Most gynecological injuries happen during or after gynecological surgeries. Gynecological surgeries can be done for many different reasons, including ovarian cysts, tubal ligation or repair of tubal ligation, uterine fibroid surgery, ablation of the uterine lining, hysterectomy, or repair of uterine prolapse. These procedures can be done via an open surgery in which an incision is made in the abdomen or within the vagina. It can also be done through a laparoscope, a narrow tube inserted into the vagina or abdominal wall which has a lighted camera to see the necessary structures and a part that contains the “tools” a doctor needs to perform the surgery.
Medical Negligence Solicitors
Specialist medical negligence solicitors deal with compensation claims for personal injury which may be litigated in a court of law if agreement for damages cannot be reached without the necessity for legal proceedings. A medical negligence solicitor is a specialist who whilst handling gynecology medical negligence compensation claims also deals with medical malpractice compensation claims which have different protocols and require specialist training. If you believe that you have been injured because of negligence by a medical practitioner, you should immediately contact a medical negligence solicitor for advice. Time limits apply in medical negligence compensation claims and time is of the essence – there are usually exceptions for minors and those who are mentally incapacitated. Location is relevant so you should contact a medical negligence solicitor in your locale for accurate advice.
If the surgery is for an ovarian cyst, the cyst can simply be ruptured or can be removed in its entirety. In such cases, the doctor needs to be wary that some ovarian cysts are related to cancer of the ovary. If the ovary itself is not biopsied, cancer of the ovary may be missed and the patient will not be diagnosed until a much later date, resulting in increasing debility and death. This surgery is often done via a laparoscope.
Laparoscopic Vaginal Surgery
Laparoscopic vaginal surgeries carry risks that are not as great for open surgeries. This is because doctors cannot always see everything clearly in laparoscopic surgery. There is an increased risk for bowel perforation that accidentally happens while doing gynecological surgery. Unrecognized bowel perforation can lead to infection being drawn into the abdominal space. This is called peritonitis. The infection can easily spread from here to the bloodstream, leading to sepsis, and possible cardiovascular collapse and death. It can happen with any type of gynecological surgery done with a laparoscope.
If a patient wishes permanent sterilization, the doctor can do a tubal ligation. Tubal ligations involve taking the tube that leads from the ovaries to the uterus, cutting it and tying off the ends so that no eggs can pass through the tube. The problem with this surgery is that the doctor can mistake a ligament or other tissue for the tube and will fail to close one or both fallopian tubes. This means the woman could still get pregnant even when she thought she could not become pregnant.
Tubal Ligation Reversal
Some women want to regain their fertility by having a reversal of their tubal ligation. This can be done via a laparoscope with all the risks that go along with laparoscopy. The doctor may or may not be able to restore your fertility through a reversal process. Be sure to choose a skilled surgeon who has had significant success in reversing tubal ligations.
There can be benign or cancerous tumors of the uterus that need removal. If a woman has one of the benign tumors, called a myoma, and wishes to retain her fertility, the myoma or myomas are removed if they are causing pressure on the bladder or causing excessive vaginal bleeding. It can be done via a hysteroscope, a sort of laparoscope for the inside of the uterus. It can also be done for external myomas using a laparoscope. Risks can include infection, excessive bleeding or puncturing of the uterine wall or the bowel. All of these can be serious complications and can lead to longer hospitalization, the need for further intervention and disability or death.
The woman may require a hysterectomy. A simple hysterectomy involves removing the cervix and uterus itself while retaining the egg-containing ovaries and fallopian tubes. A total hysterectomy removes the cervix, uterine body, fallopian tubes, and ovaries. Both procedures can be done via an open surgery, which is done if cancer is found or suspected. They can also be done via a vaginal incision or a laparoscope.
Risks include excessive bleeding or hidden bleeding that is not identified until the patient begins to show signs of low blood volume and shock. There can be infection or perforation of the bowel, which can be deadly. There can be mistakes in which the doctor took the ovaries and fallopian tubes when the patient did not want such a thing to happen. Loss of the ovaries plunges a woman into instant menopause, something she may not have anticipated.
The patient may have a uterine or bladder prolapse and require a sling or other mesh support to keep the uterus from falling out. This is often done if the woman wishes to retain her fertility yet suffers from debilitating prolapse. Unfortunately, such mesh or sling procedures can fail, and they can erode into the bladder, uterus or bowel causing bleeding, infection and the need for additional surgeries. Natural “slings” can be created that have fewer complications, but they tend not to work as well.
It is up to the gynecologist to explain the risks versus benefits of every gynecological procedure and to tell the patient whenever there is a chance that something besides the planned procedure. For example, the doctor may plan to do a simple hysterectomy but should warn the patient that, if the ovaries look abnormal or cancerous, they will be removed as well. The patient can then come back and say that, under no circumstances, should the ovaries be removed, and the doctor will have to abide by that.
Other complications need to be explained to the patient, such as bleeding complications, infectious complications and complications related to perforation of the uterus, bladder, or bowel. The doctor also needs to tell the patient of the chance that the surgery will fail to relieve the patient’s symptoms. For example, removing and internal myoma may still result in the patient having heavy bleeding for another reason altogether.
The doctor also needs to respond quickly to these possible complications, even if they are complications that have been explained as possibilities. If a patient is showing evidence of bleeding, for example, a laparoscopic or open procedure needs to be done promptly to stop the bleeding and prevent shock. Antibiotics are sometimes given preventatively but if infection happens anyway, the doctor must choose an antibiotic that is more effective in stopping the onslaught of infectious organisms.