Operative Laparoscopy and Hysteroscopy is being routinely carried out at Sir Ganga Ram Hospital

        Procedures being carried out in Operative Laparoscopy are :

• Laparoscopic Hysterectomy (removal of Uterus) / Laparoscopically assisted Vaginal Hysterectomy (LAVH) for various abnormalities of the Uterus like Fibroids, excessive bleeding etc.
• Laparoscopic removal of both the Ovaries (bilateral oophorectomy) along with Hysterectomy.
• Laparoscopic Myomectomy (fibroid removal) in cases where uterus is required to be preserved for further child bearing etc.
• Laparoscopic Ovarian Cystectomy (removal of cyst of Ovary)
• Laparoscopic Adhesiolysis (removal of adhesions) occuring because of infections, Endometriosis or caused because of previous operations.
• Laparoscopic removal of Ectopic pregnancy (pregnancy existing outside the uterus like in the tube and ovary etc.)
• Laparoscopic Salpingostomy (opening of blocked tube mouth), Neosalpingostomy (creating new tubal opening), Tubal anastomosis in cases of Infertility.
• Laparoscopic correction of Congenital anomalies of the Reproductive system.

        Operative Hysteroscopy procedures being :

• TCRE (Trans Cervical Resection of Endometrium) for excessive bleeding of the Uterus caused because of defective lining of the uterus (endometrium).
• Septal resection (resection of Septum of the Uterus).
• Submucous Myoma resection (removal of fibroid inside the uterine cavity).
• Uterine Polyp resection (removal of polyp of Uterus).
• Tubal catheterization for blocked tubes in cases of Infertility.

WHAT IS LAPAROSCOPIC SURGERY ?
Laparoscopic Surgery, also called minimal invasive surgery, endoscopic surgery or key hole surgery, is the latest form of treatment available for gynaecological disorders requiring surgical intervention (operation).

HOW IS LAPAROSCOPIC SURGERY CARRIED OUT ?
A small incision (about 1 cm.) is made at the lower end of the navel. Through this a laparoscope is introduced inside the abdomen. It is a tube which contains lenses and has a camera attached to the outside end. This is connected to a Television monitor and allows the surgeon to see everything inside.

The surgeon then makes one or two more half a cm to one cm incisions in the abdomen to allow the introduction of thin long instruments for carrying out the operation.

WHO CAN GET THE LAPAROSCOPIC SURGERY DONE ?
Patients who have been advised for Hysterectomy (removal of uterus) for various disorders of the uterus, can in many cases be done laparoscopically and benefit from the advantages of Laparoscopic surgery .

In those patients where conservative operations on the uterus have to be performed like Myomectomy (removal of fibroid / myoma), Adhesiolysis (removal of adhesions), Ovarian Cystectomy (removal of cyst of Ovary), treatment of Endometriosis, treatment for Ectopic Pregnancy (pregnancy existing outside the uterus, like in the uterine tube, ovary etc.), diagnosis and treatment of various causes of Infertility etc., Laparoscopic surgery if possible is the treatment of choice.

Patients suffering from excessive bleeding of the uterus because of defective lining of the uterus (endometrium) were in the past advised Hysterectomy conventionally for it, now endoscopically TCRE (Trans Cervical Resection of the Endometrium) is a treatment of choice, for them.

For those patients having congenital abnormalities of the uterus like Septum inside the Uterus etc, or adhesions inside the uterus, this mode is the treatment of choice.

And patients having undiagnosed pain in abdomen and other diseases where a definite diagnosis has not been made, can undergo laparoscopic evaluation to be followed by laparoscopic intervention if required at the same time.

THE ADVANTAGES OF LAPAROSCOPIC SURGERY OVER CONVENTIONAL SURGERY

• It gives rise to minimal tissue handling and much less tissue trauma to the other adjacent normal organs resulting in very less pain after the operation.
• 2-3 very small incisions of 0.5 - 1.0 cm are given on the abdomen resulting in less amount of blood loss, less post operative pain, less chances of wound infection, early healing of wound.
• blood loss is very less because even the smaller blood vessels are directly visualised on the TV monitor with the magnified view provided by the laparoscope.
• as the abdominal incision is very short and the operative work is very specific with minimal blood loss, the chances of post operative infection are very less.
• the hospital stay is usually 1-3 days even for the major operations like Hysterectomy while in cases of conventional surgery the same procedures will require 5-7 or even more days of Hospital stay.
• the recovery time for the patient is very less and they can resume their normal day to day activities in a period of 1-2 weeks while in cases of conventional surgery the recovery period is quite long and can extend to 6-8 weeks or more.
• for infertility patients, laparoscopic surgery has come as a boon,as with minimal tissue handling, minimal bleeding and much less chances of adhesion formation after the operation, the chances of achievement of pregnancy are much greater than that attained by the conventional surgery.
• as far as the total expenditure of the patient is concerned, laparoscopic surgery comes out to be more cost effective than the conventional surgery.
• very small incisions on abdomen are much more cosmetic with very little scarring.

WHERE SHOULD ONE GET THE LAPAROSCOPIC SURGERY DONE ?
Before getting the Laparoscopic surgery done it is always advisable to see that your Gynaecological Laparoscopic Surgeon being a Gynaecologist is well qualified and fully trained in the field of Operative Laparoscopy.

Laparoscopic surgery being one of the most advanced modalities of treatment, it is always advisable to get the laparoscopic surgery done in an advanced care institution, where the whole set of equipment is present along with its complete backup facilities.

HOW CAN ONE GET THE LAPAROSCOPIC SURGERY DONE ?
If one has been advised an operation for some Gynaecological disorder, it is better to consult a Gynaecological Laparoscopic Surgeon for undergoing Laparoscopic surgery.

An appointment can be taken with the Gynaecological Laparoscopic Surgeon. Before the consultation, it is always advisable to take all the relevant papers, investigation reports along with the Ultrasound / X-Ray report if available, and the previous treatment reports (if any) to show to him, so that your proper treatment can be planned accordingly.

After thorough examination of the patient and carrying out relevant investigations, the operative laparoscopy technique is decided for the patient and it is explained to the patient and her relatives in detail. All the queries regarding the operation are discussed with the patient and a specific date (depending upon various factors like the menstrual cycle status of the patient etc.) is finally set for operative laparoscopy.