What is laparoscopic gynaecology?
Laparoscopic gynaecology is a minimally invasive surgical procedure used to diagnose and treat various gynecological conditions. It involves making small incisions in the abdomen and using a camera (laparoscope) to visualize and operate on the pelvic organs, including the fallopian tubes, ovaries, and uterus (womb). This technique is often employed for both diagnostic and therapeutic purposes.
Benefits of laparoscopic gynaecology
Laparoscopic surgery offers numerous advantages over traditional open surgery:
- Minimally Invasive: Smaller incisions result in less trauma to the body.
- Reduced Pain: Patients typically experience less postoperative pain.
- Shorter Hospital Stay: Recovery time is faster, often requiring just a day or two in the hospital.
- Faster Recovery: Patients generally recover more quickly and can return to normal activities sooner.
- Lower Risk of Infection: Smaller incisions lower the risk of post-surgical infections.
- Enhanced Precision: The use of a laparoscope allows surgeons to perform precise operations.
Why is laparoscopic surgery done?
Laparoscopy is used for both diagnostic and treatment purposes in Gynaecology. Common indications for this procedure include:
- Diagnosis and Treatment of Infertility
- Diagnosis and Treatment of Endometriosis
- Treatment of Ectopic Pregnancy
- Treatment of Ovarian Cysts
- Treatment of Uterine Fibroids
- Evaluation of Chronic Pelvic Pain
While laparoscopic surgery is preferred in many cases, it may not be suitable for all patients or conditions. The approach should be individualized based on the patient's unique medical situation.
How is the laparoscopic procedure carried out?
Laparoscopy is typically performed under general anaesthesia, meaning the patient is unconscious during the procedure. The process is divided into several stages:
Pre-Procedure Preparation
- Tests: Ultrasounds, X-rays, blood tests, and urine tests may be required.
- Fasting: The patient may need to fast for several hours before the surgery.
- Enema: In some cases, an enema may be recommended to clear the bowel.
- Medication: Patients should inform the doctor about any regular medications they take.
During the Procedure
- anaesthesia and Catheterization: Once the patient is asleep, a catheter is inserted to collect urine.
- Abdominal Insufflation: The abdomen is inflated with carbon dioxide gas to create space between the abdominal wall and organs, reducing the risk of injury.
- Incision and Laparoscope Insertion: A small cut is made near the navel, and a laparoscope is inserted. This provides real-time images of the pelvic area on a monitor.
- Surgical Procedure: Depending on the purpose of the surgery, the surgeon may perform a diagnostic examination or carry out therapeutic procedures. Additional small incisions may be made to insert surgical instruments for treatment.
Post-Procedure Recovery
- Recovery: The patient is monitored until the effects of anaesthesia wear off.
- Oral Intake: Once stable, the patient may begin taking oral feeds.
- Discharge and Follow-Up: The patient is discharged with specific instructions on post-operative care, including medications and potential side effects. Follow-up appointments are scheduled for stitch removal and further assessment.
Risks of laparoscopic gynaecology
Though laparoscopic surgery is generally safe, there are potential risks associated with the procedure, including:
- Injury to Blood Vessels, Nerves, or Organs: In rare cases, injury to internal organs such as the bladder, bowel, ureters, or pelvic structures can occur.
- Allergic Reactions: Some patients may have allergic reactions to medications or materials used during the procedure.
- Hemorrhage: Excessive bleeding may occur, requiring emergency open surgery.
- Wound Infections: While the risk is low due to the small incisions, infections can still occur at the incision sites.