What is Laparoscopy?
This is a keyhole endoscopic procedure that enables a thorough examination of female pelvic organs such as the uterus, cervix, fallopian tubes, and ovaries. Dye is injected into the uterine cavity to detect leakage into the pelvic cavity through the fallopian tubes. This helps to test the patency of the fallopian tubes.
The benefit of laparoscopy over other tubal potency techniques is that it enables corrective procedures or therapies to be performed concurrently with the diagnostic process.
Why is Laparoscopy performed?
Laparoscopy is often indicated in infertility patients because it is the most reliable approach to examining the health of the pelvic organs. It permits the dye to be used to ensure that the tubes are open and healthy. Laparoscopy is also used to address problems that might lead to infertility, such as ovarian cysts, endometriosis, fibroids, and adhesions.
Are there any risks associated with laparoscopy?
Any surgical treatment involves risks, although they are modest.
The risk of bleeding is quite minimal. It is very uncommon, with just one in every 10,000 instances. If internal bleeding is suspected, the laparoscopy must be prolonged into a wider incision known as a laparotomy.
Infection-It is essential to keep the wound clean and follow the aftercare guidelines to reduce the risk of infection.
Injury to neighboring structures – The reproductive organs are bordered by other pelvic organs such as the bladder, ureter, and intestines. These structures are particularly prone to injury during demanding laparoscopic procedures. These problems are uncommon, occurring in around 1 in 2000 instances.
Blood clots (deep vein thrombosis) -There is a subgroup of patients who may be at more risk than others of such complications. It usually occurs after a patient has been laying or sitting still for an extended period of time after surgery. It is critical to get up and walk as soon as possible following surgery to maintain the blood circulating in your legs and body.
Endometriosis therapy and laparoscopy
Endometriosis is a disorder that may lead to painful menstrual cycles and infertility. It occurs when minute quantities of Endometrium, the lining of the uterus or womb, begin to settle in the pelvic cavity. Endometrium travels backward through fallopian tubes and usually settles around or in the ovaries. When endometrium starts settling down in the ovaries it is known as Endometrioma. Diathermy may be used to treat endometriosis during laparoscopy (electrocautery or heat treatment). Endometriosis is characterized by painful, heavy periods and, in many cases, infertility. A small camera is introduced via an incision in the abdomen during laparoscopic surgery to treat endometriosis. To provide a clear vision, the abdomen is inflated with gas. After choosing a treatment method, the surgeon destroys the endometrioma with lasers, electricity, or a freezing technique. This is a cyst or endometrial cell that develops outside of the uterus, potentially on the ovary or in the fallopian tubes. Excision of endometriosis refers to the removal of scar tissue and enlarged cells or cysts. Laparoscopic endometriosis helps the surgeon treat endometriosis with few motions and without injuring neighboring healthy cells. It can be used in conjunction with hormone treatment.
Adhesions and Laparoscopy (Laparoscopic Adhesiolysis)
Pelvic infection, endometriosis, or previous surgeries are the most prevalent causes of adhesion development in the pelvic cavity. They may cause the ovaries, uterus, and fallopian tubes to clump together, interfering with the usual physiology of attaining spontaneous pregnancy.
In such circumstances, laparoscopy may assist to relieve the pelvic organs of adhesions. Adhesions have the ability to reoccur.
Ovarian Cyst and Laparoscopy (Laparoscopic Cystectomy)
A pelvic ultrasound-detected ovarian cyst is not always an unhealthy condition. The ovary has a tendency to make a cyst every month under normal conditions. Follicular cysts or corpus luteal cysts may occur. They usually regress on their own and do not need intervention or therapy. In such circumstances, the cyst requires either medicinal or surgical treatment. If they need surgical treatment, they may be safely removed through Laparoscopy. The aim of these surgeries is to remove only the cyst and preserve the normal ovary as much as possible to preserve the ovarian reserve. This procedure removes cysts from one or both ovaries. The formation of cysts at some point in the life of a female is quite common. Some cysts disappear on their own. At times, they disrupt menstrual cycles or pregnancy, or they induce discomfort during intercourse or your period. These cysts can be removed by making a small incision on the abdomen.
Lap Surgery for Ectopic Pregnancy
When pregnancy – or, more precisely, embryo implantation – occurs inside the fallopian tube, it is not viable. The foetus will not survive, and it may cause hemorrhaging, even compromising the woman’s life. When hormones or other medications are ineffective or have failed to treat an ectopic pregnancy, laparoscopic surgery is indicated. A small camera-mounted cannula is introduced into the abdomen at or below the navel. After that, the fertilized cells are removed. In addition, the surgeon attempts to repair or remove the damaged portion of the fallopian tube. This is known as a salpingectomy or a salpingostomy, depending on whether the tube must be removed entirely or mended partially to stop the rupture and bleeding.
Lap Sacrocolpopexy is the surgical repair of an organ that has prolapsed or has fallen back down in the pelvis. This procedure is essential to maintain the bladder, intestines, and sacral promontory working normally. It can treat prolapse of the vaginal walls, cervix, or uterus in older women. The surgeon might use this procedure to restore the prolapsed walls of the vaginal vault, cuff, or apex. Furthermore, it aims to restore and strengthen the pelvic region’s natural anatomic support so that all bladder and bowel functions are unaffected. Laparoscopic Sacro colpopexy is chosen over abdominal surgery because it is less intrusive and allows for a faster recovery.
Tubal Surgery and Laparoscopy
Previous infections, endometriosis, or pelvic organ surgery may damage or restrict the fallopian tubes. Laparoscopy may help with tubal surgery to open the fallopian tubes and increase the likelihood of spontaneous pregnancy. It is critical to note that although surgery may assist open the fallopian tubes, it does not always help the tubes function properly. There can be chances of pregnancy getting stuck in the tube (Ectopic pregnancy). As a result, it’s critical to understand the increased risk of ectopic pregnancy with subsequent pregnancies after tubal surgery.
Individualized approaches to these procedures are critical to their effectiveness. Such surgery may not be appropriate for all people with tubal problems.
How is laparoscopy in gynecology performed?
During the procedure
Laparoscopy is often done under general anesthesia. As a result, there is no discomfort during the procedure. A needle is inserted into the abdomen to fill the abdomen with carbon dioxide gas. The gas widens the abdominal cavity by enabling a clearer view of the organs, keeps the abdominal wall away from the organs, and minimizes the chance of abdominal organ damage. The surgeon makes a small incision below the umbilicus to insert the laparoscope. The footage from the camera attached to the laparoscope is sent to a screen, providing a clear and enlarged picture of the pelvic tissues. The video can also be saved for future use. If the surgery is just for diagnosis, only one incision is necessary to introduce the laparoscope. If a surgical procedure is to be conducted, further small incisions will be necessary to implant the surgical tools. Following the surgery, the incisions are sutured (stitched) and dressed.
After the procedure
Depending on the procedure, patients are frequently discharged on the same day or within 24 to 48 hours. Patients can return to normal activities in 1 to 2 days, but they should avoid straining, hard lifting, sports, exercise, and other specified activities until the doctor recommends it. The recovery period is determined by the surgery. It might range from a few days to several weeks. Pain, swelling, and bruising may occur in patients, although this normally disappears within a few days. Typically, pain relievers and antibiotics are provided. Recovery from laparoscopic procedures is faster than with open surgery.
Gynecological laparoscopy is a common and relatively safe surgery. For most women, the benefits of improved symptoms or having a clear diagnosis are far greater than the disadvantages. Bleeding, infection, an unanticipated response to anesthesia, or developing a blood clot in one of your legs are the most common risks of any operation (Deep Vein Thrombosis).
Although uncommon, other organs in the abdomen (such as the colon, bladder, or major blood arteries) may be mistakenly damaged during laparoscopic surgery. If this occurs, it will be fixed as soon as it is detected.
It is also possible that the womb will be injured or ruptured during the procedure. This might result in bleeding and infection, necessitating further surgery and antibiotics. Your surgeon may be required to change your keyhole technique to open surgery. This entails making a larger incision on your abdomen. This is only done if the surgery cannot be completed safely with the laparoscope.
When Should You Seek Medical Help?
Laparoscopy, both diagnostic and therapeutic, is now a frequent surgical treatment that is typically safe and successful. However, like with any surgical procedure, problems and failures are possible. These have a risk of less than 1%. If within 24 hours of being discharged you have severe abdominal pain and/or are vomiting, have a temperature, and/or your abdomen is getting more and more swollen and increasingly becoming more sore and tender to touch and/or it hurts badly when you cough please consult your gynecologist immediately.