Laparoscopic Gynaecology Surgery
Laparoscopy is a surgical procedure that has been used widely in medicine over 40 years. The faster recovery time, the minimizing of pain, hospitalization and the better aesthetic result are some of the advantages which made laparoscopy very popular among patients and surgeons. Also some technical parameters such as the magnification offered by the endoscope during the procedure and the small risk of complications resulted to the wide use of laparoscopic surgery in gynecology. Laparoscopy has gained a leading role and appears to be the gold standard method for a quiet wide range of gynecologic procedures such as tubal ligation, removal of ovarian cyst or adnexa, treatment of ectopic pregnancy, hemorrhagic rupture of a cyst, exploration of chronic pelvic pain, sterility, treatment of endometriosis, removal of fibroids, hysterectomy, and lately for treatment of pelvic organ prolapse, urinary incontinence and even in gynecologic cancers. Despite the advantages of laparoscopic procedures, they do not come without risk and complications for the patient. As with laparotomy there is always danger for deep vein thrombosis, inflammation and creation of adhesions. It should be noted though that compared to laparotomy there is a higher risk of injury to the major blood vessels positioned in the pelvis and the urinary system, and that is why patients considered to be subjected to laparoscopy should be carefully chosen.
Indications for Laparoscopy
- Diagnostic laparoscopy
- Laparoscopic total hysterectomy (leaving the ovaries inside)
- Laparoscopic myomectomy - removal of fibroids
- Laparoscopic supracervical (subtotal) hysterectomy
- Endometriosis resection (removal)
- Ovarian cystectomy - removal of a cyst in the ovary
- Laparoscopic ovarian drilling
- Tubal occlusion
- Adhesiolysis (Separation of adhesions)
Thorough preoperative evaluation of the patient, combining ultrasonography with the measurement of tumor markers, may greatly improve the accuracy of diagnosis of malignancy. Moreover, laparoscopy is, in the first place, used as a diagnostic tool whereby the pelvis and the abdominal cavity are thoroughly evaluated.