total laparoscopic hysterectomy
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What is Laparoscopic Hysterectomy?
It is a procedure by which Hysterectomy (removal of uterus) is carried out laparoscopically. It is
a broad term which includes the removal of Uterus with the aid of Laparoscope and very fine
instruments, without making a big incision on the abdomen.
What are the advantages of Laparoscopic Hysterectomy over conventional surgery?
Its advantage over the conventional hysterectomy are that it gives rise to minimal tissue
handling and thus much less trauma to other adjacent normal organs resulting in very less pain
and lesser chances of adhesion formation; after the operation. 2-3 very small incisions of
0.5-1.0 cm (as compared to 10-15 cms in conventional procedure) are given on the abdomen
resulting in less blood loss and lesser chances of wound infection with decreased hospital stay
and early recovery time as compared to conventional surgery.
Who can undergo Laparoscopic Hysterectomy?
Usually all the patients who have been advised for hysterectomy can undergo Laparoscopic
Hysterectomy.
Can a person who has undergone operations in the past go in for Laparoscopic
Hysterectomy?
Yes, a patient who has undergone operations in the past can undergo this procedure and if
there are adhesions because of previous operations, they can be removed along with the
laparoscopic hysterectomy, in the same sitting.
Can associated ovarian, tubal or uterine disease all these be treated in the same
operation laparoscopically?
Yes, it is very much possible to treat/remove the ovaries and tubes while carrying out
laparoscopic hysterectomy.
Do I need any special investigations for Laparoscopic Hysterectomy?
The usual routing tests are required as for any other operative procedure and no special
investigation is required for laparoscopic hysterectomy.
Do we need any preparation / medicines before undergoing Laparoscopic Hysterectomy?
To make the operation easier, the recovery after the operation faster and resumption of normal
work/activity earlier, some medicines along with diet restriction is started 2 days before the
operation.
Can a person having disease like Diabetes or Hypertension undergo this procedure?
Yes, after controlling the Diabetes and Hypertension a person can undergo this procedure, and
in fact the advantages of lesser chances of infection and early recovery are much beneficial for
them.
Where should one get the Laparoscopic Hysterectomy done?
It is an advanced laparoscopic surgery procedure, and its always advisable to get it done in an
advanced care institution, where the whole set of equipment is present along with complete
backup facilities.
Do I have to get admitted a day before the surgery?
If you are fully investigated and have undergone Anaesthetic checkup, you can get admitted the
morning of the operation.
Under what type of Anaesthesia is it carried out?
This procedure is carried out under general anaesthesia.
How is the surgery performed?
A small incision (about one cm) is made at or near the navel. Through this a laparoscope is
introduced inside the abdomen. It is a tube having lenses inside and a special camera attached
to the outside end. This is then connected to a television monitor and allows the surgeon to see
inside the abdominal cavity. After that two / three small half to one cm incisions are made on
either side on the abdomen, to allow the introduction of thin long instruments, with which the
operation is carried out.
After how many days can I go back home after the surgery?
On an average the total hospital stay is for one – two days, after which you can go back home.
What are the usual precautions I have to take after I reach home?
On an average, two hours after lunch and eight hours rest after dinner is what is usually
recommended. You can climb stairs for two to three floor slowly, walk to one km slowly and
carry out sedentary work at home without much difficulty. One can have bath as the dressing is
waterproof.
When do I see the doctor again after the operation?
Routinely, the patient is called seven days after the operation for the change of dressing and
then after four weeks for a routine checkup.
When can I resume my normal activity / go back to work?
You can resume normal activity like walking, jogging, cooking, driving, sitting in front of the
computer within few days. Intercourse, strenuous exercise, lifting of heavy weights, swimming
etc. has to be avoided for a period of twelve weeks.
why laparoscopy
Gargi Hospital Hospital - Your Trusted Healthcare Partner
Why Laparoscopic surgeries have become so popular?
Laparoscopic surgeries have become very popular in short span of time, infact they have replaced all traditional abdominal surgeries. Their popularity is due to the immense advantages they have got over traditional surgeries. The advantages and benefits to the patients are
They are less pain
Patient recovers very fast (24-48 hrs.) and can resume to work within few days.
No post operative rest required
No scars on the abdomen
No changes of wound infection
No changes of post operative hernias and adhesions
Apart from these benefits, patients also will have immense long term benefits.
In Laparoscopic surgery enough advancements have taken place for the last 5-10 years. In the years to come many more advancements can be expected for the benefits of the common man.
Now the Surgeon inserts instruments like scissors, Graspers, Cautery etc., through other small parts, which were inserted in to tummy earlier and various operations, are carried out.
- Laparoscopy for Gynaecology
- Laparoscopic myomectomy (Fibroid removal)
- Laparoscopic Hysterectomy (Uterus removal)
- Laparoscopic for ovarian cyst removal
- Laparoscopic surgery for endometriosis
- Laparoscopic surgery for tubular recanalisation (Joining the tube)
- Polycystic ovary drilling
- Laparoscopic surgery for tube pregnancy removal
Hysterectomy:
So far was risky and painful. Now with Laparoscopic surgery, it is possible to remove all types of uterus through small holes and recovery is less than 24 hours. The patient can get back home the next day and carry on with all the day-to-day activities.
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Gynaecological Laparoscopic Surgeries :
Gynaecologists are pioneers in this field what were once diagnostic procedure became completely therapeutic procedure from 90's onwards. Today with breakthrough in technology, we are able to perform gynaecological surgeries including cancer surgeries through Laparoscopic approach.
Fallopian Tube Surgeries
These are the surgeries, which were introduced earlier into practice. Laparoscopic removal of the Fallopian tubes for tubal pregnancy is one of the commonest surgery performed by us today.
Similarly Laparoscopic removal of the tubes for Hydrosalpinx, (due to tubal infection) Tuberculosis etc., is also a very common surgery performed.
Removing the tubal blocks and tubal adhesions is helpful and suitable way through Laparoscopic surgery.
Laparoscopic Tuboplasty or delicate repair of the damaged Fallopian tube using micro instruments, and this is called Laparoscopic microsurgery.
Laparoscopic Surgery for Uterus Problems :
Laparoscopic surgery is extremely useful in the treatment of uterus problems.
It is useful for removal of fibroids and thanks to development of Advanced Morcellators, with this technique. Even huge fibroids can be removed form the body.
Laparoscopic Surgery is very useful in removal of the uterus for various reasons like, Heavy bleeding, infection, fibroids, Endometriosis etc.,
Now the uterus removal operation is done commonly through Laparoscopic method.
Laparoscopic Surgery for Uterus and Cervix Cancer :
Cancer surgeries through laparoscopy is in practice for last few years. Especially if the uterus cancer is in earlier stages it can be completely removed laparoscopically.
Cysts and problems of the Ovaries :
Overian cysts is an extremely common problem in adult females causing pain and discofort in the tummy, through laparoscope all tyres of cysts can be removed with ease.
Endometriosis :
Endometriosis is a disease of the ovaries causing cysts, adhesions etc., and the women will have pain and infertility as their problem. Laparoscopic surgery is a "Gold Standard" for this disease, which involves removal of the cysts and adhesions.
hysteroscopy
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Hysteroscopy
The Procedure
Hysteroscopy is an surgical procedure in which a small telescope (the size of a pencil) is used to inspect the inside of the uterus. A camera is attached to the end of the telescope and the image is viewed on a video monitor. Surgery is carried out while looking at this monitor. This is what the telescope looks like and it is inserted thru "sheaths" of different sizes.
- The first step involves cervical dilatation. The cervical opening must be enlarged to allow passage of the hysteroscope
- Once inside the uterus, gas or fluid is used to distend the cavity.
- Your gynaecologist may then inspect the uterine walls, openings of the fallopian tube, and overall architecture of the womb.
- Hysteroscopy may be recommended for evaluation for abnormal uterine bleeding recurrent pregnancy loss, or recurrent abortions are also evaluated by hysteroscopy
- abnormal findings on a hysterosalpingogram, ultrasound, or pelvic exam may also require a hysteroscopy for further evaluation
- uterine fibroids, polyps and septums [divisions] are evaluated as well as treated hysteroscopically
Diagnostic Hysteroscopy
Diagnostic hysteroscopy can be performed with a smaller instrument. This procedure is generally shorter and can be done under mild sedation or short general anaesthesia for better comfort The procedure is quick and inexpensive.
This is the image of a normal tubal ostium [the junction of the fallopian tube with the uterus] This is a normal uterine cavity
Operative Hysteroscopy
Operative hysteroscopy is performed under general anaesthesia. This will allow the physician to both diagnose and treat most findings, which are encountered at the time of the procedure.
The Operative Hysteroscope has ports, which allow the physician to insert operating tools, such as, scissors, cautery devices or a laser fiber. These may be used to resect or cauterize specific abnormalities under direct visualization. The hysteroscope is also valuable in treating some forms of tubal occlusion. Many patients with a blockage in the fallopian tube may have an obstruction at the junction between the uterus and fallopian tube. The Hysteroscope is used to pass a small catheter through this contracted area under direct visualization. Occasionally, scar tissue can be disrupted and allow passage of sperm as the result of the procedure.
A physician will be able to evaluate the cervical canal, the contour of the uterus, and the quality of the endometrial lining. The tubal ostia are the openings of the fallopian tube into the uterine cavity. They should be easily seen with the hysteroscope.
After Your Hysteroscopy
Complications are infrequent from hysteroscopy. Some patients may experience mild cramping. This usually is the result of the need to dilate the cervix for insertion of the scope. In general, patients are able to return to their normal activity level in 1-2 days after surgery.
Possible Risks
The possible risks of hysteroscopy include bleeding, infection and uterine perforation. Fortunately, these risks are infrequent. Occasionally, your physician will utilize a simultaneous Laparoscopy to aid in the prevention of uterine perforation if extensive hysteroscopy surgery is planned.
Advantages of a hysteroscopy over a plain D&C
Nowadays it is rare for a D&C to be done alone. It is usually combined with a procedure known as a hysteroscopy. This is because it is conclusively proven that a D&C [which is really a "blind" procedure] even in the best of hands gets only about 50% of the lining of the uterus while there may be a disease in the remaining portion which has been missed.
A hysteroscopy allows the gynaecologist to view the inside of the uterus and take a biopsy from the area which is worst affected and to localize the area and extent of the disease too.