Laparoscopy is a minimally invasive surgical technique used in procedures as a diagnostic tool or for surgeries such as removal of the uterus, fibroids, ovarian cysts, pelvic adhesions, endometriosis etc. For many procedures, such as removal of an ectopic pregnancy, treatment of endometriosis, or ovarian cystectomy, laparoscopy has become the treatment of choice.
Compared with laparotomy, multiple studies have shown laparoscopy to be safer and to have a shorter recovery time Bedekar Hospital has facilities for basic and advance laproscopic/ keyhole surgery.We have all latest equipment for the same.
Frequently, the physician needs to assess the pelvis for acute or chronic pain, ectopic pregnancy, endometriosis, adnexal torsion, or other pelvic pathology, or for determination of tubal patency.
Trocar placement is similar to diagnostic laparoscopy. Bipolar electrosurgery, clips, or silastic bands may be used to occlude the tubes
Lysis of adhesion
Adhesions may form due to prior infection, such as a ruptured appendix or pelvic inflammatory disease (PID), endometriosis, or previous surgery. Adhesions may contribute to infertility or chronic pelvic pain. The chances of pregnancy after lysis of adhesions is relatively low for most patients, and this type of surgery has been largely supplanted by in vitro fertilization and embryo transfer. Likewise, adhesiolysis is often ineffective in curing chronic pelvic pain, in part because most adhesions rapidly reform after surgery.
Adhesions may be lysed by blunt or sharp dissection.
Treatment of endometriosis
Endometriosis, a cause of female infertility, is a condition in which endometrial tissue, the tissue that lines the inside of the uterus, grows outside the uterus and attaches to other organs in the abdominal cavity such as the ovaries and fallopian tubes. Endometriosis is a progressive disease that tends to get worse over time and can reoccur after treatment. Symptoms include painful menstrual periods, abnormal menstrual bleeding and pain during or after sexual intercourse.
The blood that is shed from the endometrial tissue in your abdominal cavity has no place to go, resulting in pools of blood causing an inflammation that forms scar tissue. The scar tissue can block the fallopian tubes or interfere with ovulation. Another result of endometriosis is the formation of ovarian cysts called endometrioma that may also interfere with ovulation.
Laparoscopy is the most common procedure used to diagnose and treat endometriosis.10 Endometriotic lesions may be resected or ablated. Both of these techniques have shown to improve fertility and decrease pelvic pain.
Treatment of ectopic pregnancy
Ectopic pregnancy is a pregnancy that implants and grows outside the uterine cavity; either in the fallopian tubes or ovary or rarely in the abdominal cavity. With advances in sonography ectopic pregnancy can be diagnosed very early before itruptures causing heavy blood loss. If surgical treatment is required for ectopic pregnancy it is bettermanaged by laparoscopic surgery. A salpingostomy or salpingectomy may be performed to remove the embryo and gestational sac.
In some women, the follicle (egg) manages to grow but is unable to rupture leading to formation of small grape like cysts within the ovary. These cysts contain androgenic hormones impairing fertility. While rupture of the eggs can be induced in some of the women, a segment of these woman may be resistant to the drugs(thick capsule).These women may need surgical drilling of the ovary, where puncture holes are made in both ovaries using monopolar current through the endoscope. Good results are seen following this surgery.