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Laparoscopic Surgery

What is laparoscopic surgery used? When we talk of surgeries, laparoscopic surgery comes under the category of minimally invasive surgeries. There is an interesting history related to the use of laparoscopic surgery as it has really come a long way. From being used for conventional gynecology surgery to being used for intestinal and gall bladder surgery now. In this procedure, doctors make small incisions through the abdomen and then insert thin and long tubes (catheters) for the purpose of manipulation, cutting, and sewing tissues. These incisions can be 0.5 to 1 cm in length. After these tubes are inserted, particular instruments (used for the cutting, sewing, and manipulation) along with an advanced camera called a laparoscope (to get live feedback of the internal organs which are being operated) are inserted through them. The organ/body part which is going under the laparoscopic procedure is first inflated with carbon dioxide which makes the area better for working and viewing. Due to the great amount of accessibility and reduced cutting, this surgery is also the best for getting biopsy samples also.

The doctor can use laparoscopy for the following body parts:

  1. Ovaries

  2. Fallopian tubes

  3. Pancreas

  4. Uterus

  5. Gall Bladder

  6. Abdomen (stomach)

A laparoscopy may be recommended by your doctor if other diagnostic tests are not helpful in confirming the cause/state of a condition. Laparoscopy can be used by the doctor for the following things:

  • For finding the cause of pain in the pelvic and/ or abdominal region.

  • To investigate a tissue mass.

  • To confirm conditions like endometriosis, PID, etc.

  • To look for any blockages in the fallopian tubes in cases of infertility.

How is laparoscopy performed?

Laparoscopy is a very simple and not a very demanding procedure as it just needs the patient to be in a slightly tilted position with the head being at a level lower than the feet. The doctor makes a little incision (cut) close to the navel. The laparoscope is then inserted through the incision. The abdomen is inflated (as explained above) for an increased area for viewing. This laparoscope is also accompanied by surgical instruments. There can also be another incision that can be made by the doctor in the pubic hairline which provides the doctor with an extra opening that acts as a point of access for performing certain surgical procedures. Once, the surgery is performed, your doctor will remove the tubes and stitch these small incisions. After this, you will be asked to stay in the recovery room for some time (the time duration for which generally varies from one to two hours) as a preventive measure (considering the possibility of it being a rare case of any complications being there after the procedure). Once this duration is over, you will be taken to an outpatient unit for further observation. Once, the doctor feels that the surgery has been a success (which, it mostly is), she/he then gives you certain instructions for a better recovery at home. 9 out of every 10 patients, leave the hospital in just about four hours of the laparoscopy. The doctor will ask you to return for just a few follow-up appointments within 2 to 8 weeks of the laparoscopy procedure/surgery.

There are not any specific requirements for a laparoscopy other than the basic preventive measures which should be taken for any medical/surgical procedure. These measures are:

  1. You should not eat or drink anything (even water) after midnight the day before the surgery.

  2. You should not wear any jewelry.

  3. You should avoid wearing high heels as the anesthesia may cause drowsiness and you can get injured.

  4.  You should wear loose-fitting clothes as one may feel tenderness and cramping in the abdominal region.

  5. You should remove nail polish before the surgery.

When is laparoscopy used?

Laparoscopy is recommended by your doctor in order to diagnose any cause or reason for your infertility. It is generally carried out after the usual infertility tests when they are incapable of a proper and sure-shot diagnosis or if the symptoms are severe. However, laparoscopy is not something that can be done routinely. Your doctor may recommend you a laparoscopy if you have been experiencing the following symptoms:

  1. If you experience pain during intercourse (sex)

  2. If you have been experiencing intense menstrual cramps or pelvic pain before, after, or during your menstrual cycles

  3. If she/he suspects severe pelvic adhesions, PID, etc.

  4. If she/he suspects an ectopic pregnancy

Laparoscopy is the best approach that can be used to treat serious female infertility conditions. These conditions can be any of the following:

  • In case of the fallopian tube/ tubes being blocked. Such affected tubes can be taken out through this surgery which can also improve the rates of IVF success.

  • In the case of endometriotic females, the deposits can seriously prohibit/limit the chances of pregnancy.

  • Females with ovarian cysts suffer a lot as these cysts can block the fallopian tube and cause severe pain. Laparoscopy can be used to remove such ovarian reserves and hence, proves to be a better alternative than a conventional genitalia removal surgery which makes the females incapable of ever giving birth to a child.

  • In the case of patients with PCOS, laparoscopy can be used to do ovarian drilling which includes the process of making three to eight little punctures into the ovaries. This procedure has been proven to be helpful in making such women capable to ovulate on their own without any steroid therapy.

After the surgery has taken place, the suitable options (depending on your case) for getting pregnant would be discussed by your doctor. If the surgery involved removal of any fibroids or cysts or if your fallopian tube has been repaired, there are high chances of you being able to get pregnant without the need of any hardcore medical help. If it has been several months after the surgery and you are unable to conceive/get pregnant then your doctor may give you recommendations for getting fertility treatments like IVF, IUI, etc.

Laparoscopic Surgery Advantages:

There are not one, but many benefits of laparoscopic surgery when compared to the traditional, hectic, and painful conventional surgery. A few of these laparoscopic surgery benefits are mentioned below:

1. Minimally invasive:

 Laparoscopic surgery is the most effective way to tackle any serious or deep-rooted health issue. When compared to the traditional surgical methods which leave vast scars and pain to the patients, laparoscopy is the best option that one can have as it is minimally invasive and hence, does not cause a lot of pain to the patients after the procedure.

2. Smaller scars:

The greatest advantage which one has when opting for laparoscopic surgery is that it leaves very small scars on the body after the operation. The advanced technology in the recent era has really helped us to get to this point where we can perform operations with minimal invasion in the human body and that too, with great precision.

3. Lower Blood Loss:

The requirement of blood transfusion may be there after a traditional surgery due to the risk of increased blood loss because of the large incisions involved in such surgery. On the other side, laparoscopic surgery leads to small scars and hence, causes lesser blood loss and hence requires a smaller number of transfusions.

4. Shorter stay at the hospital after the surgery:

Laparoscopic surgeries limit the patient to the hospital for 2 nights maximum when compared to the traditional surgeries which require several weeks for recovery/ healing.

5. Lesser risk of infections:

There are a lot of risks involved in patients who have undergone traditional surgery (more risk for obese patients) as the internal organs are more prone to infections due to the larger incisions/ cuts. Laparoscopic surgery, on the other hand, causes only smaller cuts and hence, the patients are not that vulnerable to infections.

6. Faster Recovery: 

Laparoscopic surgery is the best surgical method for this era as every person is too busy to give 4 to 8 weeks’ time for the recovery as taken in conventional surgeries. Laparoscopic surgery, on the other side, takes only 2 to 3 weeks at maximum for the recovery and because of this, the patient can return to normal life really faster.

Laparoscopic Surgeries Disadvantages:

As a coin has two sides, the same way, laparoscopic surgery also has both advantages and disadvantages associated with it. Even though it is the best option for surgery if we consider the least discomfort that one has to bear when undergoing laparoscopy. Yet, there are a few factors that make it a little disadvantageous for a few people which are as follows:

1. It is expensive:

It is true that laparoscopy can prove to be a blessing for the people who are going to go under surgery, still, it can be expensive for a few people as the instruments that are used in this procedure are really expensive and hence, the overall operation becomes really costly. Because of this reason, many hospitals also can’t afford to have such instruments, and hence, the access for laparoscopy is less as it is not accessible to a lot of patients.

2. It requires additional training:

To carry out laparoscopic procedures, there is a need for additional training as it requires leaving the usual working on a 3D (three-dimensional) to working on a 2D (two-dimensional) display. As simple as it sounds, this transition is not an easy one! This surgery, hence, requires hands-on experience with laparoscopic instruments.

3. Not suitable for complicated surgeries:

The tools required to perform laparoscopic surgery are not sufficient for the complicated surgeries that require a three-dimensional vision (as seen in conventional surgeries). On the other hand, laparoscopic surgery has only a two-dimensional field of vision which is not sufficient at times. 

Laparoscopic Surgery Risk Factors:

Just like any other medical procedure, laparoscopy also has certain risk factors (rarely seen) that are associated with it. These factors include:

1. There are risks of infections involved in laparoscopy. These risks, however, are very less than the ones in conventional surgery. One should, however, take care that they do not have the following symptoms as these are indicatives of infections in your body:

  • Swelling, bleeding, redness, and/ or witnessing drainage at the sites of incision

  • Chills/ fevers

  • Intense pain in the abdominal region

  • Inability to urinate

  • Experiencing shortness of breathing

  • Feeling light-headed

Other than infection, there are other risks that have been associated with laparoscopy which can be regulated/ controlled if you have a competent doctor by your side. These are:

  • General anesthesia complications

  • Abdominal wall inflammation

  • Clotting of blood 

You really need to have a competent surgeon who can tell you if the associated risks are serious in your case. These risks can be greater only for people who have undergone abdominal surgeries in the past or patients who have certain conditions. If that is the case, you need someone who is honest with you as such conditions increase the risks of adhesions being formed between your abdominal structures. Such adhesions can cause serious injuries to your internal organs over time. 

After Effects of Laparoscopic Surgery:

Even though laparoscopic surgery includes very little time to recover, yet, like any other medical procedure/surgery, it also has a few aftereffects associated with it, and hence, one can have a few symptoms after the laparoscopy. These laparoscopic surgery after-effects can involve:

  • Fatigue

  • Sore throat: This can be caused by the breathing tube during the surgery

  • Feeling discomfort at the incision site

  • Bloating in the abdomen

  • Pain in the shoulder or back can also be experienced that is caused due to the traces of carbon dioxide within the abdomen. 

Such pain should get resolved within a matter of days. However, you should immediately tell your doctor if you have any of the following symptoms:

  • Severe pain

  • Heavy bleeding or clotting during the menses

  • Experiencing fainting, vomiting, or nausea

  •  Breath shortness

Such symptoms could be hints telling about the presence of any serious complication. You can get back to your normal activities within just a few days. You should, however, follow your doctor's instructions by heart.

Conclusion:

Laparoscopic surgery is an example of a great medical achievement that we have established in this 21st century. It does not affect your fertility and hence, is a great alternative to conventional surgery which can have a serious impact on your fertility. Let alone affecting the fertility rate, laparoscopy has enhanced the fertility rate as it does not cause damage like traditional surgery. Laparoscopic surgery before IVF has really proven to be effective in enhancing fertility rates. You just need to have a competent surgeon by your side who knows what she/ he is doing. 

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