Endoscopic Gynaecological Surgeries
What is Endoscopic Surgery mean?
It is a technique to visualize the inside of your body cavity with the help of a telescope attached to a camera see your organs on a video monitor. Surgical instruments are inserted through the smaller incisions or through natural body opening to perform the surgery. Laparoscopic and hysteroscopic procedures are both considered minimally invasive.
What are the benefits of Endoscopic surgery?
Recovery time in the immediate post operative period is quicker, less chances of wound infection and breakdown, post op pain, adhesions. Patients often go home after only few hours to one or two days to recover in the comfort of their own home. The small incisions tend to be less painful and patients often need less postoperative pain medication. The cosmetic results are also appealing as the scar is limited to three or four skin incisions that are less than one cm long.
How is Endoscopic Surgery different from Open Surgery?
In open surgery, which is the traditional way of performing a surgery, surgeons make long cuts through skin, muscle and sometimes bone. Recovery from open surgery takes a longer time, and it is usually painful. Minimal access procedures are performed through one or more small incisions, and hence there is minimum scarring, and recovery is much faster and almost painless.
Are the equipments used for Endoscopic Surgery the same as for open surgery?
Equipments used for Minimal Access Surgery are different from those in open surgery. Fiber Optic cables, miniature video cameras and special surgical instruments handled via tubes inserted into the body through small incisions are some of them. An external video monitor is used to display the images of the interior of the body. The surgeon has the possibility of making a diagnosis, and simultaneously correcting the problem surgically by looking at these images.
What are possible complications following laparoscopic surgery ?
- Anaesthesia related complications
- Bruising & Hematoma formation at the site of trocar insertion
- Injury to blood vessels of the abdominal wall or those of the lower abdomen and pelvic sidewall to the urinary tract or the bowel.
- Rarely wound infection
What can I expect immediately following laparoscopic surgery?
Generally, you may experience any of the following symptoms within the first twenty-four to forty-eight hours
- Nausea and lightheadedness
- Scratchy throat if a breathing tube was used during the general anesthesia
- Pain around the incisions
- Abdominal pain or uterine cramping
- Shoulder tip pain-secondary to the carbon dioxide gas
- Tender umbilicus (belly-button)
- Gassy or bloated feeling
- Vaginal bleeding or discharge (like a menstrual flow)
What all gynaecological surgeries can be done Endoscoscopically?
Virtually any procedure that was been as an open or conventional operation previously can now be done laparoscopicaly including removal of uterus, ovarian cysts, fibroid removal , treatment of endometriosis, treatment of adhesions, treatment of ectopic pregnancy.& even gynaecological cancers. There are still times that an open (laparotomy) procedure may be necessary for a variety of reasons, however a majority of cases are treated very successfully with the laparoscopic approach. Prior surgery and obesity are not contraindications for laparoscopic surgery.
Hysteroscopy is beneficial in evaluation of infertility, recurrent abortions, removal of endometrial polyp, missing IUCD & diagnosing and treatment of Asharman syndrome.
What is the normal recovery time following endoscopic surgery?
Recovery depends on the type of procedure you had. Most patients feel well within days of surgery. But if major surgery has been performed rest is still required. Most patients will require some form of pain medicine in the immediate postoperative period. Sexual intercourse should also be postponed for 4-6 weeks.. The timing for returning to work depends on the procedure performed. Most patients who undergo an ovarian cystectomy or ectopic pregnancy are ready to return to work within 1-2 weeks. If a hysterectomy is performed, 2-4 weeks off work is recommended depending on your recovery . The doctor will discuss this with you after surgery and help you make an informed choice.
When should you contact the doctor after endoscopic surgery?
You should not hesitate to call the doctor if you develop any of the following symptoms:
- Heavy bleeding from the incisions
- Fever or chills
- Problems with urination or bowel movements
- Heavy vaginal bleeding
- Severe or increasing abdominal pain
- Vomiting
- Redness or discharge from the skin incisions
- Shortness of breath
Risks and complications of Endoscopic surgery
No surgical procedure is entirely without risk, but this type of surgery attempts to minimize such risks. Complications such as damage to other organs (bowel or bladder) and bleeding are rare events and are likely to have been recognized during the operation and appropriately corrected. Very rarely such damage occurs as a late post-operative complication and further hospitalization and/or surgery is required. Anaesthesia itself has some slight risks and these are made worse by severe obesity or cigarette smoking.
Conclusion:
In general, laparoscopic surgical techniques allow excellent diagnostic inspection of abdominal and pelvic organs and facilitate operative correction of gynaecological disorders without the necessity for large abdominal incisions, prolonged hospitalization and protracted recuperation.
