Laparoscopy

Laparoscopy refers to looking inside the body for medical purposes using a special device. It is a surgical procedure that involves insertion of a narrow telescope like instrument through a small incision in the abdomen. This allows visualization of the abdominal and pelvic organs. The device used during this procedure is called a laproscope. In gynecology, laparoscopy is used for the diagnostic inspection of the uterus, fallopian tubes and the ovaries. A special type of laparoscope, called a fertiloscope (modified for transvaginal application) is used for this purpose. 

Laparoscopy is used in the treatment of the following conditions:

  • Uterine Fibroids
  • Tubal catheterization or sterilization
  • Treatment of ovarian abscess
  • Adhesiolysis (treatment of adhesions)
  • Ovarian cystectomy
  • Excision of moderate to severe endometriosis (laser or thermal ablation)
  • Myomectomy
  • Treatment of adenomyosis
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  • Abnormality on the pap smear
  • Abnormal appearance of the cervix
  • Pelvic pain
  • Abnormal uterine bleeding
  • Indications of the presence of cancer

Laparoscopy is used as a diagnostic procedure for the following conditions:

  • To confirm the presence of adhesions, Polyps or Septum
  • To obtain a biopsy of the ovaries
  • Evaluation of endometriosis
  • Acute appendicitis or acute salpingitis
  • Detection of pelvic mass such as fibroids or ovarian cyst
  • Exploration of small ovarian cyst or par ovarian cyst
  • To obtain a biopsy from the uterus

Laparoscopy is a minimally invasive technique. In an open surgery, the procedure is performed through a single incision in the abdomen. In laparoscopy, 4 - 5 small incisions are made in the abdomen in order to perform the procedure. Through one of these incisions, the surgeon inserts a laparoscope. The laparoscope has a light and a small camera attached on one end, the images from which can be seen on a screen present in the operation room. This helps in identifying the abnormality or condition. Once the problem has been identified, the surgeon inserts small, long surgical tools through the other incisions in order to perform the surgery. Some surgeons may also choose to perform robot-assisted laparoscopy. In this technique, the surgery is performed with the help of a robotic device which is controlled by the surgeon sitting in an adjacent room. If performed by an experienced doctor, it can be less invasive and offer more precision.

Complications from a laparoscopy are unusual, but there is a possibility that the following conditions may occur:-

  • A hole or tear in the are being examined
  • Bleeding
  • Risk of infection
  • Hemorrhage (Retro-peritoneal bleeding, omental vessels, inferior epigastric vessels)
  • Surgical emphysema
  • Injury to the cervix, bowel, bladder or uterus
  • Fever
  • Reaction to the anesthesia administered during the procedure
  • Heavy vaginal bleeding or discharge
  • Severe abdominal pain
  • Intrauterine scarring

Laparoscopic surgeries are more advanced and less invasive as compared to open surgeries. The recovery time is usually shorter as compared to a traditional surgery and the patient also experiences comparatively lesser pain. In many cases the patient can go home on the day of the surgery or on the next day itself. Laparoscopy also leaves the patient with less visible scars and fewer post procedure medications.