Laparoscopic Surgery

Laparoscopy  is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera. The laparoscope aids diagnosis or therapeutic interventions with a few small cuts in the abdomen.

Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery, is a modern surgical technique. There are a number of advantages to the patient with laparoscopic surgery versus the more common, open procedure. These include reduced pain due to smaller incisions, reduced bleeding and shorter recovery time.

Advantages

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include: 

  • Reduced hemorrhage, which reduces the chance of needing a blood transfusion
  • Smaller incision, which reduces pain and shortens recovery time, as well as resulting in less post-operative scar.
  • Less pain, leading to less pain medication needed
  • Although procedure times are usually slightly longer, hospital stay is less, and often with a same day discharge which leads to a faster return to everyday living. 
  • Reduced exposure of internal organs to possible external contaminants thereby reduced risk of acquiring infections

A laparoscopic hysterectomy is a minimally invasive surgical procedure to remove the uterus. A small incision is made in the belly button and a tiny camera is inserted. The surgeon watches the image from this camera on a TV screen and performs the operative procedure. Two or three other tiny incisions are made in the lower abdomen. Specialized instruments are inserted and used for the removal process.

Some women do not have their ovaries removed when they undergo a hysterectomy. If the ovaries stay inside, the woman does not need to take any hormones after the surgery and she does not have hot flashes. Some women remove their ovaries because of family history of ovarian cancer or they have an abnormal growth on their ovary.

Women can choose to either keep the cervix in place (called a “laparoscopic supra-cervical hysterectomy”) or remove the entire uterus and cervix (“ total laparoscopic hysterectomy”).

Keeping the cervix in place makes the operation a little faster and safer. When the cervix is in place there is a 5% chance that the woman will have monthly spotting at the time of her menstrual periods. Women whose cervices stay in place need to continue getting pap smears.

If the woman wants to be 100% certain that she will never menstruate again, she needs to have the entire uterus removed. If the patient has a history of pre-cancerous changes of the cervix or uterine lining, she should have the entire uterus removed. If the operation is being done for endometriosis or pelvic pain, many doctors think the chances for pain reduction are better if the cervix is removed.

Who should have laparoscopic hysterectomy surgery?

Most patients who are having a hysterectomy to treat abnormal uterine bleeding or fibroids can have a laparoscopic hysterectomy. It may not be possible in some cases. For example, if the uterus is bigger than a 4 month pregnancy but depends on the surgeon, if she’s had multiple previous operations in her lower abdomen. It is usually not done for women with a gynecologic cancer. 

What is a laparoscopic ovarian cystectomy?
An ovarian cystectomy is surgery to remove a cyst from your ovary. Laparoscopic surgery is a minimally invasive surgery technique that only uses a few small incisions in your lower abdomen.

Why are you having this surgery?
Many women will have an ovarian cyst at some point during their lives. Commonly, cysts will cause little to no symptoms. However, if a cyst is causing painful or discomforting systems, surgical removal of the cysts may be the best treatment option. Some symptoms of an ovarian cyst include pelvic pain, especially during your period or sexual intercourse.