August 11, 2015

Gynecological Laparoscopic Surgery

Laparoscopic Hysterectomy

In this type of hysterectomy, the surgeon inserts a thin, lighted telescope-like instrument called a laparoscope and other small surgical instruments into the navel and abdomen through 3 to 4 small incisions, each less than a quarter-inch long. The laparoscope acts like a video camera, guiding the surgeon as she carefully removes the uterus through one of the openings.

Because laparoscopic hysterectomy does not require the surgeon to make a large abdominal incision, it’s a less invasive procedure than traditional methods of hysterectomy.

In a laparoscopic hysterectomy, the cervix, the bottom part of the uterus, may be left intact.

Benefits of laparoscopy hysterectomy include:

  • Better visualization
  • The procedure can often be done outpatient, or involves an overnight hospital stay
  • Less pain medication is required
  • Fewer complications
  • Smaller (hardly visible) scars
  • Back to work sometimes in as little as 1 week.

Diagnostic Laparoscopy

A Diagnostic Laparoscopy helps identify the cause of pain in the abdomen and pelvic area. It is done if other noninvasive tests do not identify the cause of pain. Laparoscopy may detect or diagnose the following conditions:

  • Appendicitis
  • Cancer, such as ovarian cancer
  • Ectopic pregnancy
  • Endometriosis
  • Inflammation of the gallbladder (cholecystitis)
  • Pelvic inflammatory disease

Diagnostic laparoscopy is a procedure that allows the surgeon to look directly at the contents of a patient’s abdomen or pelvis, including the fallopian tubes, ovaries, uterus, small bowel, large bowel, appendix, liver, and gallbladder.

The surgeon makes a small cut below the navel area and inserts her instruments under direct visualization.   Carbon dioxide gas is passed into the area to help move the abdominal wall and any organs out of the way, creating a larger space to work in. This helps the surgeon see the area better.

A tube is placed through the cut in your abdominal area. A tiny video camera (laparoscope) goes through this tube and is used to see the inside of your pelvis and abdomen. Additional small cuts may be made if other instruments are needed to get a better view of certain organs.You will have bandages over those small incision areas.

Laparoscopic Ovarian Cystectomy (Removal of Cysts)

An ovarian cystectomy procedure removes cysts from an affected ovary and in most cases ovaries are left intact. In order to rule out the possibility of ovarian cancer, your doctor may also biopsy any tissue that has been removed.

A cystectomy may be required if a cyst:

  • Affects fertility
  • Bleeds
  • Causes pain
  • Doesn’t go away after several periods
  • Grows larger over several cycles
  • Shows signs of being malignant

A laparoscopic cystectomy procedure is a relatively minor surgery, usually lasting no longer than an hour. The doctor places the patient under general anesthesia, and inserts a thin tube called a laparoscope through several small incisions in the abdomen. She then threads surgical tools and a fiber-optic camera through the laparoscope to perform the cystectomy (removal of cysts).  Laparoscopic ovarian cystectomy recovery times are also shorter for than those of a traditional open abdominal cystectomy procedure.

Laparoscopic Lysis of Adhesions

Adhesions are abnormal attachments between abdominal organs of all sorts. Because internal organs normally move independently of each other, adhesions can affect the functioning of organs and may result in chronic abdominal pain. Before the laparoscopic technique was developed, adhesions were often left untreated.  With the development of minimally invasive surgery, adhesions can now be removed with little internal and external scarring.

Your surgeon will make three to four small incisions, and insert tube-like instruments through them. The abdomen will be filled with gas to help the surgeon view the abdominal cavity. A camera will be inserted through one of the tubes.  In this manner, the surgeon will be able to work inside your abdomen without making a larger incision.Once the adhesions are identified, they are cut to free the organs from each other. The laparoscopic devices arethen removed, and the incisions are closed.