polyps.


Giving information about types of closed surgery, Dr. Instructor U. Mert Yeşiladalı said, “We perform fibroid, cyst or cancer surgery through the abdominal incision by the traditional method known as open surgery among the people. Closed surgeries, on the other hand, are surgeries that we perform by inflating the abdomen with gas by entering through several holes without creating an open incision. There are many different closed surgical methods. There are several methods, such as laparoscopy, hysteroscopy or robotic surgery, and they can be used to treat most gynecological conditions, from removal of cysts and fibroids to gynecological cancers.


Dr. Instructor U. Yesiladalı said:

“Using closed methods is more difficult for surgeons than open methods and requires a longer training period. However, its prevalence has increased with the education of physicians on the subject and the benefits it brings to patients. In a study that recently performed hysterectomy surgery on approximately 5,500 people in the United States; The patients whose uterus was removed by the closed method were discharged on the same day and their complication rates were monitored. When we perform this surgery with the open method, the patient may need to stay in the hospital for 2-3 nights. In the framework of the study, the patients operated on with the closed method were discharged on the same day, and it was observed that there was no increase in the number of complications and even a decrease in the number of complications. Thus, we have seen that even in hysterectomy operations, the closed method is preferred and the patients are discharged on the same day, no increase in complications, but even a decrease in some complications such as infection.


Dr. Instructor U. Yeşiladalı said, “Because these operations are performed through small holes, no skin tissue needs to be healed. With the rapid healing process caused by the small incision, the patient gets to the point where he can perform his daily functions the next day. In addition to less bleeding and a lower infection rate, a much shorter infection time is also important for the patient. Aesthetically there are no traces left. Removal of intrauterine pathologies such as myoma removal, cyst surgery, hysterectomy surgery, polyp can be performed much more easily with the closed method. After all, it can be used in all age groups and with all gynecological problems. At this point, it is important that patients choose centers that specialize in closed methods.


Noting that open surgeries will decrease over time, Dr. Instructor U. Yeşiladalı continued his words as follows:

“We have now started to do more than 90 percent of operations with the closed method. In the next 10 and 20 years, especially with the developments in robotic surgery, closed surgery will probably become the standard. I believe that open surgery will almost completely disappear in the near future, except in very specific cases. Even today we have the technology to break up 10-12 cm fibroids and remove them by entering the abdomen through a 1 cm hole. Although the situation is now, we can say that open operations will largely be a thing of the past in the future.”

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