Laparoscopy

Laparoscopy

DEFINITION

A gynaecological laparoscopy is the use of a narrow, tube-like telescope called a laparoscope for examination of reproductive organs (the fallopian tubes, the ovaries and the womb). The instrument is inserted through small cuts on abdomen under general anaesthesia. Laparoscopy can also be used for surgery for many gynaecological disorders.

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

Diagnostic Laparoscopy

Laparoscopy in gynaecology can be used to check for any abnormalities in the uterus, ovaries, fallopian tubes, and other organs which are not evident by other diagnostic procedures such as X-rays and other scans.

Operative Laparoscopy

Laparoscopic surgery can be used to address a number of gynaecologic conditions that used to require large incisions. Laparoscopic techniques allow surgery to be performed with less suffering to patients, and minimal damage to body tissues.

Laparoscopy is used to diagnose and treat the conditions of pelvic pain, infertility, fibroids, cysts, tumours, endometriosis, ectopic (tubal) pregnancies, pelvic inflammatory disease, and other gynaecological problems.

Laparoscopic Surgery – Ovarian Mass or Cyst

An ovarian cyst is a closed sac within the ovary that contains fluid or solid material which may cause pain or can become cancerous. Ovarian cysts or masses can often be removed via laparoscopy with several tiny incisions in the abdomen.

Often just the cyst or mass can be removed, leaving the ovary in place, but sometimes it is necessary to remove the entire ovary. If an ovary is removed, the other remaining ovary will take over the function for both ovaries, so menstrual periods and fertility generally aren’t affected.

Laparoscopic removal of Uterus (Hysterectomy)

Laparoscopic Hysterectomy can recommended to patients for problems associated with periods, pelvic pain, tumours uterine bleeding and other related conditions. These conditions may cause complication in pregnancy and abdominal pain.

Women can choose to either keep the cervix in place (called a “laparoscopic supracervical hysterectomy”) or remove the entire uterus and cervix (“total laparoscopic hysterectomy”). Women whose cervices stay in place need to continue getting pap smears.

In the Total Laparoscopic Hysterectomy or TLH, the laparoscope is used to remove the entire uterus from the abdomen. The ovaries may or may not be removed at the same time.

Entire uterus should be removed –

• If the woman wants to be 100% certain that she will never menstruate again.

• If the patient has a history of pre-cancerous changes of the cervix or uterine lining.

Laparoscopic removal of fibroid (myomectomy)

Fibroids are non-cancerous tumours of the uterus, which can appear on the inside or outside lining of your uterus, or within its muscular wall.

Myomectomy is an operation to remove fibroid tumours (myomas) from the uterus. This technique retains the uterus, and is an alternative treatment to hysterectomy.

Fibroids often cause no problems, but may occasionally be associated with infertility, miscarriage and premature labour or heavy, lengthy and painful periods.

ADVANTAGES OF LAPAROSCOPY

• Small incisions and less scarring

• Gentler handling of the body tissues and organs during the operation

• Less postoperative pain

• Less postoperative narcotic use for pain relief

• Shorter hospitalisation

• Faster overall recovery with an earlier return to normal activity