Laproscopic Gynecological Surgery

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Apollo Hospitals

Health & Medicine

Laparoscopic Gynecological
surgery- Key hole surgery
Dr Rooma Sinha, MD, DNB
Senior Consultant Gynecologist & Laparoscopic Surgeon
Apollo Health City; HYDERABAD
www.gynecologyhyderabad.com,drroomasinha@hotmail.co
m; 9550326662; 9849008180

What is keyhole surgery?
• ALSO CALLED "MINIMALLY INVASIVE SURGERY",
"MINIMAL ACCESS SURGERY", "OPERATIVE
ENDOSCOPY".
• It was also often wrongly called "Laser Surgery"
because the early users emphasized the use of lasers
(more fashionable and high tech then) rather than the
small size of the laparoscopic technique.

• Laparoscopic surgery is now firmly established as the
operation of choice or Gold standard for treatment of
most gynecological problems needing surgery.

• This is a surgical technique to visualize
the abdominal cavity without opening
the cavity.

• A laparoscope is introduced through the
umbilicus with 10mm hole and the
cavity is visualized to look for problems.

• The laparoscope is attached to a camera
and video monitor that helps us see.

• To perform surgeries two to three small
holes of 5mm are made through which
instruments to operate are passed and
surgery is performed.

Benefits of laparoscopic Surgery
• Less post operative pain since the incisions are
much smaller
• Quicker recovery time & earlier return to full
activities
• Shorter hospital stays
• Smaller scars
• Less internal scarring when the procedures are
performed in a minimally invasive fashion
compared to standard open surgery

Gynecological Surgeries done by
laparoscopy
• MOST BENIGN SURGERY IN GYNECOLOGY CAN NOW BE
ACHIEVED LAPAROSCOPICALLY
• HYSTERECTOMY FOR CONDITIONS LIKE
FIBROIDS, ADENEOMYOSIS, HEAVY MENSTRUAL FLOW
• OVARIAN CYSTECTOMY & OOPHORECTOMY
• SURGERY FOR INFERTILITY
• ADHESIOLYSIS
• ENDOMETRIOSIS SURGERY
• SURGERY FOR URINARY INCONTINENCE
• ECTOPIC PREGNANCY
• CHRONIC PELVIC PAIN

Acceptance of Laparoscopic
Surgery
• This technique is well established and has gained
tremendous acceptance among public.
• The number of surgeries performed laparoscopically 10
years ago and now by us is depicted in the table. This it self
is the testimony of this fact. Patients now demand for their
procedures to be done laparoscopically.

Cost
• Surgeries performed by laparoscope may be
10% -15% higher than their counterpart open
procedures but this a small price to pay if you
take the patients comfort, less days spent in
the hospital and overall quick recovery.

What is new in Laparoscopic
surgery?
Use of robotic technology!!
• Provides 3D vision
• Better & easier suture capability without tremor
• The robotic arms and the EndoWrist instruments with
natural hand and wrist motions that mimic movements
performed in open surgery. In fact, the EndoWrist
instruments are designed with seven degrees of
freedom, one more than the human hand.
• A third instrument is also in the surgeon’s control for
precise surgery

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It has not changed the nature of disease The basic principles of good surgery still apply,including appropriate case selection, excellent exposure,adequate retraction and a high level technical expertise If a procedure makes no sense with conventional access, it will make no sense with a minimal access approach The cleaner and gentler the act of operation, the less the patient suffers, the smoother and quicker his convalescence,the more exquisite his healed wound. We actually do not know what is there stored for us, but we believe that laparoscopy is trending towards advancement and nano and robotic technology is going to replace in future. 3D cameras have come into existence and various newer technologies are being invented.

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