This method involves the viewing, with a telescopic camera, of the woman’s internal reproductive organs without requiring the surgical opening of the abdominal walls. Endoscopy is used widely and successfully in almost all gynaecological operations.
In Gynaecology, endoscopy includes laparoscopy and hysteroscopy, which are applied for diagnostic and surgical purposes. In endoscopy, we utilize special self-lit telescopic video cameras, which are inserted into body cavities through small (11mm) incisions and transmit images of the internal organs to special monitors, thus giving physicians the ability to diagnose and repair a variety of problems.
The main applications of Laparoscopy in Gynaecology are:
- Diagnostic laparoscopy for abdominal pain and infertility
- Surgical repair of the fallopian tubes in cases of hydrosalpinx or adhesions
- Diagnosis and treatment of ectopic pregnancy
- Diagnosis and treatment of endometriosis
- Removal of ovarian cysts
- Removal of fibroid tumours
- Laparoscopic hysterectomy, i.e. removal of the uterus, with or without the appendages (fallopian tubes and ovaries)
- Laparoscopic attachment of the uterus or stump to the sacro-coccygeal ligament, for prolapse issues
- Laparoscopic pelvic lymph node removal in gynaecological oncology cases
Using laparoscopy, surgical interventions are performed through small incisions (5-11 millimetres) on the abdominal wall. Dilating the abdomen with CO2 gas is a necessary requirement for laparoscopic surgery. The evolution of laparoscopy has led globally to the development of new surgical techniques, known collectively as Minimally Invasive Surgery (MIS). Special laparoscopic tools are used, for these new techniques, which are inserted in the abdomen through small incisions and function as extensions of the surgeon’s hands, allowing him/her to perform surgical interventions inside the abdominal cavity using video monitors.
The benefits of laparoscopy compared to traditional surgical procedures are the following:
- Shorter hospitalization period (a few hours, and in 5% of cases, 24-hour stay in the clinic)
- Small surgical scars (5-11 millimetres)
- Quick return to normal activity and work
- Minimal pain
- Better aesthetic result in scar healing
Laparoscopic surgery is performed under general anaesthesia. Before and after the procedure, women are administered a special course of analgesic medications to avoid post-operative pain.
What you need to know before undergoing laparoscopic surgery
There is no surgical procedure without potential complications; however, these are no different than with traditional surgical procedures, they are rare, and in the hands of an experienced laparoscopic surgery team they can be dealt with, properly. In some cases, laparoscopic surgery may turn into a traditional surgical procedure (open abdomen).
After surgery, the patient may experience:
- itching sensation in the pharynx, due to intubation for anaesthesia
- abdominal cramps
- discomfort in the shoulders and chest due to the dilation of the abdomen with gas
- vaginal bleeding
The above mild symptoms subside quickly with or without medication, and a few hours after surgery the patient can be discharged.