Dr. Pani Bushan

Q1. What exactly is Laparoscopy?

Laparoscopy is an alternative to 'Open' surgery wherein the abdomen is opened by tiny 'key hole' incisions and surgery is done. 'Scopy' means the use of an endoscope or telescope to see inside the abdomen. This is attached to a camera and a light source and the inside of the abdomen is projected on to a monitor. The surgeon performs surgery looking at this screen. The surgeon makes a total of 2-4 small cuts on the abdomen ranging from half to 1 cm through which the telescope and other thin surgical instruments are passed into the abdomen. When the uterus is removed , known as hysterectomy, there is also a cut at the top of the vagina where the uterus is attached.

Q2. What kind of gynaecological surgeries can be performed by Laparoscopy?

Most surgeries done in gynaecology can now be performed by Laparoscopy and do not require the large incision as for open surgery. Laparoscopy can be done sometimes only for diagnosis and is called Diagnostic Laparoscopy, as in checking whether the tubes are open or not and to look for any causes of infertility or pain outside the uterus. In women who are unable to conceive, Diagnostic Laparoscopy is often combined with Hysteroscopy (endoscope inside the uterus, inserted from below, via the vagina). When laparoscopy is done to perform some surgical procedure inside the abdomen it is called Operative Laparoscopy. This may be for simple procedures like sterilization, minor adhesions, drilling ovaries; or for intermediate or major reasons like fibroids, endometriosis, removal of ovaries or tubes or both or removal of uterus, for staging of cancers or radical surgeries for cancer. However, about 5% of all surgeries including those for cancer or very large tumours may benefit from open surgery.

Q3. Why does an expert surgeon recommend Laparoscopy over Open Surgery?

Laparoscopic surgery has many advantages above open surgery: the incisions are much smaller (open surgery incisions are 8-10 cms long), therefore pain is much less; requirement for pain killers (which can have side-effects like sleepiness, impaired judgement) is lesser; hospital stay is shorter; complications fewer; requirement for blood transfusions infrequent; recovery in terms of physical, emotional and mental state is much better and quicker; return to work is faster with consequent lesser loss of working and earning days. Surgery with laparoscope is more precise because it is magnified view. Further vision is much better because it's like having your eye behind the structure because you can see with the telescope at places where the surgeon's eye cannot reach.

Q4. If the cuts on the abdomen are so small in Laparoscopic surgery, how do you remove the uterus or a large tumour from inside the abdomen?

Quite often if the tumour is not malignant and contains fluid, it is punctured to collapse it into a smaller size. If it is solid, it can be cut into smaller pieces inside the abdomen using a special instrument. The collapsed or cut structures can be removed gently through the 1 cm cut on the abdomen which may be increased a bit if required. After hysterectomy, the uterus can be removed easily from below, through the vagina.

Q5. Will there be much pain or discomfort after Laparoscopic Surgery?

There may be some pain and discomfort in lower abdomen for one day to few days after Laparoscopic surgery but this is much less as compared to open surgery because the incisions on the abdomen are much smaller and there is much less tissue handling inside the abdomen by fine instruments instead of rough, big, gloved hands which can cause tissue injury in open surgery. There may be some pain in the shoulder following laparoscopy. This is not serious and is due to the gas used in the surgery to make space for instruments.

Q6. When can I be discharged from hospital?

Following Diagnostic Laparoscopy or with simple Operative Laparoscopy you can expect to be discharged from hospital latest by the morning after surgery. In most other cases of intermediate or even major surgery, discharge is generally 1-2 days following the surgery unless there is some health issues prior to the surgery or any complication during the surgery. The complication rates for Laparoscopic surgery are not more than for open surgery and depend upon patient factors like anaemia, diabetes, obesity and skill of the surgeon.

Q7. When can I perform routine household activities or return to work after Laparoscopic Surgery?

Recovery after surgery depends upon many factors: presence of health problems before surgery; why the surgery is required; what surgery is being done; problems or complications of surgery, anaesthesia or blood transfusions. If all is well, one can perform routine household activities by 1 week, provided one doesn't feel tired. Although there may not be any harm, it may be unwise to be normally active within 48 hours of procedure. Following Diagnostic Laparoscopy or Operative Laparoscopy for simple procedures, one can return to work in 1 week. For other procedures, a 2-3 week off from work is reasonable. It depends on the type of work you are returning to. Avoid too rapid return to work if it is manually hard or requires standing for long durations of time. Sometimes a surgical procedure brings on a well needed rest and break from a lifetime of work. Mostly, when you return to work depends upon your own body and its signals of tiredness. You need to listen to those signals.

It has been seen that children absolutely resist taking medicines, especially the conventional kind that may not agree with their sweet craving taste buds. Yet, the sweet pellets of Homeopathic medicines appeal to many children. Also, these drugs are safe and they make use of the body’s defences when it comes to fighting and treating ailments. Read on to know more about improving your child’s health with the help of homeopathy.

Treating Infant Problems: Homeopathic drugs are known to treat a number of infant related ailments like teething and the aches and pains caused by the same, as well as colic and other ailments like ear ache. These drugs are usually quick and effective when it comes to removing the discomfort that the child may be experiencing which can keep the child from turning cranky. These medicines can be used to treat acute and sudden problems as well as long term issues that seem to reoccur often.

Side Effects: One of the most common benefits of Homeopathic drugs includes the lack of side effects for children and adults alike. This quality is especially helpful for children. Let us understand why. The side effects of many conventional medicines may have a direct or indirect bearing on the growth as well as the development of the child’s immunity. With Homeopathy, the child is at no such risk. With its complete lack of side effects, these kinds of medicines ensure that the child’s growth, development and immunity do not suffer. In fact, these medicines are completely safe and are known to use resources from within the body rather than impairing such resources with an intense effect.

Response: Children are known to respond to very well to Homeopathic remedies because their bodies are still not used to the intensity of conventional medication, which makes them more receptive in general.

Various Homeopathic Medicines for Children: Aconite is one of the most widely used Homeopathic drugs that is used for treating sudden ailments like fever, fright, shock and cough or cold, as well. Arnica can also be used for various injuries. Belladona is best used for fever and persistent crying or fretfulness. Borax can be used to cure various digestive upsets. Calendula is also used to treat minor abrasions as well as sun burns as well as scalds and wounds. Chamomilla also helps in treating bedwetting problems for children. One can also use Homeopathic drugs on a regular basis once teething begins so that the child is not prone to fever and fits of crying. Also, children can be given Homeopathic drugs for deworming at least once a year. This will also help to clear out the toxins and build better appetite. If you wish to discuss about any specific problem, you can consult a Homeopath.