Gynecology doctor. Reception of a gynecological surgeon

Any surgical intervention related to obstetrics and surgical treatment of diseases of the female genital organs is the area of ​​work of a gynecologist surgeon. Patients with infertility in 50% of cases become patients of this particular doctor. A good gynecological surgeon has a deep knowledge of medicine and practices the most modern surgical techniques.

C-section

At childbirth, a gynecologist surgeon is present only when absolutely necessary. Normal childbirth takes an obstetrician-gynecologist. The surgeon is involved in the event that any complications arise during labor, or the woman was initially shown a caesarean section.

During childbirth, the decision to perform a caesarean section is made jointly by the obstetrician-gynecologist and the surgeon. An indication for it can be the incorrect position of the baby in the womb, which cannot be corrected, as well as a threat to the life of the mother or child. The operation is performed under epidural or spinal anesthesia. Less often - under general anesthesia in the presence of special indications. A woman under epidural/spinal anesthesia is conscious during the operation.

Cesarean section is a full-fledged operation with all the ensuing threats and consequences. There is a risk of bleeding, infection, etc. A horizontal incision is made in the skin, subcutaneous fat, and uterus on the lower abdomen. The gynecologist surgeon removes the baby and the placenta from the uterine cavity. Then the doctor puts stitches on the cut areas. This is a simplified scheme for performing a caesarean section.

Indications for caesarean section

With certain indications, a woman can receive a referral for this operation in advance. The gynecologist surgeon prescribes a caesarean section in such situations:

If a pregnant woman has a severe chronic disease (heart disease, myopia, diabetes mellitus, etc.);
narrow pelvis of the first and second degree;
very large fruit;
placenta previa;
2 or more scars on the uterus after previous operations;
deformation of the pelvic bones;
symphysis (divergence of the pubic bones);
malformations in the development of the genital organs;
cicatricial narrowing of the vagina;
rupture of the perineum in previous births;
the age of the woman in labor is over 30 years in combination with other indications;
genital herpes in the acute phase;
delayed pregnancy, etc.

Surgical intervention in such situations avoids the danger to the life of the baby and the deterioration of the health of the woman.

Laparoscopy in the hands of a gynecologist surgeon

Laparoscopy is one of the most advanced methods of modern surgery. It is used to treat various diseases, including gynecological. During laparoscopy, a gynecologist surgeon does not completely cut the patient's abdominal cavity, but inserts a special device, a laparoscope, into it through a micro-incision, and literally performs the operation on a closed area of ​​\u200b\u200bthe body. This removes various tumors, adhesions, etc.

The progress of the operation is monitored using a monitor, which displays an image from the laparoscope camera. This device is a telescopic tube equipped with a whole set of sophisticated devices: a lens system, a camera, an optical cable with halogen or xenon illumination, etc.

Thanks to the use of a laparoscope by a gynecologist, it becomes possible to perform minimally invasive (low-traumatic, without large abdominal incisions) operations. This technique helps to solve a lot of complex issues and even perform operations on the uterus directly during pregnancy. The operation is almost jewelry. In the hands of a skilled and experienced gynecological surgeon, this technique gives amazing results.

A consultation with a gynecological surgeon is necessary if the following symptoms and indications are present:

• malformations of the organs of the reproductive system;
• cicatricial narrowing of the vagina;
• deformation of the pelvic bones;
• suspicion of obstruction of the fallopian tubes;
• bleeding after intercourse;
• complicated pregnancy (narrow pelvis, the presence of scars on the uterus after a cesarean section, genital herpes in the acute period, placenta previa, etc.).

Specialists of the GMS Surgical Center carry out surgical treatment of diseases in the safest and most gentle way, taking into account the individual characteristics of the patient's body.

What does a specialist treat?

A gynecological surgeon is engaged in the diagnosis and treatment of the following diseases and pathological conditions:

• uterine fibroids;
• adhesive disease of the pelvic cavity;
• ectopic pregnancy;
• ovarian cyst;
• abscess and cyst of the Bartholin gland;
• ovarian apoplexy;
• neoplasms of the vulva, vagina, ovaries;
• endometriosis;

• non-developing pregnancy;
• prolapse and prolapse of the genital organs;
• congenital and acquired pathologies of the development of female genital organs;
• age-related changes (flabbiness, sagging tissues, etc.);
• a miscarriage that has begun (abortion in progress);
• cancer of the vagina, vulva, body of the uterus, cervix, ovaries;
• erosion and leukoplakia of the cervix;
• polyp of the cervical canal.

The doctors of our Center perform both classical and laparoscopic operations, and also actively use radio wave and endovascular surgical technologies. The use of low-traumatic, organ-saving techniques can significantly reduce the time of postoperative rehabilitation and quickly return the patient to her usual life.

Appointment We will gladly answer
for any questions Oksana coordinator

Preparation, diagnosis, initial appointment

Consultation with a gynecologist surgeon begins with an anamnesis. The doctor will ask a series of questions about existing complaints, symptoms, menstrual cycle, intimate life, etc. Then the specialist conducts an external and internal examination and sampling. The internal examination takes 5-10 minutes and includes:

• examination of the vagina and cervix in the mirrors;
• taking a smear;
• bimanual research.

After the examination, the doctor conducts a series of instrumental studies:

• transvaginal ultrasound of the uterus and appendages;
• colposcopy.

If necessary, additional examinations are prescribed - blood tests for hormones, cytological examination of the cervix, hysteroscopy, biopsy, CT, MRI, diagnostic laparoscopy.

It is better to plan a visit to a gynecologist surgeon in the second week of the monthly cycle - after the end of menstruation, the picture will be more accurate. This recommendation does not apply to emergency cases, in case of acute pain, bleeding and other warning signs, a doctor should be visited immediately.

• 2-3 days before the examination, exclude sexual contact;
• transvaginal ultrasound and colposcopy are performed with an empty bladder.

The appointment of a gynecological surgeon does not provide for any complex preliminary preparation.

What operations does the specialist perform?

Experienced gynecological surgeons at the GMS Hospital Surgery Center perform the full range of gynecological operations:

• removal of ovarian cysts, vagina, labia;
• removal of a Bartholin's gland cyst;
• colporrhaphy and colpoperineoplasty;
• Manchester operation for genital prolapse;
• hysterectomy (removal of the uterus);
• tracheloplasty;
• bougienage of the cervical canal;
• cystectomy;

• adnexectomy (removal of uterine appendages);
• hysteroresectoscopy;
• removal of an endometrial polyp;
• embolization of uterine arteries;
• oophorectomy (removal of the ovary);
• removal of the polyp of the cervical canal;
• salpingo-ovariolysis (dissection of adhesions between the ovary and the fallopian tube);
• separate diagnostic curettage;
• levatoroplasty to restore the muscles of the entrance to the vagina.

Some surgical procedures are performed on an outpatient basis and do not require a hospital stay. The use of modern low-traumatic technologies makes it possible to reduce the period of hospitalization to 1-2 days.

What to Expect After Consulting a Gynecological Surgeon

The GMS clinic surgeons-gynecologists take a comprehensive approach to drawing up a treatment plan. At the consultation, the doctor will carefully evaluate all the parameters - the patient's condition, research results, existing contraindications, and based on all this, will determine the next steps:

• if an emergency surgical intervention is necessary, the patient is hospitalized and, after a short preparation, is operated on;
• if the condition is not life-threatening, a planned operation is scheduled - the doctor will set a date, give recommendations on preoperative preparation and draw up a plan of rehabilitation and recovery measures for inpatient and outpatient treatment.

You can make an appointment with a GMS Hospital surgeon-gynecologist online or by phone.

The cost of services of a gynecologist surgeon

The prices indicated in the price list may differ from the actual ones. Please check the current cost by calling +7 495 104 8605 (24/7) or at the GMS Hospital at: Moscow, st. Kalanchevskaya, 45.

The price list is not a public offer. Services are provided only on the basis of a concluded contract.

Our clinic accepts MasterCard, VISA, Maestro, MIR plastic cards.

On the basis of the gynecological departments of the hospital GKB No. 31, a clinic of the Department of Obstetrics and Gynecology of the Russian National Research Medical University has been deployed.

Gynecology City Clinical Hospital No. 31 is rightfully considered one of the best in Moscow. All types of conservative and surgical treatment of any gynecological diseases are used. Hysteroscopic and laparoscopic diagnostics are possible, and surgical treatment using these methods allows to speed up the recovery period as much as possible and is the most gentle for patients.

Since 2004, the modern organ-preserving method for the treatment of uterine fibroids and adenomyosis has been firmly rooted in the hospital - uterine artery embolization.

detailed information

general information

Head of Department No. 1 - Doctor of Medical Sciences, Professor E.N. Kaukhova.
Head Nurse of the Department Yu.N. Tarasova.

Head of Department No. 2 - Ph.D. O.I. Mishiev.
Senior nurse - N.G. Kosolapova.

In two gynecological departments of the hospital, all types of conservative and surgical treatment are successfully applied, including for the following diseases:

• uterine bleeding of the reproductive, perimenopausal periods, menopausal periods;
• diseases of the cervix;
• physiology and pathology of the postmenopausal period;
• intrauterine pathology (uterine fibroids, adenomyosis, endometrial polyps, endometriosis, synechia, foreign bodies);
• ovarian formations in patients of different age periods
• inflammatory diseases of the internal genital organs.

The main types of surgical treatment:

• diagnostic laparoscopy;
• abdominal surgery and laparoscopic operations in the amount of amputation and extirpation of the uterus;
• abdominal surgery and laparoscopic operations on the appendages;
• vaginal extirpations;
• plastic vaginal surgeries, including prolapse of the uterus and prolapse of the walls of the vagina;
• laparoscopic surgery for the treatment of infertility;
• laparoscopic organ-sparing operations in tubal pregnancy; restoration of patency of pipes;
• hysteroscopic treatment of intrauterine pathology;
• electrosurgical, laser and thermal ablation of the endometrium, embolization of the uterine arteries.

The motto of the team of gynecological departments is
warm care for patients.

The clinic receives dozens of letters of thanks. The implementation of high-tech methods is carried out by the doctors of City Clinical Hospital No. 31 in close professional contact with the staff of the department.

general information

• • Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty of the Russian National Research Medical University - Doctor of Medical Sciences, Academician of the Russian Academy of Sciences, Member of the Presidium of the Board of the Russian Society of Obstetricians and Gynecologists, Chairman of the Presidium of the Moscow Society of Obstetricians and Gynecologists, member of the New European Surgical Academy (NESA), member of the International Federation of Obstetricians and Gynecologists ( FIGO)- Kurtser Mark Arkadievich— student of the founder and honorary head of the department — Savelieva Galina Mikhailovna, Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Honored Scientist, Vice President of the Russian Association of Obstetricians and Gynecologists, Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty from 1971 to 2017.
    At the moment, the achievements of the clinic are associated with the implementation of a wide range of laparoscopic therapeutic and diagnostic interventions on the pelvic organs. Over the past 20 years, one of the employees of the department, Doctor of Medical Sciences, Professor Sergei Vyacheslavovich Shtyrov a school of endoscopic gynecology was established on the basis of 31 hospitals.Professor Valentina G. Breusenko- the founder of the hysteroscopic method in the City Clinical Hospital No. 31. At the present stage, with the introduction of hysteroresection, laser ablation and thermal ablation of the endometrium, the arsenal of hysteroscopic operations performed has significantly expanded. Since 2004, the modern organ-preserving method for the treatment of uterine fibroids and adenomyosis has been firmly rooted in the hospital - uterine artery embolization. Over the past 5 years, cooperation with the department has allowed practitioners to defend 4 doctoral and 38 master's theses. Currently, a grant has been received to carry out scientific developments on the topic "Early diagnosis of ovarian cancer." To the staff of the department: Academician of the Russian Academy of Medical Sciences G.M. Savelieva, professors V.G. Breusenko, S.V. In 2003, Shtyrov was awarded the Prize of the Government of the Russian Federation for the development and implementation of endoscopic methods of diagnosis and treatment in gynecology.

general information

Uterine artery embolization (UAE) is one of the modern directions of surgical treatment of uterine diseases, which consists in puncture of the artery on the thigh, catheterization of the uterine vessels and the introduction of particles of a special embolization preparation.

Symptomatic or growing uterine fibroids

• Size up to 20 weeks of pregnancy in the absence of severe pathology of the cervix, endometrium and ovaries.
• In patients interested in pregnancy, with a confirmed role of uterine fibroids in the pathogenesis of infertility or with a high risk of miscarriage, when it is impossible to perform a safe myomectomy.
• As preparation for myomectomy or hysteroresectoscopy.

Intensive uterine bleeding of various etiologies, when other methods of treatment are impossible or are associated with a real threat to the life of the patient.

When determining the indications for UAE for fibroids, the motivation of patients is important: the patient's strong desire to preserve the uterus, avoid surgery, and interest in pregnancy.

Uterine artery embolization (UAE) is performed in:

general information

Robotic surgery is a new, high-tech type of minimally invasive surgery, which consists in surgical intervention through small incisions on the patient's skin and the ability to operate remotely. This ensures minimal trauma, faster recovery, reduces the length of the patient's stay in the hospital, and minimizes the likelihood of further complications.

Benefits of Robotic Surgery

The da Vinci Si robot does not perform operations on its own, contrary to popular belief. But thanks to remote control and high-quality imaging, it allows the operating surgeon to make more precise movements and eliminate hand tremors. That is, the robot follows all the movements of the surgeon, and he is not able to move or program himself.

These factors create ideal conditions for the surgeon and facilitate complex laparoscopic operations. As a result of the maximum precision of even very complex instrument movements, excellent image quality and the ability to operate on small and hard-to-reach areas, patients spend less time in hospital, feel less pain, lose less blood, have a better aesthetic result, recover faster and return to hospital sooner. Everyday life.

Robotic operations in gynecology City Clinical Hospital No. 31

In the 1970s and 1980s, laparoscopy began to be widely introduced into clinical practice, which was associated with the advent of fiber optics and special instruments. As a result, not only the quality of diagnostics has improved, but some interventions on the abdominal organs have also become possible. By the way, in our country, the experience of using laparoscopy in gynecology was summarized in 1977 in a monograph by G.M. Savelyeva, Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, professor and our doctor, under whose leadership the first operation was performed in our hospital after its opening in 1970.

At the moment, almost all gynecological operations are performed using laparoscopy and a robot. Robotic surgery in gynecology is one of the fastest growing areas and is used in the treatment of all benign and malignant gynecological diseases. Our gynecologists perform operations on women with genital prolapse (prolapse), including pelvic floor support (promontofixation using a mesh implant), removal of myomatous nodes (myomectomy) with preservation of the uterus, panhysterectomy with lymph node dissection. Thus, operations that were previously performed laparoscopically can now be reliably performed using a robotic method.

Operation of uterine fibroids and ovarian formations

Today, endoscopic operations are routinely performed regardless of the size of the uterus. Depending on the localization of myomatous nodes and their number, removal can be done with small incisions and without resorting to open surgery. In this case, uterine fibroids, regardless of their size, are removed from the abdomen in small sections using a marcellator.

Radical hysterectomy (removal of the uterus) is a classic and effective method of treating oncological diseases of the uterus and appendages at the initial stage. Robot-assisted surgery makes it minimally invasive, with less blood loss and hospital stay.

Experience in conducting robotic operations in City Clinical Hospital No. 31

At the moment, in City Clinical Hospital No. 31, robotic operations of varying complexity using the da Vinci robotic system are carried out on a regular basis.

Today, gynecological robotic surgeries include removal of ovarian tumors, myomectomy, promontofixation, total and partial hysterectomy, endometriosis treatment, and endometrial and ovarian cancer treatment.

general information

Laparoscopy is an endoscopic method of emergency and elective surgery. It allows you to examine the internal organs of the abdomen through a small opening in the abdominal wall. Inspection is carried out using an optical tube. After 2-3 other punctures, the necessary manipulations with the organs are performed. Laparoscopy is practically bloodless and less traumatic.

At the origins of laparoscopic gynecology in Russia is the Academician of the Russian Academy of Medical Sciences, Professor, Head of the Department of Obstetrics and Gynecology of the Pediatric Faculty of the Russian State Medical University Galina Mikhailovna Savelyeva. Every laparoscopy specialist rightfully calls her your Teacher.

The range of surgical interventions performed by laparoscopic access is wide: gynecological operations, cholecystectomy and hernioplasty, gastrectomy, pancreatoduodenal resection and operations on the colon and rectum.

general information

Ectopia of the cervix (also Ectopia of the epithelium of the cervix, Pseudo-erosion of the cervix, Erosion of the cervix, Endocervicosis) - the location of the cylindrical epithelium lining the cervical canal, on its vaginal surface, which looks like a red spot around the outer opening of the canal. Ectopia occurs in about half of women of reproductive age and almost never occurs in women over 40 years of age.

general information

Hysteroscopy - examination of the walls of the uterine cavity using a hysteroscope, followed by (if necessary) diagnostic and surgical manipulations. Hysteroscopy allows you to identify and eliminate intrauterine pathologies, remove foreign bodies, take tissue biopsies, and remove endometrial polyps.

Indications for a diagnostic procedure are:

• Anomalies in the development of the uterus.
• Bleeding in postmenopause.
• Infertility.

Indications for a surgical procedure are:

• Submucosal uterine fibroids.
• Intrauterine septum.
• Intrauterine synechia.
• Endometrial polyp.
• hyperplasia of the endometrium.

Contraindications are:

• Recently transferred or existing by the time of the study, the inflammatory process of the genital organs.
• Progressive pregnancy.
• Profuse uterine bleeding.
• Stenosis of the cervix.
• Advanced cervical cancer.
• General infectious diseases in the acute stage (influenza, pneumonia, pyelonephritis, thrombophlebitis).
• Severe condition of the patient with diseases of the cardiovascular system, liver, kidneys.

Indications for a diagnostic procedure are:

• Submucosal uterine fibroids.
• Intrauterine septum.
• Intrauterine synechia.
• Endometrial polyp.
• hyperplasia of the endometrium.
• Removal of remnants of the intrauterine contraceptive.

Indications for a surgical procedure:

• Suspicion of internal endometriosis of the uterine body, submucosal fibroid node, synechia (unions) in the uterine cavity, remnants of the fetal egg, cervical and endometrial cancer, endometrial pathology, perforation of the uterine walls during abortion or diagnostic curettage.
• Suspicion of malformations of the uterus.
• Menstrual disorders in women of childbearing age.
• Anomalies in the development of the uterus.
• Bleeding in postmenopause.
• Infertility.
• Control examination of the uterine cavity after surgery on the uterus, in case of miscarriage, after hormonal treatment.

Every woman, even if she cannot complain about her state of health, sooner or later comes to see a gynecologist. And this is not surprising, because gynecology as a branch of medicine deals with diseases that are unique to the female body. Gynecology is very closely related to obstetrics, which studies the phenomena that occur in the body of a woman who plans to become a mother or has already become one, and covers the period from conception to the completion of the postpartum period.

What does he do?

A gynecologist is a specialist whose task is to preserve and restore the normal functioning of the organs of the female genital area in order to be able to realize the reproductive function inherent in nature. Therefore, for any questions related to various aspects of women's health, infertility problems, pregnancy and childbirth, you should contact a gynecologist.

When should you consult?

What symptoms should let a woman know that it's time to visit a gynecologist? There are many of them, it is impossible to list them all. It can be:

• painful, heavy or too scanty periods, or their absence,
• lower abdominal pain, vaginal discharge,
• discomfort (burning) when urinating,
• any changes occurring in the vulva.

And, it goes without saying, from the moment of pregnancy, a woman should be under the constant supervision of a gynecologist.

How to become a gynecologist?

In order to get the profession of a gynecologist, one should enter any of the universities in Moscow, the list of specialties of which includes “General Medicine” (duration of study is 6 years), then undergo postgraduate education (1-3 years). For example, a reasonable choice would be the First State Moscow Medical University. I. M. Sechenov or the Faculty of Fundamental Medicine of Moscow State University. M. V. Lomonosov.

According to the established procedure, students first study general subjects, and the division into specialties occurs towards the end of the training. Mastering knowledge in the field of the chosen profession continues in the internship, during the internship in medical institutions in Moscow or another city in accordance with the distribution.

Famous specialists of Moscow

Assistance during childbirth in Russia has long been provided by midwives. It is they who can be considered the forerunners of those who later began to call themselves an obstetrician. The business of helping women in childbirth was put on a scientific basis in 1758 with the opening of an obstetric school in Moscow, later transformed into a midwifery institute. Classes at the school were invariably conducted by Professor I. F. Erasmus. A lot of time has passed since then. Moscow remembers many outstanding gynecologists: V. M. Richter, A. Ya. Krassovsky, V. I. Kokh, A. M. Makeev, N. N. raise gynecology as a science to its due height.