Today the Laparoscopic & Hysteroscopic approach is being used in a growing number of Gynecological procedures with significant potential medical and economical and faster recovery benefits to patients. Furthermore, in this era of consumer rights more and more patients are demanding to know all the available options.
Answer to most Common but Important Questions
1. What is Video Laparoscopy ?
Video Laparoscopic Surgery (VLS), commonly practised all over the world today, involves smaller and safer incisions to be made for complex Gynaecological Surgeries. A small access (small wound: 1 cm) is made with the help of a rod shaped telescope attached to a camera & medical monitor so as to see the target organs. The diseased organ is visible under high magnification, which is examined & operated simultaneously with minimum trauma to the patient. The technique also enhances the precision and efficiency of doctors.
2. Why Laparoscopic surgeries have become so popular?
Laparoscopic surgeries have become very popular in short span of time, in fact they have replaced all traditional abdominal surgeries. Their popularity is due to the immense advantages they have got over traditional surgeries. The advantages and benefits to the patients are
• They are less pain
• Patient recovers very fast (24-48 hrs.) and can resume to work within few days.
• No post operative rest required
• No scars on the abdomen
• Less chances of wound infection
• No chances of post operative hernias and adhesions
• Apart from these benefits, patients also will have immense long term benefits.
3. How the Gynecological Laparoscopic Surgeries had developed in last few years?
Gynecologists are pioneers in this field by starting Laparoscopic Tubal Ligation operations in 1950s and then what was once diagnostic procedure became completely therapeutic procedure from 90's onwards. Today with breakthrough in technology, we are able to perform almost all Gynecological surgeries including cancer surgeries through Laparoscopic approach.
4. What role does the video play in a Laparoscopy?
After Laparoscope is attached to the Endoscopic camera, the target organ's picture is visible on the monitor. Normal and diseased organs can also be seen on the monitor. Two lateral ports (0.5 cm incision) are placed on the abdomen and instruments are passed through them. Throughout this procedure, the organ is examined & operated simultaneously, with minimum trauma to the patient.
5. When should one opt for a Laparoscopic Surgery?
One should opt for a laparoscopic surgery when one wants more reliability, more safety, less pain and quick recovery. Traditional Gynaecological surgeries such as Infertility treatment, Fibroid, Ovarian cysts, Ectopic Pregnancy, Endometriosis & Chocolate Cyst, Septet uterus, Tubal Ligation and Recanalisation, Vaginoplasty, Prolapse & Stress Urinary incontinence Surgery, Excessive menstrual bleeding, Scanty menstrual bleeding, Tubal block, Removal of uterus etc. that were done by open (laparotomy) method, can now be carried out effectively and safely by Laparoscopic surgery.
6. Is Laparoscopy too expensive for Indian patients?
No, the charges are comparable to the traditional method. The surgery has its own unique advantages:
a) Recorded video of Gynaec Endoscopic surgery shows the quality of surgical skill and also helps in teaching and learning purpose.
b) It also helps in deciding the future treatment protocol by different consultants after an Endoscopic surgery in infertility patient.
c) Recorded video of laparoscopic suturing helps in assuring scar integrity during subsequent pregnancy in a patient following a fibroid surgery
d) In the event of post-operative complications it helps in medico–legal protection in the court of law.
e) Recorded video of Ectopic pregnancy helps in conveying the condition of the affected tube.
7. What are the Other advantages of Video-Laparoscopy?
The patient is discharged on the same day of the surgery (shorter hospitalisation). Rapid convalescence (faster return to normal activity) helps in getting back to routine work within 2-3 days. The medication required is less. The possibility of post-operative adhesion formation will be less, and the possibility of pain because of post-operative adhesions will also be less.
Advantages of Laparoscopy when compared to the 'open traditional method
a) Faster recovery helps the patient to resume with her routine activity within 2-3 days after operation, as against the 15-30 days recovery for the traditional (Open) method.
b) Less adhesions after fibroid or chocolate cyst.
c) Less cuts, less pain, quicker relief & recovery.
8. When it comes to Laparoscopy, where do we stand on the international front?
WINGS Hospital endoscopy department -- GRACE Endoscopy Centre , have state-of-the- art facilities that meet international standards
a) State of the art operation theatre.
b) Richard wolf HD camera.
c) Ultrasonic energy device( harmonic scalpel).
d) Enseal (vessel sealer).
e) High end BOWA cautery.
f) Power plus morcelator
9. What care should be taken before deciding Laparoscopic Surgery?
It is obvious that the Success of the surgery depends upon the doctor as well, and while choosing the doctor / hospital certain things are needed to be taken care of
a) Experience & Exposure of the Endoscopic Surgeon for different Endoscopic Surgeries.
b) Safety monitoring during Laparoscopic Surgery like Multipara Monitoring including EtCo2 and Glycine deficit (less than 1.5 liter)/ S.Na level (Normal is 135 mEq/L) during Hysteroscopic Surgery.
c) Live oprative file (Video/CD/DVD) of the operation must be kept with you for future reference.
d) Selection criterias & optimum councelling before operation from the right person to understand the advantages and limitations of Endoscopy surgery.