Gynae Surgery

Pre-assessment

Patients coming to Belfast City Hospital for surgery may be asked to come up to meet one of our medical team for a pre-assessment appointment in the Outpatient Department prior to surgery to ensure they are fit and safe for surgery. In some cases patients are asked to have an anaesthetic assessment. Most patients are admitted on the morning of their surgery but some may be admitted the day before.


  • Cervical

    If a patient is to have surgery to treat their cervical cancer they may undergo a laparoscopic radical trachelectomy or a laparoscopic radical hysterectomy. Both types of surgery involve a lymph node dissection to see if the cancer has spread to the patient’s lymph nodes.

    Surgery via a radical hysterectomy usually involves removing the womb, nearby lymph nodes and a small part of the vagina and tissue surrounding the cervix. Surgery is generally offered to patients whose cancer is in the early stages (where it is only in the cervix). In some cases the ovaries and fallopian tubes may also be removed but where possible (particularly within young women) this is avoided as it brings on early menopause. Hormone replacement therapy (HRT) may be given in this case to prevent symptoms of the menopause.

    Women who have been diagnosed with very early stage cervical cancer may have a radical trachelectomy as their cancer treatment. In this surgical procedure the cervix and surrounding tissue and the upper part of the vagina are removed. The womb is not removed. This type of cancer treatment tries to preserve fertility of women who have been diagnosed with early stage cervical cancer.

    After surgery, the tissue which has been removed will be examined to determine if the patient’s treatment is complete or if they need any further treatment such as radiotherapy or chemoradiation.

    Post Surgery

    There are some things you may wish to consider in relation to your surgery:

    • Drips and Drains – Patients will be given a drip in their arm following their operation. This gives fluids into the arm until patients can eat and drink normally again. Some patients may have a drainage tube inserted into their abdomen to drain excess fluid.
    • Catheter – Patients will have a catheter tube inserted while under anaesthetic to drain the urine from their bladder. Some patients may have problems passing urine after radical surgery. Patients will be guided on how to manage this by nursing staff.
    • Pain – Patients will be given pain killers as needed following their operation. These pain killers may be administered via a drip, via an injection or in tablet form. Doctors and nurses will work out what dosage of painkillers is best for each patient.
    • Changes to the body – Patients who have their womb removed as part of their surgery will no longer have their periods. Most women will return to their normal sexual activity after they have recovered from their surgery. Patients who are concerned about problems after surgery should talk to their doctor or clinical nurse specialist.
    • Rest and Activity – Patients will need some rest to recover from the procedure following keyhole surgery for cevical cancer, but it is expected that they will return to normal activities and exercise within a short time period.

    The gynaecology clinical nurse specialist is available at Belfast City Hospital to provide to support to all Gynaecology patients if they want someone to talk to.

    Once patients have undergone cervical cancer surgery they will be given their results at a results appointment in the Outpatient Department. At the time of the results being given, a consultant will discuss the next steps following surgery.

  • Ovarian

    Surgery is one of the main treatments used to treat ovarian cancer patients. It may be used alone or in combination with chemotherapy. The aim of surgery is to completely remove the cancer. The main type of surgery used to treat ovarian cancer is a laparotomy. This involves the removal of the womb, fallopian tubes, ovaries, omentum, the appendix and sometimes lymph nodes. Some patients may need to have a portion of their bowel removed to ensure that the cancer is completely removed. This may result in a colostomy.

    In some cases patients may not be diagnosed until after their operation. The type of surgery performed will depend on the type, stage and size of the cancer and whether it has spread. Surgery is conducted at the Belfast City Hospital.

    It is important that patients know all the facts about the type of surgery they are having. Patients will discuss their treatment with their consultant prior to treatment beginning.

    Post Surgery

    There are some things you may wish to consider in relation to your surgery:

    • Drips and Drains – Patients will be given a drip in their arm following their operation. This gives fluids into the arm until patients can eat and drink normally again. Some patients may have a drainage tube inserted into their abdomen to drain excess fluid.
    • Catheter – Patients will have a catheter tube inserted while under anaesthetic to drain the urine from their bladder.
    • Pain – Patients will be given pain killers as needed following their operation. These pain killers may be administered via a drip, via an injection, an epidural or in tablet form. Doctors and nurses will work out what dosage of painkillers is best for each patient.
    • Changes to the Body – Although patients will no longer have monthly periods or be able to become pregnant, patients will, when they feel ready, be able to be sexually active again. If patients have any questions or need someone to talk to about their body and/or sexual health they can contact the Gynaecology Clinical Nurse Specialist (CNS) who is located in the Belfast City Hospital and provides support and advice to all gynaecology patients on an emotional and physical level.
    • Rest and Physical Activity – The abdominal muscles (tummy) and skin will take time to heal following an operation. Patients may be advised not to drive for six weeks after their operation as they may suffer from discomfort trying to wear a seatbelt.

    Some women take longer to recover than others from their operation. Patients who are having problems may find it helpful to telephone or come in to talk to the Gynaecology Clinical Nurse Specialist (CNS) who works in the Belfast City Hospital providing care and support to all gynaecology patients before, during and after cancer treatments.

  • Vulval

    Surgery is the main treatment used to treat vulval cancer patients.Vulval surgery is performed at the Belfast City Hospital. This form of cancer treatment aims to remove the cancer tumour and the non cancerous surrounding cells. Making sure that all the cancer is removed is the most important factor in trying to cure the cancer. At the same time the surgeon will try, as far as possible, to preserve the appearance and function of the vulva and nearby tissues.

    Different operations can be used to treat vulval cancer. The type of operation a patient will have depends on the size and position of the cancer. There are two types of surgery used to treat patients with vulva cancer:

    1. Radical Vulvectomy: This type of surgery removes most of the vulva.
    2. Wide Local Excision or partial vulvectomy: This type of operation removes the cancer tumour on the vulva and a border of healthy tissue surrounding the cancer.

    If needed, the surgeon will perform reconstructive surgery to the vulva at the same time of the surgery to remove a patient’s cancer.

    The first place vulval cancer spreads to are the lymph nodes of the groin. For some patients the surgeon will remove and assess their lymph nodes during vulval surgery. Other patients may have their lymph nodes removed as part of a follow up surgery if the results of their first surgery indicate that the cancer may have spread.

    Some cancer patients who have had their lymph nodes removed during surgery may develop lymphodema (a build up of fluid in one or both of the legs). If this occurs the doctor or clinical nurse specialist will refer the patient to their local lymphoedema specialist.

    Many women are cured of their vulval cancer with surgery alone, however some women may need radiotherapy or chemotherapy after their operation.

    If the vulval cancer spreads to organs close to the vulva such as the bladder, womb or bowels, a pelvic exenteration may be performed to remove any affected areas.

    Post Surgery

    There are some things you may wish to consider in relation to your surgery:

    • Drips and Drains – Patients may need a drip to administer antibiotics to prevent infections. Patients who have their lymph nodes removed may have a drain (a tube) inserted into their groin. This tube will drain any fluid that may gather. A small suction bottle will be attached to the drain to remove the fluid collected.
    • Catheter – Patients will have a catheter tube inserted while under anaesthetic to drain the urine from their bladder.
    • Dressings – Patients may have dressings applied to their vulval and/or groin area.
    • Pain – Patients will be given pain killers as needed following their operation. These pain killers may be administered via a drip, via an injection or in tablet form. Doctors and nurses will work out what dosage of painkillers is best for each patient.
    • Bowels – Patients may not have bowel movements for a few days following their operation. This is expected following a vulval operation and patients may be offered laxatives to prevent constipation.
    • Changes to the Vulva – Patients may experience numbness or altered sensation around the operation site after surgery. This is due to the effects of surgery on the nerves close by. It often improves over a period of months. Vulval surgery may alter the appearance and function of the vulva and patients can experience long-term emotional and physical side effects. It is common for patients to feel upset after their cancer surgery and each patient has their own way of coping. If patients need someone to talk to the Gynaecology Clinical Nurse Specialist is available at the Belfast City Hospital to provide to support to all gynaecology patients.
    • Rest and Activity – The nurses will encourage patients to start moving about as soon as possible after their operation. The amount of rest and/or activity patients do will be dependent on the type of surgery they have had. Clinical staff will advise patients on what activities they can take in the weeks following their surgery.

    Patients will be given their results either when they are an inpatient or at an outpatient results appointment. During the results appointment, the Consultant will explain the next steps of the cancer pathway.

  • Womb

    Surgery is the main treatment used to treat womb cancer. Many women are cured of their womb cancer with surgery. It may be used alone or in combination with radiotherapy and chemotherapy. The aim of surgery is to completely take away the cancer.

    Different operations can be used to treat womb cancer. Most patients will have a keyhole hysterectomy but some will need to have an open hysterectomy. Most women will have their fallopian tubes and ovaries removed. Some women will have their lymph nodes and omentum removed to see if the cancer has spread. The doctor will make this decision.

    Womb surgery is performed in the Belfast City Hospital. Patients will be admitted to Ward 5 South.

    Post-surgery

    There are some things you may wish to consider in relation to your surgery:

    • Drips and Drains – Patients will be given a drip in their arm following their operation. This gives fluids into the arm until patients can eat and drink normally again. Some patients may have a drainage tube inserted into their abdomen to drain excess fluid.
    • Catheter – Patients will have a catheter tube inserted while under anaesthetic to drain the urine from their bladder
    • Pain – Patients will be given pain killers as needed following their operation. These pain killers may be administered via a drip, via an injection or in tablet form. Doctors and nurses will work out what dosage of painkillers is best for each patient.
    • Changes to your Body – Patients will no longer have monthly periods or be able to become pregnant, but they will, when they feel ready, be able to be sexually active again. The surgeon may advise patients not have sex for at least six weeks after their operation to allow for recovery. Patients who have any questions or need someone to talk to about their body and/or sexual health can contact the Gynaecology Clinical Nurse Specialist (CNS) who is located in the Belfast City Hospital and provides support and advice to all gynaecology patients on an emotional and physical level.
    • Rest and Physical Activity – The abdominal muscles (tummy) and skin will take time to heal following the operation. A physiotherapist will discuss rest and activity with patients before they are discharged from hospital.

    Some women take longer to recover than others from their operation. Patients may find it helpful to telephone or come in to talk to the Gynaecology Clinical Nurse Specialist (CNS) who works in the Belfast City Hospital providing care and support to all Gynaecology patients before and after cancer treatments.

    Patients will be given their results either when they are an inpatient or at an outpatient results appointment. During the results appointment, the Consultant will explain the next steps of the cancer pathway.

  • Vaginal

    Vaginal cancer occurs very rarely. For information on surgical treatment of vaginal cancer, please follow this link or contact the Gyane Oncology Clinical Nurse Specialist.

    The post surgery pathway for cancer is similar to the one followed by womb (enodmetrial) or cervical cancer patients.

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