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Laparoscopy Tips

Laparoscopy & Endometriosis - How Can Former Help Latter?

Dr. Seema Saxena 85% (10 ratings)
MBBS, MS - Obs & Gynae (Gold Medalist)
Gynaecologist, Delhi
Laparoscopy & Endometriosis - How Can Former Help Latter?

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? 

  1. If the endometriosis pain has returned after a hormone therapy 
  2. If there is a growing endometriotic cyst 
  3. If the scar tissue found on the pelvic wall poses a threat to fertility 
  4. If the endometriosis interferes with other organs such as the bladder etc. 
  5. If the pain during menses ( dysmenorrhoea) refuses to subside 

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.

1462 people found this helpful

Appendectomy - How Is It Performed?

Dr. Atul Mishra 87% (27 ratings)
MBBS, MS General Surgery, FRCS
General Surgeon, Ludhiana
Appendectomy - How Is It Performed?

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.

Other rare complications may include lack of intestinal peristalsis (ileus), gangrene of the bowel, injuries to the internal organs and infections in the peritoneal cavity (peritonitis).

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.

2041 people found this helpful

Laparoscopic Abdominal Cerclage For Mid Trimester Miscarriage!

Dr. Ajay Aggarwal 92% (766 ratings)
MBBS, MD - Obstetrtics & Gynaecology, Fellowship in Laparoscopy, DNB (Obstetrics and Gynecology)
Gynaecologist, Chandigarh
Laparoscopic Abdominal Cerclage For Mid Trimester Miscarriage!

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 - Know Merits Of It!

MBBS, MS - Obstetrics & Gynaecology
Gynaecologist, Noida
3D Laparoscopy - Know Merits Of It!

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.

They include:

Radical Hysterectomy -This is an operation mainly performed to treat cancer that affects the uterine cervix.

  1. Parametrectomy - This is an extremely viable technique for women suffering from invasive cervical cancer or recurrent endometrial cancer of the vagina after having undergone hysterectomy previously.
  2. Difficult TLH (Frozen Pelvis and Endometriosis) - Difficult TLH aims to solve a case for all patients, who suffer from the problem of containing Double Uterus, Double Cervix and Double Vagina with Severe Pelvic Endometriosis along with Diffuse Pelvic Adhesion after having undergone Hemi-Subtotal Hysterectomy previously.
  3. Completion - This surgery gets conducted for all those who are suffering from Endometrium and Ovarian cancers.
  4. TLH - This surgery involves a laparoscopic ligation of the arteries and veins present in the ovaries, with the removal of the uterus either through the vagina or abdomen. Finally, it involves the laparoscopic closure of the vaginal cuff.
  5. Adenomyomectomy - The surgery is performed in order to conserve the uterus for future pregnancy in patients, who are suffering from massive adenomyosis.
  6. Myomectomy - It involves the surgical removal of uterine fibroids. This is an extremely effective procedure.
  7. Adnexal and Retroperitoneal Masses - This 3D Laparoscopic Surgery even helps to get rid of these masses and avoid complications.
  8. Prolapse of Uterus and Bladder - This condition is caused due to the weakening of the muscles and tissues that provide support to the organs in the pelvis. The surgery helps to attach the vaginal vault to the sacrum with surgical mesh.
  9. Tuboplasty - This surgery mainly attempts to restore patency along with the functioning of the Fallopian Tubes, which can help women to achieve pregnancy.
  10. Sling Surgeries - Those who suffer from urinary stress incontinence, sling surgery can help ease out the symptoms of incontinence.
  11. Fertility Enhancing Surgeries - 3D Laparoscopic surgeries can help to perform even all those surgeries to enhance the rate of fertility like Endoscopic Reproductive Surgery.
  12. Ectopic Pregnancy - There are times when ectopic pregnancy can lead to heavy bleeding. Under those circumstances, 3D Laparoscopic Surgery helps in conducting emergency surgery through an abdominal incision.

Advantages of 3D Laparoscopy

There are quite a number of advantages related to the use of 3D Laparoscopy towards carrying out surgeries for different organs.

The advantages include:

  • As this requires a minimum incision, hence there are almost no complications involved. So, there is a faster recovery period for the patients.
  • Shorter stay in the hospital
  • The improved manner of performing cosmesis or correction of a body part through surgeries.
  • This method of surgery ensures a lot lesser amount of blood loss.
  • There is a very less amount of pain, which patients have to suffer after the surgery gets conducted.
1302 people found this helpful

Benefits Of Laparoscopic Surgery!

MCh - Surgical Gastroenterology/G.I. Surgery, MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
Surgical Gastroenterologist, Delhi
Benefits Of Laparoscopic Surgery!

Benefits Of Laparoscopic Surgery!

Laparoscopic Surgery - All You Need To Know About It!

Dr. Puneet Gupta 85% (10 ratings)
MBBS, MS - General Surgery, Fellowship in Minimal Access Surgery, DNB - General Surgery, Fellowship in Surgical Gastroenterology
General Surgeon, Lucknow
Laparoscopic Surgery - All You Need To Know About It!

There are many kinds of conditions and symptoms that require different kinds of surgery for treatment as well as diagnostic management. One such procedure is called a laparoscopy or laparoscopic surgery. This is a surgical diagnostic management procedure that is known to be a low-risk process with minimal invasion and suitable for various types of ailments. Read on to know everything about laparoscopic surgeries.

  • Definition: A laparoscopic surgery is one where small incisions are made and an instrument called a laparoscope is used in order to take a look at the organs in the abdominal region. This tool is a long tube-shaped one that comes with its own high-intensity light and a high-resolution camera that can easily move along the walls of the organs while the camera sends back imagery that will be displayed on a video screen in front of the doctor. This avoids the need for open surgery and helps the doctors in getting samples for a biopsy on an outpatient basis.
  • Need for Laparoscopy: This procedure is performed when the patient complains of persistent pain that is also sharp and shooting, in the abdomen region and surrounding areas like the pelvic cavity. This non-invasive method helps in diagnosis where other imaging methods like an ultrasound and CT or MRI scans would have failed to give a conclusive reason for the pain and suffering of the patient. When these tests do not supply enough reason for proper diagnosis, then the doctors usually resort to this kind of procedure.
  • The Organs it can be used for: The laparoscopic surgery can be used for many organs including the appendix as well as the gall bladder, the pelvic region and the reproductive organs, the small and large intestines, the spleen, the stomach, the liver and the pancreas.
  • What all can it Detect: The laparoscopic surgery can help in detecting a number of issues including any abnormal growth or mass that may be a tumour. It can also point at the presence of any disease in the liver, as well as the proper functioning of certain treatments. Also, it can show the amount of fluid that may or may not be present in the abdominal cavity and the extent of cancer's progression in the body.
  • Risks: There are a few side effects or risks of this method including fever, chills, swelling, bleeding or redness of the site where the incision was made for the surgery, and shortness of breath. All these symptoms must be reported to the doctor immediately as they may point at the presence of an infection. Also, there is a risk of organ damage in this procedure.
980 people found this helpful

Laparoscopic Surgery - What Are The Utility Of It?

Dr. Bijay Kumar 89% (39 ratings)
MS - General Surgery , MBBS
General Surgeon, Patna
Laparoscopic Surgery - What Are The Utility Of It?

There are many kinds of conditions and symptoms that require different kinds of surgery for treatment as well as diagnostic management. One such procedure is called laparoscopy or laparoscopic surgery. This is a surgical diagnostic management procedure that is known to be a low-risk process with minimal invasion and suitable for various types of ailments. Read on to know everything about laparoscopic surgeries.

  • Definition: A laparoscopic surgery is one where small incisions are made and an instrument called a laparoscope is used in order to take a look at the organs in the abdominal region. This tool is a long tube-shaped one that comes with its own high-intensity light and a high-resolution camera that can easily move along the walls of the organs while the camera sends back imagery that will be displayed on a video screen in front of the doctor. This avoids the need for open surgery and helps the doctors in getting samples for a biopsy on an outpatient basis.
  • Need for Laparoscopy: This procedure is performed when the patient complains of persistent pain that is also sharp and shooting, in the abdomen region and surrounding areas like the pelvic cavity. This non-invasive method helps in diagnosis where other imaging methods like ultrasound and CT or MRI scans would have failed to give a conclusive reason for the pain and suffering of the patient. When these tests do not supply enough reason for proper diagnosis, then the doctors usually resort to this kind of procedure.
  • The Organs it can be used for: The laparoscopic surgery can be used for many organs including the appendix as well as the gall bladder, the pelvic region and the reproductive organs, the small and large intestines, the spleen, the stomach, the liver and the pancreas.
  • What all can it Detect: The laparoscopic surgery can help in detecting a number of issues including any abnormal growth or mass that may be a tumour. It can also point at the presence of any disease in the liver, as well as the proper functioning of certain treatments. Also, it can show the amount of fluid that may or may not be present in the abdominal cavity and the extent of cancer's progression in the body.
  • Risks: There are a few side effects or risks of this method including fever, chills, swelling, bleeding or redness of the site where the incision was made for the surgery, and shortness of breath. All these symptoms must be reported to the doctor immediately as they may point at the presence of an infection. Also, there is a risk of organ damage in this procedure.
1486 people found this helpful

Laparoscopic Surgeries - Know Pros & Cons Of Them!

Dr. Ajay Aggarwal 92% (766 ratings)
MBBS, MD - Obstetrtics & Gynaecology, Fellowship in Laparoscopy, DNB (Obstetrics and Gynecology)
Gynaecologist, Chandigarh
Laparoscopic Surgeries - Know Pros & Cons Of Them!

Laparoscopic surgeries are minimally invasive surgeries where a very small incision is made on the patient’s belly button. After making this incision, a camera called the laparoscope is inserted from the hole and then the condition of the organ is evaluated upon a television screen in order to perform the operation. An air pocket via carbon dioxide is then made for the surgeon to carry out the operation. This procedure, although used widely has a couple of advantages and disadvantages which should be kept in mind before undergoing the surgery.

Advantages of Laparoscopic Surgeries
In comparison to a traditional, large surgery, laparoscopy is much more comfortable and is less painful as well. The small incision takes less amount of time to heal, therefore the patient is allowed to get back to his/her regular activities much sooner. Patients who go through laparoscopic surgeries spend less time in the hospital and get discharged on the same or the next day as well.

Laparoscopic surgeries help in reducing the risk of bleeding during the surgery as the incision is relatively very small than the ones made during traditional surgery. The amount of blood loss is minimal in such a case and therefore the need of blood transfusion is also decreased, significantly.

Another important factor which can be counted in is that, with the help of laparoscopic surgeries the risk of exposing the internal organs to contamination is also reduced. This allows the chance of post-operative infection risks to diminish as well.

Disadvantages of Laparoscopic Surgeries
Just like a coin which has two sides, laparoscopic surgeries also have its advantages and disadvantages which you need to consider before going through it. One of the most important factors is that laparoscopic surgeries are extremely expensive as the instruments required to carry out the operation is very costly. A number of less affluent hospitals can therefore not afford to have the instrument; this makes laparoscopic surgeries less accessible to a vast number of people.

Laparoscopic surgeries may not be suitable for complicated surgeries. The tools required to carry out a laparoscopic surgery may not be sufficient for an operation which needs a 3-dimensional field of vision. For surgeries where large chunks of tissues are to be removed, these minimally invasive surgeries are not preferred.

Laparoscopic surgeries may also need a second open surgery in case of any complication during the procedure. Thus, the risk of having two surgeries increases for patients who opt for laparoscopic surgeries. These surgeries also need a special skill set and every hospital is not equipped with specialized personnel who know how to operate the unit. Therefore, you should consider every aspect before going through the procedure.

2054 people found this helpful

Laparoscopy - Does It Help In Gynaecological Cancers?

MBBS, DNB, FNB - Minimal Access Surgery, Fellowship in Robotic and Laparoscopic Colorectal Surgery (FRLCRS)
General Surgeon, Noida
Laparoscopy - Does It Help In Gynaecological Cancers?

Minimally invasive surgery or laparoscopic surgery is increasingly becoming popular in all fields of surgery including gynecological oncology. Given its many advantages, it is easy to see why people prefer this form of surgery. The use of laparoscopy in the field of gynecological oncology began in the late 1980s. The first laparoscopic-assisted hysterectomy was performed in 1989.

Laparoscopy and Endometrial Cancer:

The endometrium refers to the lining of the uterus. Endometrial cancer is rare are usually affect women over the age of 55 years. A hysterectomy is one of the forms of treatment for this condition. If detected in its early stages, this hysterectomy may be performed laparoscopically. As compared to traditional surgery, this reduces the hospital stay required and is associated with fewer postoperative complications. Laparoscopy may also be used to restage patients who have already undergone a hysterectomy.

Laparoscopy and Cervical Cancer:

The lowermost part of the uterus is known as the cervix. A pap smear can help in the early detection of cervical cancer. This can be treated surgically in the form of a lymphadenectomy or a radical hysterectomy. One of the factors crucial to the management of this type of cancer is an evaluation of the lymph nodes.

This is where laparoscopy is very useful. As in the case of endometrial cancer, laparoscopy may also be used for a hysterectomy procedure. A laparoscopic lymphadenectomy may also be performed to investigate the extent to which the cancer has spread. Advanced stages of cervical cancer can be treated with chemotherapy and radiation. In such cases, the role of laparoscopy may be limited to staging the patient before treatment.

Laparoscopy and Adnexal Masses:

Adnexal masses refer to ovarian abnormalities and development of masses in the fallopian tubes, uterus and other organs in the pelvic cavity. Laparoscopy is routinely used to treat benign Adnexal masses. It can also be used in the management of malignant adnexal masses. However, its role is less clearly defined in such cases. When using laparoscopic procedures to address adnexal masses, it is important to identify benign masses beforehand.

Laparoscopy and Uterine Cancer:

Laparoscopy can be used in a number of ways when it comes to the management and treatment of uterine cancer. These include staging apparent early stage cancer, determining the extent of the disease and resectability potential and to reassess a patient in cases of recurrent cancer. A hand assisted laparoscopy may also be used to resect the disease in some cases. 

2281 people found this helpful

Laparoscopy Surgeries & Infertility - How Former Can Help Latter?

Rubi Kumari 91% (570 ratings)
MBBS, Diploma in Gynecology and Obstetrics
Gynaecologist, Motihari
Laparoscopy Surgeries & Infertility - How Former Can Help Latter?

Almost every woman wants to lead a healthy life with their loved ones and experience the joy of motherhood when the right time comes. However, as much as you detest it, the last decade or two has seen a steady rise in gynecological problems. While some of the gynecological conditions are minor and can be easily treated and taken care of, others may give you a hard time. From PCOS to Endometriosis, left untreated, some of these problems may trigger infertility, complicating things further.

Open surgeries have long been the only surgical option to deal with such critical problems. However, the advent of Laparoscopy has brought about a much-needed relief benefitting millions of women with gynecological problems worldwide. Based on the latest technology and being minimally invasive, laparoscopy comes with a lot of benefits. In addition to surgically treating a condition, laparoscopy also ensures an accurate and better diagnosis. In this article, we will discuss the laparoscopic surgeries to deal with infertility and other related gynecological issues.

Infertility and Laparoscopic surgery

Identifying the underlying factor(s) responsible for infertility can go a long way to treat the condition successfully. Some of the factors that contribute towards infertility include

  1. PCOS: Polycystic Ovarian Syndrome is a medical condition whereby formation of a cyst(s) take place in one or both the ovaries. These cysts affect the ovulation process as the eggs either do not mature or the ovary fails to release the mature eggs. To deal with this situation, a surgeon often performs the Laparoscopic Ovarian Drilling or Ovarian Diathermy.
    • Here, the surgeon makes small cuts in the abdomen (belly button).
    • To inflate the stomach, the surgeon inserts carbon dioxide gas inside the stomach.
    • The Laparoscope along with the surgical instruments are next inserted inside through the incisions.
    • Parts of the ovary that are being affected are destroyed using Electrocautery.
  2. Ovarian Diathermy plays a significant role in normalizing the ovulation process, which was affected by PCOS.
  3. A blocked fallopian tube can also trigger infertility. In this case, Laparoscopic Fimbrioplasty (performed when there is a scar or a blockage in the part of the fallopian tube that is adjacent to the ovary) comes in handy. It is a laparoscopic reconstructive procedure that helps to open the tubal blockage, thereby restoring the fimbriae (finger-like projections located at the tube ends that aids in the transportation of the matured eggs from the ovary into the uterus).
  4. Endometriosis: This is a medical term used to define a condition whereby the endometrial cells grow outside the uterus, often in the ovary or the fallopian tube resulting in pain and infertility. Here also, laparoscopy comes as a savior, getting rid of any scarred tissues, endometrial implants or endometrioma (endometriosis cyst that forms in the ovary), thereby improving the condition.
  5. Laparoscopy can also be used to treat ovarian cancer, removal of fibroids (uterine myomas or uterine tumors), hysterectomy (uterus removal).
  6. Laparoscopy plays a significant role in reversing the tubal ligation (closure of the fallopian tube to prevent pregnancy).
3093 people found this helpful
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