Laproscopy

Laparoscopy is a procedure to look inside the abdomen by using a high definition, thin telescope called laparoscope. It is used to light up and magnify the structures inside the abdomen. A laparoscope is passed into the abdomen through a small incision in the abdomen. A laparoscopy may be done to find the cause of symptoms such as infertility or abdominal / pelvic pain . Or, it may be done if a previous test such as an X-ray or ultrasound scan has identified a problem within the abdomen or pelvis. A laparoscopy enables a doctor to see clearly inside the abdomen and perform the treatment at the same time in many cases.

In addition to simply looking inside, a doctor can use fine instruments, which are passed into the abdomen through small incisions in the abdomen. These instruments are used to cut or trim tissues, perform sample taking (biopsies), grasp organs, etc., inside the abdomen. The laparoscopic surgery is also sometimes called ‘keyhole surgery’ or ‘minimally invasive surgery’. This surgery is usually done under general anesthesia 

Laparoscopic surgery generally has a shorter healing time as compared to a conventional open surgery. It requires shorter hospitalization, is less painful, leaves smaller scars and has a faster and better recovery.

Some commonly performed   laparoscopic gynaecologic procedures include:

• Ovarian cyst removal
• Surgery for endometriosis (removal of endometrioma, ablation of endometriotic spots)
• Tubal ligation ( surgical contraception )
• Hysterectomy ( removal of uterus)
• Myomectomy ( removal of fibroids from the uterus)
• Treating ectopic pregnancy
• Fertility enhancing surgeries like releasing adhesions, removal of blocks in the fallopian tube
•  Polycystic ovarian drilling
• Burch procedure for urinary incontinence
• Surgery for gynaecologic cancers

Advances in Laparoscopy

• Robotic surgery is sometimes used for gynecological laparoscopy. Robotic arms are steadier than human hands. They may also be better at fine manipulations.
• Micro laparoscopy is a newer approach. It uses even smaller scopes. This procedure can be done with local anesthesia in your gynecologists clinic.

WHY TO CONSIDER LAPAROSCOPY OVER CONVENTIONAL SURGERY?

• Less discomfort .
• Less hospital stay, with a quicker recovery time compared to regular surgery
• Lesser blood loss
• Minimal Scar
• Faster recovery
• Better cosmetic results
• Better magnification and visualisation of internal organ

Hysteroscopy

 A specialized gynaecological procedure in which the surgeon looks inside the uterus with a camera after distending it with a media solution and then proceeds to perform the required surgical procedure. Usually, an OPD procedure, may be done without anesthesia or under short general anesthesia.

Advantages include better visualization, ease to do procedures which cannot be done by conventional techniques, lesser blood loss, lesser pain and faster recovery.

Following procedures can be done by hysteroscopic technique:

Hysteroscopic endometrial biopsies, removal of lost IUCDs, hysteroscopic synechiolysis, hysteroscopic myomectomies, hysteroscopic polypectomies, hysteroscopic septal resection

Dr Anjali Kumar is a well known gynaecological endoscopic surgeon in Gurgaon, having done certificate course and training from World Association of Laparoscopic Surgeons and Ethicon endosurgery Institute New Delhi. She has more than 25 yrs of experience in gynaecologic laparoscopic surgeries and has performed many complicated gynaecological laparoscopic surgeries till date. Her area of expertise includes laparoscopic hysterectomies, laparoscopic myomectomies, laparoscopic management of ectopic pregnancies (tubal conservation surgeries), laparoscopic treatment of ovarian cysts, laparoscopic fertility enhancing surgeries,  laparoscopic surgery for endometriosis, tubal ligations and many more.