لاپاراسکوپی Laparoscopy

Laparoscopy

Laparoscopy is a minimal invasive surgery that uses a thin, lighted tube put through an incision in the belly to look at the abdominal organs or the female pelvic organs. Patients must receive general anesthesia during this procedure. In Laparoscoy, small incisions between 0.5 and 1 cm are made on the abdominal wall through which an instrument called a laparoscope can be placed. The abdominal cavity is able to be visualized by filling it with an absorbable gas, typically, carbon dioxide.
Laparoscopy is used to find problems such as cysts, adhesions, fibroids, and infection. Tissue samples can be taken for biopsy through the laparoscope.

Why Laparoscopy is done?

In many cases laparoscopy can be done instead of laparotomy surgery that uses a larger incision in the belly. Laparoscopy can be less stressful and may have less problems and lower costs than laparotomy for minor surgeries. Laparoscopy in obstetrics and gynecology can be used for removing endometriosis, performing hysterectomy (uterus removal) and removing ovarian cysts.

Laparoscopic Hysterectomy

Hysterectomy is a surgery to remove the uterus. It prevents future pregnancy and eliminates fibroid-related bleeding and pressure symptoms. There are two categories of hysterectomy:

  • Total hysterectomy is removal of the entire uterus, including the cervix. Laparoscopic hysterectomy involves removing the entire uterus with minimally-invasive techniques. A normal sized uterus, once it is detached from its supports, can be removed through the vagina. A large uterus can be reduced to smaller pieces using a laparoscopic morcellator.
  • Supra-cervical hysterectomy is removal of the upper part of the uterus, but not the cervix.

Benefits to supra-cervical hysterectomy include slightly faster surgery and shorter recovery time.
The only medical reason for removing the cervix is to prevent cancer of the cervix. If a woman is at low risk for this problem, then the cervix may be left in place, as long as she agrees to continue having regular Pap smears performed.

Laparoscopic Endometriosis Removal

Endometriosis is a female health disorder that is the abnormal growth of cells (endometrial cells) in a location outside of the uterus. These implants are most commonly found on the ovaries, the Fallopian tubes, outer surfaces of the uterus or intestines, and on the surface lining of the pelvic cavity.
Endometriosis disorder can lead to pain, irregular bleeding, and infertility. Although endometriosis is typically diagnosed between ages 25 – 35, the condition probably begins about the time that regular menstruation begins.
Endometriosis can be treated at the time of diagnosis. Advanced laparoscopic surgery for chronic pelvic pains and suspected endometriosis should be performed by a surgeon with the necessary skills and expertise in the resection of such lesions and in an operating room equipped for such a surgery. Care should be taken to perform endometriotic implants as complete as possible resection of deep infiltrating endometriotic nodules which are usually the cause of pelvic pains. To reduce pain transmission, nerve interruption procedures should be considered. Adhesions should be completely resected and measures preventing their reformation should be applied.

Laparoscopic Ovarian Cyst Removal

Cysts are fluid-filled sacs that can form in the ovaries. The most common is a functional cyst. It forms during ovulation. That formation happens when either the egg is not released or the sac – follicle – in which the egg forms, does not dissolve after the egg is released.
Surgery is an option if the cyst doesn’t go away using non-surgical treatments, grows, or causes you pain. A Laparoscopic Ovarian Cystectomy is a type of minimally invasive surgery. The laparoscope will be used to locate the cyst. Once found, the doctor will make one or two more incisions Small instruments can be placed through the small incisions allowing the surgeon to remove an ovarian cyst. Patients must receive general anesthesia during the procedure and typically go home the same day.
The advantages of laparoscopy over traditional abdominal ovarian cystectomy surgery include a shorter post-operative hospital stay, a shorter recovery interval and less pain. Also since smaller instruments are used, more ovarian tissue can be spared and scarring and adhesions after the surgery can be minimized.
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Before laparoscopy

  • At the hospital laboratory tests on your blood and urine will be done to determine if there are any abnormalities that may be of importance to your surgery. Also you may need imaging tests, such as an ultrasound, CT scan, or MRI. Imaging tests may also help your caregiver see if your ovaries or nearby organs have health problems like cancer.
  • Do not eat or drink for 12 hours. An empty stomach helps lower the chance of vomiting during or after the surgery. Your caregiver may ask you to drink a special liquid or a powder that is mixed with liquid. This drink is called a bowel preparation and will cause you to empty your bowels.
  • You should remove all jewelry, nail polish, glasses and contact lenses prior to coming to the hospital.

After Laparoscopy

  • You may have minor pain at the incision sites and in your shoulders and chest (from Carbon Dioxide used to inflate your abdomen). It is possible to develop a sore throat from the airway tube used in your windpipe during your anesthesia.
  • It is normal to have slight vaginal bleeding for a few days after the surgery.
  • You should have someone drive you home from the hospital, and not drive on your surgery day. Avoid exercise or lifting greater than 25 pounds for 7 days.
  • Keep your incisions clean and dry. Any bandage can be removed the following day.