What is laparoscopy?

Laparoscopy is a way of doing surgery using small incisions (cuts). It is different from “open” surgery where the incision on the skin can be several inches long. Laparoscopic surgery sometimes is called "minimally invasive surgery." What is laparoscopy in gynecology? A gynecological laparoscopy (keyhole surgery) is a procedure to look inside your lower tummy (abdomen) to examine your womb (uterus), fallopian tubes and ovaries. Gynecological laparoscopy can be used to diagnose a condition and/or to treat it.

How is Gynecology laparoscopic surgery done?

Laparoscopic surgery is done by using a special instrument called a laparoscope. The laparoscope is a long, slender device that is inserted into the abdomen through a small incision. It has a camera attached to it that allows the obstetrician–gynecologist (ob-gyn) to view the abdominal and pelvic organs on a screen. If a problem needs to be fixed, other instruments can be used. These instruments usually are inserted through additional small incisions in the abdomen. They sometimes can be inserted through the same single incision made for the laparoscope. This type of laparoscopy is called “single-site” laparoscopy.

Advantages of Gynecology Laparoscopic Surgery

  • Less pain compared to open surgery
  • Fewer complications
  • Less scarring
  • Shorter hospital stays
  • Faster recovery
  • No / Less Blood loss, Less pain and discomfort
  • Same day Discharge

Some of the laparoscopic procedures include:

audiology & speech
  • Diagnostic laparoscopy
  • Hysterectomy
  • Hysteroscopy
  • Myomectomy
  • Endoscopic Gynecology Procedures

Other Surgical Procedures includes-

  • Diagnostic laparoscopy
  • Microlaparoscopic pain mapping
  • Laparoscopic removal of endometriosis
  • Laparoscopic removal of ovarian cysts
  • Laparoscopic removal of adhesions (scar tissue)
  • Laparoscopic removal of a tube and ovary
  • Laparoscopic uterine suspension
  • Hysteroscopic surgery (removal of polyps or fibroids from the inside of the uterus)
  • Laparoscopic bladder support surgery
  • Endometrial ablation (for heavy periods)

Fibroids


audiology & speech
Fibroids are abnormal growths that develop in or on a woman's uterus. Sometimes these tumors become quite large in size and it may cause severe abdominal pain and heavy periods. In other cases, they appear with no signs or symptoms at all. The growths are typically benign, or noncancerous.

    Symptoms of fibroids may include

  • heavy bleeding during periods (Includes blood clots)
  • increased menstrual cramps
  • pain during intercourse
  • swelling or enlargement of the abdomen
  • pressure in your lower abdomen
  • increased urination
  • menstruation goes longer than usual
  • Pelvis or lower back pain

How it can be treated:

    Don’t Strain

  • Straining during bowel movements.
  • Physical Fitness
  • Massage
  • Healthy Diet

Hysterectomy


Hysterectomy for noncancerous reasons is normally considered only after all other treatment approaches have been tried without success Hysterectomy for noncancerous reasons is normally considered as the last option after all other treatment approaches if those doesn’t work.

    Symptoms of Hysterectomy may include:

  • Fever or chills.
  • Unusual vaginal discharge.
  • Heavy discharge
  • Shortness of breath or chest pain
  • Heavy periods – which can be caused by fibroids.
  • Prolapse of the uterus.
  • Cancer of the womb, cervix or ovaries.
  • Problems urinating or having a bowel movement.
  • Redness or discharge from incisions.
  • Pelvic pain – which may be caused by endometriosis, unsuccessfully treated pelvic inflammatory disease (PID), adenomyosis or fibroids.

    A hysterectomy is a procedure to remove the uterus. This surgery may be done for different reasons, includes:-

  • Uterine fibroids which is causing pain or bleeding.
  • Prolapse Surgery, which is a sliding of the uterus from its normal position into the vaginal canal
  • Endometriosis
  • Chronic pelvic pain
  • Adenomyosis, or a thickening of the uterus
  • Cancer of the uterus, cervix, or ovaries
  • Abnormal vaginal bleeding

Hysteroscopy


Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix. It allows for the diagnosis of intrauterine pathology and serves as a method for surgical intervention (operative hysteroscopy).

    When you will need Hysteroscopy

  • Abnormal Pap test results
  • Diagnose and screen the reason behind infertility or repeated miscarriages
  • Examine and remove uterine scarring, polyps, or fibroids
  • Removal of a small tissue sample (biopsy)
  • Removal of endometrial lining
  • Uterine bleeding
  • Find and remove displaced IUDs (intrauterine devices)
  • Bleeding during / after menopause
  • Place small birth control inserts into the fallopian tubes

    How is hysteroscopy is performed?

  • Abnormal Pap test results
  • One may be prescribed a medication to help you relax.
  • You will then be prepared for anesthesia.
  • The hysteroscope is inserted through vagina and cervix into the uterus.
  • Saline is then inserted into the uterus, through the hysteroscope, to expand it and to clear away any blood or mucus.
  • A light shone through the hysteroscope allows the doctor to see inside the uterus and the openings of the fallopian tubes into the uterine cavity.
  • Finally, if surgery needs to be performed, small instruments are inserted into the uterus through the hysteroscope.
  • The time it takes to perform hysteroscopy can range from less than 5 minutes to more than an hour.
  • The length of the procedure depends on whether it is diagnostic or operative and whether an additional procedure, such as laparoscopy, is planned at the same time.

Myomectomy


Myomectomy is a surgical procedure to remove uterine fibroids — also called leiomyomas. These common noncancerous growths appear in the uterus, usually during childbearing years, but they can occur at any age.

    When you will need Myomectomy

    Myomectomy is recommended for fibroids causing symptoms that are troublesome or interfere with ones normal activities. The reasons to choose a myomectomy instead of a hysterectomy for uterine fibroids include:

  • You plan to bear children
  • Your doctor suspects uterine fibroids might be interfering with your fertility
  • You want to keep your uterus
  • How it is done?

    Depending on the size, number and location of fibroids, surgeon may choose one of the following surgical approaches to myomectomy.

    Abdominal Myomectomy

  • A horizontal bikini-line incision.
  • A vertical incision

    Minimal Invasive Surgery

  • Laparoscopic or Robotic myomectomy
    In laparoscopic or robotic myomectomy, the doctor accesses and removes fibroids through several small abdominal incisions.
  • Laparoscopic myomectomy.
  • Robotic myomectomy.
  • Hysteroscopic myomectomy.

Endoscopic Procedures in Gynecology


  • Fibroid
  • Ovarian cysts
  • Ectopic Pregnancy
  • Endometriosis
  • Pelvic Adhesions
  • Gynecological Cancers
  • Infertility
  • Abnormal uterine bleeding
  • Uterine Polyps
  • Uterine malformation
  • Pelvic Organ Prolapse
  • Cervical Incompetence leading to Recurrent Midtrimester Abortions

    Endoscopy in Gynecology

  • Laparoscopy - Diagnostic - Operative
  • Hysteroscopy –Diagnostic-Operative

Procedures :-

    Laparoscopic :-

  • Laparoscopic Hysterectomy – Total / Subtotal
  • Laparoscopic Myomectomy
  • Laparoscopic Ovarian cystectomy
  • Laparoscopic Clearance of pelvic endometriosis
  • Laparoscopic Management of Ectopic pregnancy
  • Laparoscopic Surgery for prolapse
  • Laparoscopic Adhesiolysis
  • Laparoscopic Evaluation for Infertility
  • Laparoscopic Cervical Encerclage
  • Laparoscopic Management of Ovarian Torsion
  • Laparoscopic Metroplasty (Correction of Uterine malformations)

    Hysteroscopic :-

  • Diagnostic Hysteroscopy
  • Hysteroscopic Polypectomy
  • Hysteroscopic Myomectomy
  • Hsyteroscopic Synechiolysis (adhesiolysis)
  • Hysteroscopic Endometrial Biopsy
  • Hysteroscopic Removal of Intrauterine device
  • Hysteroscopic Septal Resection

Expert Team


Dr. Preeti Tandon

Specialist Gynecologist and Obstetrician and Laparoscopic Gynecologist
MD. MBBS ,FICOG

Dr. Sagimole Tojichen

Specialist Obstetrician & Gynecologist, & Gynae Laparoscopic Surgeon
MBBS, DGO, DNB, MRCOG (UK)

Dr. Elizabeth Mathew

Specialist Obstetrician & Gynecologist
M.B.B.S, DCH (RCPS Glasgow), MRCOG, IBCLC, FRCOG

Dr. Jamalunnisa Gaffar

Specialist Obstetrician & Gynecologist
MBBS, DGO, MRCOG I