Laparoscopy in Gynaecology:

What is Laparoscopy?

Laparoscopy is a minimally invasive surgical procedure that allows the surgeon to access the internal organs without having to make large cuts on the skin.

Since laparoscopy uses minimal cuts, it is also known as key-hole surgery.

How is it performed?

Laparoscopy is performed with the aid of an instrument called a Laparoscope. A laparoscope is a thin tool that has a video camera and light at the end of it. This instrument is inserted inside the body through the small cut made by the surgeon which helps them visualise the internal organs clearly on a monitor.

Advantages of Laparoscopy

When compared to the traditional surgical procedures, laparoscopy offers:

• A faster recovery time and thus a shorter hospital stay.
• Less pain and bleeding after the procedure.
• Reduced scarring.
• One can resume daily activities sooner.

Laparoscopy in Gynaecology

Laparoscopy in gynaecology can be used for both diagnosis and treatment. Diagnostic laparoscopy can help your gynaecologist visualise the internal organs thereby allowing them to see if you have a condition such as endometriosis, fibroids, polyps, or any other abnormal findings, and as a treatment, it helps your doctor perform multiple surgical procedures.

• Miniature instruments of laparoscopy can help your doctor perform a variety of surgeries including:
• Removal of ovarian cyst.
• Hysterectomy (removal of the uterus).
• Surgical contraception.
• Removal of ovaries.
• Removal of fibroids.
• Removal of ectopic pregnancy.
• Endometrial tissue ablation.
• Blockage of blood flow to fibroids.
• Surgery to treat prolapsed uterus.

Laparoscopy may also be used to diagnose:

• Endometriosis.
• Uterine fibroids.
• Ovarian cysts or tumors.
• Ectopic pregnancy.
• Pelvic abscess, or pus.
• Pelvic adhesions.
• Cause of Infertility.
• Pelvic inflammatory disease.
• Cancer of reproductive organs.

What to expect during laparoscopy?

The following is done during the procedure:

General anaesthesia is given- but one can expect an early discharge from the hospital.

A catheter is inserted to collect the urine, and the abdomen is filled with a harmless gas (carbon dioxide) through a needle

The surgeon makes a small cut and inserts the laparoscope inside which transmits clear and magnified views of the internal organs on a screen. The video can also be recorded for future reference

In case a surgical procedure is done through laparoscopy then additional cuts may be made through which additional instruments are inserted to perform the surgery

After the procedure, the instruments are removed and incisions are closed using stitches

Since laparoscopy needs minimal invasion, early discharge and minimal tissue trauma is expected.

Recovery following laparoscopy

After the procedure, your vital signs are closely monitored. You’ll stay in recovery until the anesthesia wears off, you start urinating on your own and the urinary catheter is removed.

Recovery time depends on the procedure that has been performed. In some cases, one can expect a same-day discharge from the hospital, while in others one may need to stay in the hospital for a day or two.

While the after-effects of laparoscopy are minimal as compared to conventional surgical procedures you may feel some bruises and tenderness in the abdomen. Nausea can also be felt for a day or two.

Medication including antibiotics and pain killers will be prescribed by your doctor as needed and one can expect a complete recovery within a few days to weeks depending on the procedure performed.

Risk of complications in laparoscopy

Though the risk of complications is lesser with laparoscopic procedure, it may be increased in case of:

• Previous history of major pelvic or abdominal surgery
• History of pelvic infections
• Bowel disease
• In chronic smokers
• If the woman is obese
• In women with poor nutritional status
• If the woman has diabetes or other major systemic illness

Patients going for laparoscopic surgery are thus advised to give a clear and detailed history to their gynaecologist about the medicines they are taking, previous procedures done, etc. to expect minimal complications and best results.

Dr.Chandana, a leading Obstetrician, and Gynaecologist in Hyderabad has performed many successful laparoscopic surgeries.