What you need to know about:

Gynecologic Laparoscopic Surgery

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Recovery Period:

3 to 4 weeks

Permanence:

Permanent

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Time it takes:

30-60 minutes

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Anesthetize:

General anesthesia combined with epidural anesthesia

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Overview of

Gynecologic Laparoscopic Surgery

in Thailand

A surgical practice mainly used for the diagnosis and treatment of various gynecological disorders is called gynecological laparoscopic surgery. It typically involves a laparoscope, a device that is inserted into the cavities of the pelvis and abdomen to examine female reproductive organs such as the ovaries, uterus, and fallopian tubes.

The 2 types of gynecological laparoscopic surgeries used for examination and treatment are laparoscopic surgery and hysteroscopic surgery.

The laparoscopic surgery comprises a tiny camera that is inserted into the abdominal cavity while the hysteroscopic surgery uses a hysteroscope - a thin telescope with a camera and light attached to its end—inserted from the cervix through the vagina to inspect the uterus for any disorders, abnormalities or operation.

Goals of

Gynecologic Laparoscopic Surgery

Besides the use of laparoscopy in the diagnosis of gynecological abnormalities, it is also considered a treatment of choice for several pelvic and abdominal disorders.

Because of its less invasive technique, Laparoscopic surgeries have largely replaced the traditional abdominal surgeries that require a large incision for different treatments. Endometriosis, fibroid tumors, infertility, chronic pelvic pain, and ovarian cysts are some of the common examples.

Other procedures that can be performed laparoscopically include myomectomy, i.e. removal of fibroids, sterilization (tubal ligation), gynecological cancer stage hysterectomy—basically the removal of the uterus with or without the cervix, and tubal reanastomosis - the reversal of tubal ligation.

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Gynecologic Laparoscopic Surgery

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Pros and cons of

Gynecologic Laparoscopic Surgery

Pros

Negligible effects on the other organs situated in the abdomen.
The risk of adhesion is least likely to happen
In comparison with open surgery, the chances of complications are less.
Laparoscopic surgery only requires a minute surgical incision, unlike the usual open abdominal surgery. Therefore, the risk of developing a complication is very little and the recovery rate is faster. It also reduces hospital stay and the postsurgical pain; hence the return to the activities of daily living is much quicker than with the open surgery.

Cons

Even though it has lesser complications than the open abdominal surgery, still the laparoscopic surgery may cause

Infection
Abscess
Incision site pain
Hemorrhage

It may also cause damage to the adjacent internal organs, such as the ureter, bowel and bladder, nerves, and blood vessels.

Risk of blood clotting and hernia may include as well.

How it works:

Gynecologic Laparoscopic Surgery

The surgeon makes a tiny incision just below or inside the umbilicus of the patient under the effect of general anesthesia.

Through the incision, a small needle is inserted inside the abdominal cavity where carbon dioxide gas is introduced to expand the abdomen so it gives the surgeon better clarity and easier access to the internal organs.

Finally, the laparoscope is inserted through that incision with other surgical instruments, and the procedure is carried out.

Preparation before

Gynecologic Laparoscopic Surgery

Pre - treatment

A thorough history and physical examination of the patient is conducted before the surgical procedure.

The detailed past medical history and assessment allow the surgeon to decide if the patient is healthy enough for laparoscopic surgery. This includes the history of any diseases or allergies, drug history, surgical history, dietary modifications, etc.

Also, any possible pregnancy must be ruled out. Thorough blood tests, chest x-ray, ECG, and other important physical examinations are performed. Patients are directed to restrict eating and drinking at least 6 hours prior to surgery.

Recovery after

Gynecologic Laparoscopic Surgery

Post - treatment

Hospital recovery: After the procedure, a saline solution is administered intravenously that provides nourishment until the patient is allowed to eat orally. A urinary catheter is also inserted during the hospital stay. Any post-surgical pain, nausea, dizziness, or other symptoms should be immediately reported to the on-duty staff so they can be treated appropriately. The patient will be asked to take a few sips of water or fluid and gradually work toward a soft diet as soon as the intestines are functional again.

Home recovery: after discharge from the hospital, the doctor will provide a detailed home care plan to follow. It includes prescribed medications, prevention from wound infection by not letting it get wet, avoiding sexual intercourse at least for a month post-surgery, and refraining from strenuous physical exercises such as lifting and running. Follow this post-surgical care for not less than a month and keep regular appointments with the physician for follow-up.

Risks & side effects

Severe and unusual symptoms should immediately be reported to the physician. These symptoms include high fever, redness, swelling, bleeding at the site of incision, vaginal bleeding, vomiting, and nausea.

However, some of the side effects resolve on their own, such as shoulder pain, bloating due to the carbon dioxide entrapment, and chest and back pain.

Symptoms that do not subside with medication and are unbearable require emergent medical attention. Besides that, minor vaginal discharge—dark or bright red – might also be noted post-surgery. Though, it mostly resolves on its own.

FAQs:

Gynecologic Laparoscopic Surgery

What disorders are treated using gynecologic laparoscopic surgeries?

A number of diseases or disorders are regularly treated by gynecological laparoscopic surgery, including:

Fibroids: mostly benign (non-cancerous) and a few malignant (cancerous), fibroids are abnormal cells that grow mainly outside or inside the wall of the uterus. Laparoscopic surgery is performed in order to remove them as they cause heavy bleeding and pain.
Ovarian cyst: a fluid-filled sac developed in one or both the ovaries of some women. Often symptom-less, the cyst doesn’t require any treatment. However, if it doesn’t subside on its own, the physician might suggest laparoscopy to get rid of it.
Endometriosis: it is a condition where tissues of the uterus start to grow in other places. It is a painful medical condition and if signs and symptoms do not resolve with medications, laparoscopic surgery is recommended for both the diagnosis and the treatment.
Cancer: laparoscopic surgery can also be used to remove some types of cancers.
Ectopic pregnancy: fertilization that occurs outside the uterus is called an ectopic pregnancy. It might be a life-threatening condition for the woman and should immediately be removed through laparoscopic surgery.
Pelvic floor disorder: disorders such as pelvic organ prolapse or urinary incontinence can also be treated with laparoscopic surgery.
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What is the normal recovery time after surgery?

Depending on the individual and the surgical procedure, the normal recovery time may vary from patient to patient. Post-surgery, the majority of patients are prescribed pain medication for one week. It is also recommended to refrain from sexual contact, strenuous physical activity, and heavy lifting at least for a month. If there are no post-surgical complications, the patient may return to work but it must not include physical exhaustion.

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