Laparoscopy is an alternative to open surgery. It uses a laparoscope to look inside your pelvic area.
Open surgery often requires a large incision.
A laparoscope is a slender, lighted telescope. It allows your doctor to see inside your body. Diagnostic laparoscopy can determine whether you have conditions such as endometriosis or fibroids. It can also be a form of treatment. With miniaturized instruments, your doctor can perform a variety of surgeries. These include:
- Ovarian cyst removal
- Tubal ligation, which is surgical contraception
Laparoscopy generally has a shorter healing time than open surgery. It also leaves smaller scars.
Reasons for laparoscopy
Laparoscopy can be used for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into treatment.
Some reasons for diagnostic laparoscopy are:
- Unexplained pelvic pain
- Unexplained infertility
- A history of pelvic infection
Conditions that might be diagnosed using laparoscopy include:
- Uterine fibroids
- Ovarian cysts or tumors
- Ectopic pregnancy
- Pelvic abscess, or pus
- Pelvic adhesions, or painful scar tissue
- Pelvic inflammatory disease
- Reproductive cancers
Some types of laparoscopic treatment include:
- Hysterectomy, or removal of the uterus
- Removal of the ovaries
- Removal of ovarian cysts
- Removal of fibroids
- Blocking blood flow to fibroids
- Endometrial tissue ablation, which is a treatment for endometriosis
- Adhesion removal
- Reversal of a contraceptive surgery called tubal ligation
- Burch procedure for incontinence
- Vault suspension to treat a prolapsed uterus
Laparoscopy is almost always performed under general anesthesia. This means you’ll be unconscious for the procedure. However, you may still be able to go home the same day.
Once you’re asleep, a small tube called a catheter will be inserted to collect your urine. A small needle will be used to fill your abdomen with carbon dioxide gas. The gas keeps the abdominal wall away from your organs, which reduces the risk of injury.
Your surgeon will make a small cut in your navel and insert the laparoscope, which transmits images to a screen. This gives your doctor a clear view of your organs.
For diagnosis, your doctor might take a look and then be done. If you need surgery, other incisions will be made. Instruments will be inserted through these holes. Then, surgery is performed using the laparoscope as a guide.
Once the procedure is over, all instruments are removed. Incisions are closed with stitches, and then you’re bandaged and sent to recovery.
Advances in laparoscopy
Robotic surgery is sometimes used for gynecological laparoscopy. Robotic arms are steadier than human hands. They may also be better at fine manipulations.
Microlaparoscopy is a newer approach. It uses even smaller scopes. This procedure can be done with local anesthesia.
- Total Laparoscopic Hysterectomy and laparoscopic assisted vaginal hysterectomy-removal of uterus and cervix.
- Laparoscopic myomectomy- removal of fibroids.
- Lap ovarian cystectomy- removal of ovarian cyst and wall.
- Lap oophoropexy – fixation of ovaries to prevent recurrence of torsion.
- Laparoscopic colpopexy for vault prolapse (post hysterectomy).
- Lap sling surgeries for uterine descent in nulliparous women.
- Laparoscopic salpingostomy (removal of products of conception by making an incision over the tube), salpingectomy (removal of affected fallopian tube) etc for stable & unstable ectopic pregnancies
- Lap ovarian drilling for PCOD ( polycystic ovaries)
- Lap endometriotic cystectomy (removal of endometriotic cyst wall) & fulguration (coagulating) for endometriosis.
- Lap adhesiolysis.
- Lap neosalpingostomy for fimbrial blocks of fallopian tubes in infertile women
- Lap tubal recanalization – post tubal sterilization
- Lap metroplasty for bicornuate uterus