Laparoscopic Surgery/ Key Hole Surgery

Dr Yuvakshi Juneja has expertise in Total hysterectomy (TLH),  Myomectomy,  Cystectomy,  Recanalization,   Prolapse repair. Hysteroscopic Tubal Cannulation,  Myomectomy,   Synthiolysis.

 

Laparoscopy is a surgical procedure that allows a doctor to see inside of the abdomen. In a female, the uterus, fallopian tubes and ovaries are located in the pelvis which is at the very bottom of the abdomen. Laparoscopy allows the doctor to see any abnormalities that might interfere with a woman’s ability to conceive a pregnancy. The most common problems are endometriosis, pelvic adhesions, ovarian cysts and uterine fibroids.

What is a laparoscope?

A laparoscope is a thin fibre optic telescope that is inserted into the abdomen usually through the belly button. The fibre optics allow a light to be used to see inside the abdomen. Carbon dioxide (CO2) gas is placed into the abdomen prior to inserting the laparoscope. This lifts the abdominal wall and allows for some separation of the organs inside the abdomen making it easier for the fertility doctor to see the pelvic organs during the surgery.

With miniaturized instruments, doctor can perform a variety of surgeries. These include:

  • ovarian cyst removal
  • tubal ligation, which is surgical contraception
  • hysterectomy

Laparoscopy generally has a shorter healing time than open surgery. It also leaves smaller scars. A gynaecologist, general surgeon, or another type of specialist may perform this procedure.

Reasons for gynecologic laparoscopy

Laparoscopy can be used for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into treatment.

Some reasons for diagnostic laparoscopy are:

  • unexplained pelvic pain
  • unexplained infertility
  • a history of pelvic infection

Conditions that might be diagnosed using laparoscopy include:

  • endometriosis
  • uterine fibroids
  • ovarian cysts or tumours
  • ectopic pregnancy
  • pelvic abscess, or pus
  • pelvic adhesions, or painful scar tissue
  • infertility
  • pelvic inflammatory disease
  • reproductive cancers

Some types of laparoscopic treatment include:

  • hysterectomy, or removal of the uterus
  • removal of the ovaries
  • removal of ovarian cysts
  • removal of fibroids
  • blocking blood flow to fibroids
  • endometrial tissue ablation, which is a treatment for endometriosis
  • adhesion removal
  • reversal of a contraceptive surgery called tubal ligation
  • Burch procedure for incontinence
  • vault suspension to treat a prolapsed uterus

Procedure

Laparoscopy is almost always performed under general anaesthesia. This means you’ll be unconscious for the procedure. However, you may still be able to go home the same day.

Your surgeon will make a small cut in your navel and insert the laparoscope, which transmits images to a screen. This gives your doctor a clear view of your organs.

What happens next depends on the type of procedure. For diagnosis, your doctor might take a look and then be done. If you need surgery, other incisions will be made. Instruments will be inserted through these holes. Then, surgery is performed using the laparoscope as a guide.

Once the procedure is over, all instruments are removed. Incisions are closed with stitches, and then you’re bandaged and sent to recovery.

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Recovery After laparoscopy

Once the procedure is over, nurses will monitor your vital signs. You’ll stay in recovery until the anaesthesia wears off. You will not be released until you can urinate on your own. Difficulty urinating is a possible side effect of catheter use.

Recovery time varies. It depends on what procedure was performed. You may be free to go home a few hours after surgery. You might also have to stay in the hospital for one or more nights.

After surgery, your belly button might be tender. There may be bruises on your stomach. The gas inside you can make your chest, middle, and shoulders ache. There’s also a chance that you’ll feel nauseated for the rest of the day.

Before you go home, your doctor will give you instructions on how to manage possible side effects. Your doctor may prescribe pain medication or antibiotics to prevent an infection.

Depending on the surgery, you may be told to rest for a few days or weeks. It may take a month or more to return to normal activities.

Serious complications of laparoscopy are rare. However, you should call your doctor if you have:

  • serious abdominal pain
  • prolonged nausea and vomiting
  • fever of 101°F or higher
  • pus or significant bleeding at your incision site
  • pain during urination or bowel movements

The results of these procedures are usually good. This technology allows the surgeon to easily see and diagnose many problems. Recovery time is also shorter compared to open surgery.