Laparoscopic gynecologic surgery has become very popular in today’s gynecologic practice
Gynecologic laparoscopy is an alternative to open surgery.It is considered the GOLD STANDARD method for exploring INFERTILITY or CHRONIC PELVIC PAIN . It also has a unique value in the diagnosis of ENDOMETRIOSIS as it is the only mean of setting a sure diagnosis through direct view. Today more and more classic gynecologic operations are being replaced by laparoscopy, like tubal ligation, adnexal surgery, myomectomy, hysterectomy, and even cases of gynecologic cancer.
Laparoscopy is a surgical MINIMAL INVASIVE procedure doctors do to directly view a woman’s reproductive organs like uterus,fellopian tubes,ovaries,and adnexal structures without opening the whole abdomen of the patient.
A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen.Laparoscope is inserted into the pelvic and abdominal cavities to diagnose and treat gynecologic disorders. Instead of using fluid to expand the cavity, carbon dioxide gas is introduced to provide visualization of the internal organs. A camera is attached to guide the surgeon and to document the findings with photographs.
Using the laparoscope, the doctor can look directly at the outside of the uterus, ovaries, fallopian tubes, and nearby organs.
It is performed either as a purely diagnostic procedure or as a surgical treatment
1.Smaller surgical scars
2.Reduced blood loss during surgery
3.Less pain following surgery
4.Shorter hospital stay
5.Faster return to normal activity
6. Reduced Risk of Infection.
The advent of laparoscopic surgery represents a shift from the era of open abdominal surgery to the minimally invasive surgery.Laparoscopy has gained a leading role in diagnosis and treatment of following gynecologic problems-
• INFERTILITY
• REMOVAL OF OVARIAN CYST OR ADNEXA
• ECTOPIC PREGNANCY MANAGEMENT
• HEMORRHAGIC RUPTURE OF A CYST
• CHRONIC PELVIC PAIN
• ENDOMETRIOSIS
• REMOVAL OF FIBROIDS
• LAPROSCOPIC HYSTERECTOMY,
• TUBAL LIGATION
• TUBAL REANASTOMOSIS
• PELVIC ORGAN PROLAPSES
• URINARY INCONTINENCE
• GYNECOLOGIC CANCERS STAGING
DIAGNOSTIC LAPAROSCOPY
Diagnostic laparoscopy is used for the investigation of chronic pelvic pain and infertility.
Diagnostic laparoscopy is the final step in determining the cause of infertility and is also frequently performed as a standard procedure in diagnosing UNEXPLAINED INFERTILITY.
In cases of women with chronic pelvic pain, various pathology might be discovered like endometriosis, adhesions, pelvic inflammatory disease, or other kind of urinary tract or bowel pathology. Laparoscopy holds a special place in the diagnosis of this problem as it is the gold standard diagnostic test in clinical practice for the accurate diagnosis of endometriosis
RISK IN LAPROSCOPY-
Despite the advantages of laparoscopic procedures, they do not come without risk and complications for the patient.
• Deep vein thrombosis
• Bladder or bowel injury
• Inflamation
• Post operatives adhesions.
• Pelvic blood vessels injury
Patients considered to be subjected to laparoscopy should be carefully chosen.It is also important to consider that the first steps of the laparoscopic procedure are done in a “blind” way, so the selection of which patients are suitable for the procedure is something that must be done correctly, excluding patients that might be classified as high risk.
Not all gynecologic conditions can be treated with laparoscopy. Very large tumors or masses may need open surgery. Extensive endometriosis can also be very difficult to treat laparoscopically because of associated adhesions , which can involve the adjacent bowel, bladder, ureters, etc. have a world class MODULAR OPERATION THEATER equipped with the most advance GERMAN ENDOSCOPY UNIT which allow our doctor to effectively diagnose and treat most of the Gynaecological problems of female without exerting her to long hospital stay and postoperative pain.
Dr. Neha Singh MBBS, MS Obs and Gynae, Advance fellow in Reproductive Medicine. Worked at Indira IVF as Gynecologist from 2017 to 2020. She is a compassionate woman Doctor and a humble and polite human being.
