What is Laparoscopy ?
Laparoscopic surgery is also known by other names like
- Minimally invasive surgery
- Endoscopic surgery
- Key hole surgery
It is the latest and best form of treatment available for Gynecological disorders requiring surgery (operation).
How is Laparoscopic surgery carried out ?
A small incision (cut) about 1 cm is made at the lower end of the navel through this a trocar (a sharp instrument) is introduced into the abdomen the carbon dioxide gas is inserted into the abdomen through the trocar (the gas is removed at the end if surgery) following which the laparoscope (Telescope) is inserted this catties with it a fibre optic light source with a powerful xenon light which lights up the area to be operated. The laparoscope is also connected to a camera, and a T V monitor the surgeon then looks at the T V monitor and operates thru, 2 – 3, 1/2 cm size cuts made on the abdomen.
Who should get laparoscopic surgery done ?
Hysterectomy total laparoscopic – Hysterectomy for various disorders of the uterus where the uterus has to be removed.
Myomectomy – For removal of fibroid (non cancerous ball like growth) from the uterus in case where uterus has to be preserved for future child bearing.
Adhesiolysis – Is removal of adhesions. Adhesions are bands of tissue which make organs stick to each other and cause a lot of pain and are responsible for many cases of infertility and chronic pelvic pain these are best removed laparoscopically.
Ovarian Cystectomy – Is removal of cysts from the ovary.
Endometriosis – This is a condition which leads to a lot of menstrual (period) pain dysparenunia (painful intercourse) and infertility. This is the best treated Laparoscopically.
Ectopic pregnancy – Is pregnancy outside the uterus in the tube or ovary is best handled Laparoscopically especially when future child bearing is desired by the patient.
Polycystic Ovarian Drilling – PCOD is soon becoming an epidemic in India and is a major cause of infertility drilling these large ovaries (in selected cases) often restores fertility.
Diagnostic laparoscopy for infertility.
Diagnosticlaparoscopy for Chronic pelvic pain.
Radical hysterectomy – Today even Cancer surgery is best done laparoscopically as in cases of cervical (mouth of uterus) cancers.
Ileal Vaginoplasty– For Patients with absent vagina
Laparoscopic Cerclage– For recurrent pregnancy loss
Recannalisation – Conditions where the patient wants to conceive again in an already sterlised status
Wedge resection – Surgical procedure done in various disorders of the wherein uterus but the patient wants to retain the uterus
- Laparoscopic Mesh repair – Conditions with prolapse (ie mass coming per vagina)
- Lapariscopic Fistula repair
- Laparoscopic Uterine Transplant
The Advantages Of Laparoscopic Surgery Over Conventional Surgery
For the Patient
- Pre operatively only 8 hours of fasting is required by the patient and no enema or bowel preparation except in high risk cases this makes patients very comfortable preoperatively. Patients need to get admitted into the Hospital only on the day of surgery and can be at home one night before so are more comfortable facing the surgery.
- It gives rise to minimal tissue handling and much less tissue trauma to the other adjacent normal organs resulting in very minimal pain after the operation.
- 2-3 very small incisions of 0.5 – 1.0 cm are given on the abdomen resulting in less amount of blood loss, less post operative pain, less chances of wound infection, early healing of wound.
- Blood loss is very less because even the smaller blood vessels are directly visualized on the T V monitor with the magnified view provided by laparoscope.
- As the abdominal incision is very short and the operative work is very specific with minimal blood loss, the chances of post operative infection are very less.
- The hospital stay is usually 1 – 3 days even for the major operations like Hysterectomy while in case of conventional surgery the same procedures will require 5 – 7 or even more days of Hospital stay.
- The recovery time for the patient is very less and they can resume their normal day to day activities in a period of 1 – 2 weeks while in case of conventional surgery the recovery period is quite long and can extend to 6 – 8 weeks or more.
- For infertility patients laparoscopic surgery has come as a boon as with minimal tissue handling, minimal bleeding and much less chances of adhesion formation after the operation, the chances of achievement of pregnancy are much greater then that attained by the conventional surgery.
- As far as the total expenditure of the patient is concerned, laparoscopic surgery is more cost effective than the conventional surgery.
- Very small incisions on abdomen are much more cosmetic with very little scarring.
For the Surgeon
- The powerful xenon light source inserted with the laparoscope lights up the area to be operated and helps the surgeon operate better.
- The laparoscope (Telescope) magnifies the area to be operated 5 – 20 times and so very specific area can be seen very clearly (much better then the naked eye can see at open surgery) and the surgeon can operate better.
- Even very small bleeders can be checked at the end of the surgery by the surgeon. As no blood is left behind at the end of the surgery patient feels very little pain and the chances of infection are also minimal.
Where Should One Get The Laparoscopic Surgery Done ?
Before getting the Laparoscopic surgery done, it is always advisable to see that your Gynaecological Laparoscopic Surgeon being a Gynaecologist is well qualified and fully trained in the field of Operative Laparoscopy.
How Can One Get The Laparoscopic Surgery Done ?
If one has been advised an operation for some Gynaecological disorder, it is better to consult a Gynaecological Laparoscopic Surgeon for undergoing Laparoscopic surgery.
An appointment can be taken with the Gynaecological Laparoscopic Surgeon. Before the consultation, it is always advisable to take all the relevant papers, investigation reports along with the Ultrasound / X-Ray report if available, and the previous treatment reports (if any) to show to her, so that your proper treatment can be planned accordingly.
After thorough examination of the patient and carrying out relevant investigations, the operative laparoscopy technique is decided for the patient and it is explained to the patient and her relatives in detail. All the queries regarding the operation are discussed with the patient and a specific date (depending upon various factors like the menstrual cycle status of the patient etc.) is finally set for operative laparoscopy.
|Laparoscopy Surgery||Open Operation|
|Full recovery in 1 week||Full recovery in 6 weeks|
|Glucose drip for a few hours||Glucose drip for 2 – 4 days|
|Back home in 1 – 2 days||Hospital stay for days|
|No obvious scar|