Laparoscopic Surgery

This is done to know the cause of long standing abdominal pain where all other investigations could not lead to any conclusion. The conditions which may be detected only on laparoscopy are, chronic recurrent appendicitis, adhesions, chronic ectopic, chronic pelvic inflammatomy disease, abdominal tuberculosis etc.

This is done to know the intra-abdominal problems causing difficulty in getting child. It is superior & supplementary, to all other investigations. You can directly visualise internal reproductive organs directly.
We can assess tubal patency, condition of ovaries & tubes. We can detect diseases such as chronic PID leading to adhesions, & endometriosis, which can be treated laparoscopically. Conditions such as abdominal tuberculosis & genitourinary tuberculosis can be diagnosed & treated at early stage.

In some cases of acute abdominal pain, some-times it is very difficult to decide whether immediate surgery is required or not. This is because of atypical presentation, in some cases of ectopic pregnancy, subacute appendicitis, blunt abdominal trauma etc. Out of these, many conditions can be treated laparoscopically, through same ports. Few conditions which can be treated only by open surgery, we will have an idea of extent of surgery.

This is the simplest & best laparoscopic surgery. These surgeries conducted on a mass scale in camps, in the remotest of villages, which itself indicates its simplicity, safety & comfort. Patient can resume to full work as rapidly as it is done. Cosmetically very good.
However there are many misunder- standings about this surgery, because of lack of time, where patient is not explained fully e.g.

1. Shock is given in this surgery.

2. Failure rates are high.

No shock is given in this surgery. Light is used to see inside of the abdomen. Failure rates are same as open surgery.

Now its superiority over conventional open cholecystectomy is proved beyond doubt. It can be done precisely with more comfort to the patient & cosmetically fine results. Patient can resume to full work very fast. Surgery can be done through two 1 cm & two 1/2 cm. incisions & can be discharged from the hospital within two days

This is also superior to open appendicectomy in respect of post operative comfort, wound infection, early resumption to full work & cosmetic results. Laparoscopy is the only method by which appendicitis can be confirmed with certainty. At the same time whole of the inside of the abdominal can be visualised, so that co-existing disease if any can be detected, & treated through the same incisions, thus without increase in pain & discomfort.

Means division of adhesions. Adhesions are formed following previous open surgery or previous episodes of intra-abdominal infections. Adhesions are detected either during diagnostic laparoscopy for chronic abdominal pain or infertility or during laparoscopic surgery for some other condition. Adhesiolysis helps to relieve chronic abdominal pain or conceive as the case may be.

Here the diseased fallopian tube in conditions such as ectopic pregnancy hydrosalpinx or pyosalpinx is removed. This surgery is done through one 10mm and two 5mm incisions in laparoscopic method, there by avoiding large incision required in open method.

Laparoscopy oophorectomy indicated as adjuvant therapy in carcinoma of breast, is performed quite easily & safely. Removal of ovarian cyst, with or without ovary depending upon indication, can also be done easily.

Vaginal hysterectomy has very low morbidity. But is easy & safe only in cases of prolapsed, normal sized uterus. In bulky & non-prolapsed uterus, where vaginal hysterectomy is difficult, abdominal hysterectomy is safe, but has more morbidity. In such cases if Total Laparoscopic Hysterectomy is done it will be safe, & gives all advantages of vaginal hysterectomy i.e Very less postoperative pain.
Fast post operative recovery.
Short hospital stay.
Early resumption to full work.
Cosmetically very good.