Gynaecological Surgery

Gynaecological Surgery: Types of Operative Therapy

As per statistics reproductive system is the most vulnerable part of female body. This situation is conditioned on anatomic structure and complexity of functions. Numerous gynaecological diseases constitute a serious problem that may result in infertility, cysts and neoplasms of various etiology. Not all diseases may be cured by drugs. Certain complex cases require operative intervention Such problems are resolved by gynaecological surgery.

Gynaecological surgery is a sphere of general surgery specialized in operations in female reproductive system. RMI conducts laparoscopic operations qualified as less traumatizing surgery. Minimally invasive operations are characterized by absence of classical incisions. All instruments are introduced into the body through pinholes in the abdomen and the surgery procedure is demonstrated on the monitor. This surgical interference permits acceleration of rehabilitation after surgery and risks of complications.

RMI gyaecological clinic offers two types of inpatient facilities:

  • One day hospital where patients are checked in and out the same day;
  • Twenty four hour hospital intended for patients’ rehabilitation during several days.

Each hospital type effects various gynaecological surgery treatment.

Operative Therapy in RMI Clinic

Highly skilled experts
(specialists having doctorate degree in medicine as well as premium and first class specialists) effect operative treatment in RMI clinic. The clinic has modern diagnostic and surgery equipment that guarantee the best results in infertility and reproductive system care.

The following operations are performed in the day patient hospital:

  • Hysteroscopy (diagnostic and operative). Uterus and uterine cervix are examined by endoscopic instruments to verify the diagnosis. Hysteroscopy is used to treat intrauterine adhesions in uterus, polyps in uterine cervix and foreign bodies. This type of surgical intervention is used to perform endometrial biopsy and interruption of non-developing pregnancies;
  • Hystero-resectoscopy is a minimally invasive operation falling within category I surgical treatments. The operation is conducted without incisions and abdominal paracentesis (vaginal approach). This procedure is performed with hysteroscopic resectoscope. Indications: uterus pathology, uterus myoma, endometrium proliferation and polyps, synechias and septum, etc.
  • Cervical insufficiency surgical treatment during pregnancy;
  • Plastic surgery of external sex bodies.

The following conditions are surgically treated in the twenty-four hour hospital:

  • Tubal obstruction (adhesions, impaired blood and lymph flow in tubes, fluid collection, extra-uterine pregnancy);
  • Neoplasms, ovaritis and uterus inflammations;
  • Myoma, uterine fibroid;
  • Stress urinary incontinence;
  • Prosthetics of vaginal walls and sling surgery in case of uterine prolapse;
  • Intimate correction and vaginal plastic surgery.

We also maintain pregnancy during 22 weeks and in case of insuficiencia istmicocervical surgical treatment is possible in the inpatient hospital.

Gynaecological laparoscopic surgery (additionally to all other types of surgical treatment) have the following limitations and contraindications:

  • Severe respiratory, cardiovascular and gastrointestinal diseases;
  • Blood disorders (hemorrhagic diathesis, haemophilia);
  • Diaphragmatocele;
  • Acute infectious diseases;
  • Acute and chronic renal or hepatic failures;
  • Pregnancy until 20 weeks;
  • Gross obesity.

Any gynaecological surgery expert advice may be obtained any business days from 13:00 until 16:00.

RMI clinic is involved in fee based gynaecological surgery and the cost thereof is case sensitive and depends on the intervention complexity.

The list of tests necessary to conduct laparoscopic operations in RMI’s gynaecology department.

Necessary TestsValidity
Complete blood count10 days
Common urine test10 days
Biochemistry blood test (protein, sugar, urea, creatinine, total bilirubin, ALAT, AST)10 days
Coagulogram10 days
Electrolytes (potassium, sodium, calcium)10 days
Coagulation analysis10 days
HIV (RMI, City AIDS Center)3 months (barcode)
RW (rapid plasma reagin test is not accepted)1 month
Hepatitis B and C (enzyme-linked immunosorbent blood assay)3 months
Blood group and Rh factorOnce
Bacterial and purity smear10 days
Pelvic organs ultrasound scan3 months
Electrocardiography and cardiologist’s opinion10 days
Photofluorography12 months
Anesthesiologist’s advice2 days prior to surgery
General practitioner’s advice with a permit for anaesthetisation and laparoscopy10 days
Papanicolaou smear6 months
Photofluorography12 months
Ultrasound examination of lower extremity vein on therapeutic grounds6 months
СА-125 on therapeutic grounds6 months

List of Tests before Hysteroscopy

Necessary TestsValidity
Complete blood count10 days
Common urine test10 days
Coagulogram10 days
Abbreviated coagulogram10 days
HIV (RMI, City AIDS Center)3 months (barcode)
RW (rapid plasma reagin test is not accepted)1 month
Hepatitis B and C (enzyme-linked immunosorbent blood assay)3 months
Blood group and Rh factorOnce
Bacterial and purity smear10 days
Pelvic organs ultrasound scan3 months
Papanicolaou smear6 months
Electrocardiography and cardiologist’s opinion10 days

Surgery under State Program: Information for Patients

Under the State Tertiary Health Care Program (“State Program”) patients may refer to RMI for the surgery it specializes in.

Below please find responses to frequently asked questions regarding the surgery under the State Program:

What diagnosis makes the patient eligible for a surgery under the Sate Program?

The following diagnosis makes a patient eligible for laparoscopy under the State Program:

  1. Infertility due to uterine tubes disorders N 97.1
  2. Infertility due to endocrine disorders. Polycystic ovarian syndrome. N 97.0
  3. Ovarian cyst. D 27.
  4. Uterus myoma D 25.
  5. Uterus endometriosis. N 80.0
  6. Prolapse ОМТ N 81.3

In 2017, eighty nine surgeries were made under GFHC, including the following types:

  1. vaginal laporoscopic hysterectomy
  2. abdominal laporoscopic hysterectomy
  3. laparoscopic uterus promotofixation with mesh prosthesis
  4. laparoscopic cystectomy (65.10)
  5. other local laporoscopic removal or ovary destruction (65.25)
  6. laparoscopic lysis of ovarian and uterine tubes adhesions (65.82)
  7. laparoscopic full hysterectomy (68.411)
  8. laparoscopic conservative myomectomy or cyst excision of nodosities (68.4110).

This health care is intended only to Kazakhstan citizens.

How can I undergo surgery under the State Surgery in RMI? в центре ИРМ?

Kazakhstan legislation provides for the following procedures enabling the surgery under the State Program:

  1. It is necessary to undergo a screening by a surgeon and to get an advisory list specifying the relevant diagnosis, surgery and its date. Patients may visit RMI’s surgeon from 08:00 through 16:00 at Office 226.
  2. In order to get registered for an operation under the state program a patient should submit the advisory list to the maternity welfare center at the place of residence. Then the patient should wait for the allowance assignment. The relevant maternity welfare center must be informed of any change in contact details.
  3. Maternity welfare centers forward their patients’ details to Hospital Admissions Bureau for allowance assignment. The allowance is assigned in case of a positive decision.

What shall you do upon positive response obtaining?

Upon the allowance assignment the patient should agree the surgery date with the surgeon and have all necessary tests taken. As of the surgery under the State Program the patient shall have no contraindications thereto. Maternity welfare institution/healthcare management authority enters relevant records into the Hospital Admissions Bureau Portal.

A surgery under the State Program provides for a strict compliance with all requirements and recommendations of specialists. The patient must provide his/her contact details for medical records and the agreement. The clinics shall be informed of any changes to contact details as the surgery is funded from the state budget and the report regarding each program must be submitted to the Ministry of Healthcare and Social Security of the Republic of Kazakhstan.

Enjoy comfort, security and care of healthcare personnel in RMI’s inpatients hospital. State-of-the-art technology, modern equipment and highly qualified personnel all contribute to the maximum effect of the therapy.

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