Laparoscopy is one of the most common procedures for diagnosing and removing endometriosis. Instead of giving a big incision, this procedure of surgery uses lightweight instrument through a small hole or incision. There could be one or more incisions based on the number of instruments that require access inside the body. This procedure involves the use of a camera to ascertain endometriosis as well as treat it in the same sitting. This brings drastic improvement in infertility as well as pain associated with the endometriosis. If a cyst is found in the ovary, laparoscopic surgeon removes it very delicately without causing any harm to the normal ovary, as a part of the Laparoscopic Surgery for Endometriosis.
How does the procedure go?
Eating and drinking should be suspended before 8 hours of the laparoscopic surgery. The doctor takes a call on whether to give general or local anesthesia. Mostly, General anaesthesia is given during such procedures. A person specialised in Gynecological Endoscopy ( Gynaec Laparoscopic Surgeon) is the best to perform such a procedure.
How is the procedure performed?
The abdomen is first inflated with gas with the help of a needle. It pushes the abdominal wall from the organs to give clear visibility to a surgeon. The laparoscopic camera is then pushed through an incision or a set of incisions to examine the internal organ. If the scar tissue or endometriosis needs to be removed, a doctor can use one of the several laparoscopic techniques such as electrocautery, excision etc. Post the surgery, the incision is closed with stitches. The whole procedure usually takes 30-60 minutes depending upon the severity of endometriosis.
Why is laparoscopy done?
Duration of hospital stay:
Operations such as these are usually conducted at the outpatient facility owing to their less risky nature. A patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalisation may also be required. One can successfully return to normal work within 1 week of the surgery.
Post-surgical recovery: Once the laparoscopy is done, the next steps of treatment are decided based on the patient's age and severity of endometriosis. Few hormonal medicines are advised according to the desire for fertility etc. If a patient is over and above 35 years of age, the risk of miscarriages double. Since the quality of egg declines by the year, it makes sense to undergo infertility treatment such as the in vitro fertilization, intake of fertility drugs, insemination etc. If, however, the patient is below 35 years of age, makes sense to conceive naturally first and consult a doctor simultaneously. A routine check-up post-laparoscopic surgery on alternate six months for a year will keep any risks at bay.
What is an Appendectomy?
An appendectomy (which is sometimes referred to ‘appendicectomy’) is the surgical elimination of the organ known as the appendix. Appendectomy is mostly performed as an emergency surgical procedure when patients suffer from appendicitis.
How is Appendectomy Performed?
Appendectomy can be performed both as an open operation as well as laparoscopically. An appendectomy is most often performed laparoscopically, if the diagnosis is in doubt, or if the patients feel that they need to hide their telltale surgical scars near their umbilicus or in the pubic hairline.
However, although laparoscopic appendectomy has its cosmetic advantages, and its recovery time is a little quicker, this procedure is more expensive than conventional open surgery.
Conventional Open Appendectomy-
In the conventional open surgery, the surgeon makes an incision which is less than 3 inches in length in the lower right section of the abdomen. Once the infected appendix is identified, the surgeon separates the infected appendix from its surrounding tissues and removes it surgically from the cecum (an intraperitoneal pouch that forms the junction of the small and large intestine). After that, the cecum is closed and is returned back into the abdomen. In the end, the muscle layers and the skin are sewn together and the incision is closed.
Laparoscopic Appendectomy (LA)-
While performing appendectomy laparoscopically, which is also known as LA, four incisions of 1 inch in length are made in the abdomen. One incision is made near the umbilicus, while another one is made in an appropriate region between the umbilicus and the pubis. The other two incisions, which are even smaller in size, are made on the right side of the lower abdomen. The surgeon then passes the camera and special laparoscopy instruments through these openings and after identifying, frees the appendix from its surrounding tissues. Next, the appendix is removed from the cecum and the site of its former attachment is sewed. The infected appendix is removed from the body of the patient through any one of the two 1 inch incisions. In the end, the laparoscopic instruments are removed and the incisions are sutured and closed. During this whole procedure, the intraperitoneal space is filled with medical grade carbon dioxide gas, to inflate the abdomen, which is released after the surgery.
Recovery Time For Appendectomy-
The recovery time for appendectomy depends on and varies with the type of procedure and anesthesia used during the surgery. While laparoscopic appendectomy can be done on an outpatient basis so that the patients can recover back at home, an open surgical procedure will require an overnight or even longer hospital stay.
Normally patients after appendectomy can resume their normal daily activities within a few days. However, for the full recovery, it may take four to six weeks. Patients are advised to avoid strenuous activities during this period of time.
Risk and Long Term Consequences of Removing the Appendix-
While wound infections are the most common complications of this surgery, the formation of an abscess in the area of the surgical incision and also in the area close to the removed appendix has also been noticed as an aftermath of appendectomy.
Major long-term consequences of appendectomy include increased risks of bowel obstruction, stump appendicitis (infection in the retained portion of the appendix still stuck with the cecum) and development of incisional hernia at the site of the scar.
Laparoscopic abdominal cerclage- placing tape around the cervix (mouth of the uterus) to prevent miscarriage in a patient with proven cervical incompetence (loose cervix) and failed vaginal cerclage leading to second-trimester miscarriage. The tape is placed at the level of the internal os, much higher in cervix compared to vaginal cerclage, hence giving a better success rate, more than 90 percent successful pregnancy. Laparoscopy cerclage is very fast surgery, bloodless, painless and patient is discharged on the same day. Total time taken for surgery is approx 20mins.
3D laparoscopy has made a landmark achievement in the field of surgery for Gynaecology. It helps to provide in-depth perception along with the correct measurement of the dimensions related to the anatomical spaces. Thus, it contributes towards increasing the skills of the laparoscopic surgeon in his attempt towards dissecting tissues and in designing strategies related to the surgery. 3D Laparoscopy helps a surgeon to perform the intracorporeal suture in an absolutely perfect manner. This is regarded as the World’s Best 3D Laparoscopy System. The very first installation has taken place in Gujarat.
3D laparoscopy helps to reduce the time frame of a gynaecologist and along with it, it increases the accuracy level of the surgeon. Even the complications involved with carrying out this surgery are reduced.
Surgeries Performed With The Help of 3D Laparoscopy
There are a number of surgeries, which surgeons can perform with the help of 3D Laparoscopy.
Radical Hysterectomy -This is an operation mainly performed to treat cancer that affects the uterine cervix.
There are quite a number of advantages related to the use of 3D Laparoscopy towards carrying out surgeries for different organs.
The advantages include: