News

The purpose of this section of the website is to document medical and surgical advances in the field of Minimal Access Surgery. Any topics of interest resulting from scientific publications or attendance at medical or scientific meetings will be summarised for your information.

Michael is a New Zealand graduate who currently has a position as a laparoscopic surgeon at the Mater Hospital in Brisbane.
 
He demonstrated a laparoscopic hysterectomy, excision of pelvic endometriosis and a laparoscopic sacrocolpoplexy (a surgical procedure for the management of prolapse.
 
Michael is a very good surgeon and certainly appeared at ease in his role demonstrating these procedures. As is often the case with many of these meetings the discussion that is had with other participants was particularly valuable.
 
New Zealand has a small population of Obstetricians and Gynaecologists and even a smaller population of advanced Gynaecological Laparoscopic surgeons. It has become evident to me that we do need to meet on a regular basis to co-ordinate training of New Zealand registrars and Fellows in this field. We hope that this meeting in Hastings will become an annual event so that the various techniques demonstrated can be reviewed and it will also give us a opportunity as a group of Gynaecological Laparoscopists to meet and to co-ordinate laparoscopic training in New Zealand.

“Surgical techniques – Based on Fact or Fiction”
 
This was a two day meeting held in Coolum on the Sunshine Coast, Queensland which reviewed a variety of surgical techniques related to laparoscopic hysterectomy and laparoscopic excision of pelvic endometriosis. A number of experts described their surgical techniques, their reasons for choosing a particular technique and also the strengths and weaknesses of the procedure. There were also a number of helpful hints to avoid complications during this sort of surgery. As part of the course there was a thorough review of pelvic anatomy which is always a useful reminder at these sorts of conferences.
 
There was nothing particularly new that arose from the lectures presented. However, I was impressed with the degree of enthusiasm that the various Australian presenters displayed with regard to training their registrars and Fellows in laparoscopic gynaecological surgery.
 
It is vitally important that we have a streamlined training programme available to teach and upskill the next generation of Gnaecological Laparoscopists in New Zealand. In Australia these units exist in all the main centres and appear to be relatively well funded with an adequate patient workload available and the time and clinical mentoring necessary for their trainees to develop the skills required in advanced laparoscopic surgery.
 
This does appear to be in contrast to the opportunities available for registrar training in this field in New Zealand.  

I recently attended a combined American Association of Gynaecological Laparoscopy/Australian Gynaecological Endoscopy Society meeting in Brisbane from the 21st to 23rd May. Dorothy Kammerer-Doak and Leah Millheiser, both from the United States and Susan Davis from Victoria in Australia presented papers relating sexual function to a variety of gynaecological conditions and procedures including both endometriosis and hysterectomy.

The data presented supported a marked improvement in both libido and dyspareunia (pain with intercourse) following excision of endometriosis and hysterectomy.

There was discussion regarding the pros and cons of leaving or removing the cervix at the time of hysterectomy.  There was no evidence to support any difference in sexual function between the two options. 6-10% of those women who had their cervix retained experienced ongoing light bleeding at the time of their period. A significant percentage of these women later have their cervix removed.

There was discussion regarding the use of mesh as a method of treating those women with symptoms of prolapse (weakness of the support structures that hold the uterus and/or vagina in place). There was considerable concern expressed regarding the significant incidence of mesh related complications following this sort of surgery.

I will be attending a further AGES (Australian Gynaecological Endoscopy Society) meeting in Queensland towards the end of October and will outline any points of interest from the meeting once I return.