Laparoscopic Surgery

Overview

In gynecology, laparoscopy is a less invasive alternative to open surgery.  It is also known as minimally invasive or keyhole surgery.

Gynecologists use a long, thin tube with a camera and light (laparoscope) to look inside the pelvic area. Laparoscopy in gynecology is both diagnostic and therapeutic procedure. It is used to diagnose gynecological conditions and also to perform surgery to treat them. A gynecologist who specializes in this procedure makes 3 to 4 small incisions in the abdomen and inserts a laparoscope and special instruments through them to perform surgery. When compared to open surgery, laparoscopic surgery is less invasive as it involves, less incisions and scarring – and the recovery and healing is also faster with laparoscopy.

Laparoscopy is useful for the diagnosis of the following gynecological conditions:

• Endometriosis
• Uterine fibroids
• Ovarian cysts or tumors
• Uterine cancer
• Cancer of the reproductive organs
• Pelvic inflammatory disease
• Pelvic abscesses
• Ectopic pregnancy (pregnancy outside the uterus)
• Pelvic adhesions
• Causes of infertility

Laparoscopy is useful for the treatment of the following gynecological conditions

• Endometriosis
• Uterine and ovarian tumors removal
• Hysterectomy (uterus removal)
• Tubal sterilization (permanent sterilization)
• Removal of adhesions and scar tissues
• Prolapse uterus treatment
• Fibroids treatment

Laparoscopy Procedure

The procedure is performed under general anesthesia. The patient remains unconscious during the entire procedure. The surgeon Inflates the abdomen by filling carbon dioxide gas. The abdominal cavity expands and widens to provide a better view of the pelvic organs – and to prevent damage to internal organs. The laparoscopic surgeon makes 3 to 4 small incisions – one below the belly button and two each on either side. The surgeon inserts a laparoscope with a camera and light. The camera transmits the video to a screen with a clear and magnified view of the pelvic organs. For a diagnostic laparoscopy, your surgeon makes only one incision to insert the laparoscope. For a surgical procedure the surgeon makes two to three small incisions to insert specialized instruments. After completion of the procedure, the surgeon stitches or sutures the small incisions and dress them.

The Best Less Invasive Laparoscopic Treatment for Uterine Fibroids

Laparoscopic radiofrequency ablation (Acessa), also called Lap-RFA: In this procedure, your gynecologist makes small incisions in your abdomen. The doctor inserts slim laparoscope – a viewing instrument with a camera at the tip. Your gynecologist uses a laparoscopic ultrasound tool as well – to locate and treat fibroids.

After identifying the location of your fibroid, your gynecologist employs a special device – and then deploys many small needles into the fibroid. She does this to heat and destroy the fibroid tissue. After treatment the fibroid changes its consistency transforming from a hard mass to soft tissue. Over the next two to three months, the fibroid shrinks progressively and the symptoms improve.

This is, infact – the best alternative to myomectomy or hysterectomy because most women consider it as less invasive to both these procedures. In addition, many women resume their routine activities after 5 to 6 days after the procedure.

Recovery

After the procedure, the patient will stay in the recovery room for a few hours. The hospital stay would mostly be around 24 to 48 hours. The patient will return home and can resume their daily activities within a day or two. However, they are restrained from doing strenuous activities, exercise, weight lifting and other specific activities until the doctor allows them. The recovery can take a few weeks’ time. Doctors prescribe painkillers and antibiotics for a few days following the procedure. In general, the recovery after a laparoscopic surgery is faster compared to open surgery.

Bottom Line

Laparoscopy is now used for a wide range of gynecological procedures. It has become one of the most common gynecological procedures even for addressing major gynecological health issues. It is also the most common procedure worldwide for a multitude of nongynecological indications.

Laparoscopy has become the treatment of choice for the treatment of ovarian cyst, fibroids and uterine problems. In fact, laparoscopy is the gold standard treatment for endometriosis. Let it be the removal of ectopic pregnancy or uterus (hysterectomy), laparoscopy is the treatment of choice. When compared with laparotomy, laparoscopy is safe, efficient, less painful and provides shorter recovery time.

The advantages of the laparoscopic approach for other procedures, including myomectomy, sacral colpopexy, and the staging and treatment of gynecologic cancers, continue to broaden.

Modern technological advancements and evolving research have resulted in the advancements of laparoscopic techniques. Better instrumentation, technology, high-end cameras have resulted in the emergence of robotically assisted laparoscopic surgery – and now, single port laparoscopy as well.