Laparoscopy

Laparoscopy


Dr Nikam and Dr Chan are fully qualified Gynaecological Laparoscopic Surgeons. The College of O&G (RANZCOG) & the Australian Gynaecological Endoscopic Society (AGES) have laid down criteria regarding the level of credentialing of a doctor in laparoscopy based on the complexity of the surgery. For example, a Level 6 credentialed surgeon should perform a surgery for Complex Grade 4 Endometriosis.

Dr Nikam and Dr Chan have both undergone additional training in minimally invasive surgery and thereby are credentialed to perform Level 6 Laparoscopic Surgery at all hospitals. Almost all major operations are now performed by this route including hysterectomy (removal of the womb), Myomectomy (removal of fibroids), Excision of Endometriosis and repair of Prolapse. At AEVAFEM, both, Dr Nikam, and Dr Chan will be able to discuss and offer you the best possible surgical approach, should you ever need a surgery.

Laparoscopic surgery is performed under general anaesthesia. Tiny cuts are made in the patient’s belly. Gas is filled inside to create a small bubble. Doctors perform laparoscopy with a pencil-thin instrument called a laparoscope. It has a powerful light and a miniature camera that sends images of the surgery area to a video monitor above the operating table. The entry for the Laparoscope is usually through the umbilicus (belly button) and additional accessory tiny holes in the abdomen are utilized, allowing the slim operative instruments to be inserted. It is used to diagnose and treat many different conditions and diseases. At the conclusion of the surgery, the instruments are withdrawn, gas released and tiny cuts are closed with dissolvable sutures below the skin.

Laparoscopy is called minimally invasive surgery because the incisions are small (5mm – 12mm). Other non-technical names for the procedure are belly button surgery and Keyhole surgery.

There is enough research done on the laparoscopic Vs traditional Open (Laparotomy) approach. It has been proven beyond doubt that Laparoscopy has shown significant benefits to the patient. These benefits are in terms of

  • Reduced post-surgical pain
  • Reduced risk of infections and wound complication
  • Reduced risk of Postoperative adhesions
  • Decreased risk of incisional hernia
  • Increased comfort following surgery
  • Decreased need for medications,
  • Reduced hospital stay
  • Quicker return to normal physical activities and
  • Ultimately a quicker return to work
  • Improved cosmesis

Most patients can be discharged on the same-day or next-day and can return to their normal lives much more quickly than after an open surgery procedure (laparotomy or large cut on the belly).

The surgeon’s experience and prior training plays a crucial role in deciding whether operative laparoscopy or laparotomy should be used. While most surgeries can be done safely by laparoscopy, some surgeries are better suited via the open approach, especially when cancer of the pelvic organs is suspected.

Every patient is different and has different goals, hence at AEVAFEM, we discuss all the possible approaches and ensure that you are a part of the decision-making process.

Common Surgery Questions


What is Laparoscopic (or Keyhole) Surgery?

Laparoscopic procedures involve 3 to 4 tiny cuts (5 – 10 mm) in the abdomen. This allows the use of specialised instruments and a small camera inside the abdomen. The entire abdomen, pelvis, uterus and ovaries can be seen on a high definition screen.

A laparoscope is a fibre-optic telescope designed to allow the surgeon to visualise and examine the organs lying within the pelvic and abdominal cavities and perform procedures.

What are the benefits?

Laparoscopy allows all manner of procedures to be performed without the need for a large skin incision and minimal handling of internal tissues.

This typically results in:

  • less pain,
  • faster recovery,
  • minimal scarring,
  • early return to normal activity, and
  • reduced risk of infection.

Furthermore, it decreases the risk of

  • infection
  • formation of adhesions and
  • incisional hernia
How is laparoscopic surgery performed?

The operation is performed under general anaesthesia. The laparoscope is passed into the abdomen via the belly button to visualise the operative felid. Slim long instruments are inserted via the other tiny cuts to complete the surgery. The incisions are closed with surgical glue or with stitches below the skin.

What procedures can done via laparoscopy?

Almost all procedures are now amenable to laparoscopy. However, a large cut on the tummy (Open / Laparotomy) may sometimes be necessary, particularly when large masses or cancer is suspected.

Laparoscopy can be used to investigate and diagnose

  • causes pelvic pain,
  • potential causes of infertility,
  • examination of cysts and tumours,
  • to obtain biopsy samples and
  • to investigate suspected ectopic pregnancy

Common procedures include:

  • Female sterilisation
  • Treatment of ectopic pregnancy
  • Release/remove pelvic or abdominal adhesions
  • Surgically treat endometriosis
  • Excise or drain ovarian cysts
  • To enhance fertility, e.g., assisted reproductive techniques
  • Myomectomy (removal of fibroid)
  • Hysterectomy (removal of Uterus)
  • Reconstruct the pelvic floor, treat prolapse and incontinence
What are the associated risks?

No surgical procedure is entirely without risk, but this type of surgery attempts to minimise such risks. Your doctor will discuss all the possible risks associated with the procedure when you consent for the procedure. Laparoscopic surgeries are performed under General Anaesthesia. The Anaesthetist addresses the risks associated with the type of anaesthesia. Severe obesity or cigarette smoking increase your overall risk.

In particular every surgery has the risk of infection, bleeding, injury to surrounding organs and risk of clot formation in the legs and lungs. Necessary precautions are taken to minimise these risks, such as giving antibiotics, use of calf compresses to prevent clots. If a complication does arise, it is dealt with at the same time and rarely leaves any long-term sequelae.

This is a unique website which will require a more modern browser to work!

Please upgrade today!