Laparoscopy is a technique of visualising and operating on organs with the use of a thin endoscope equipped with an image transmission system and a set of manipulators introduced into the abdominal cavity. Currently, it is the basic diagnostic and therapeutic technique used in gynaecology.
Ovarian laparoscopy – what is the goal of the procedure?
Laparoscopy is used to treat many internal diseases, e.g. in the therapy of liver, abdominal cavity or spleen. It is also found in the application of gynaecology. In this field of medicine laparoscopy is used to treat fallopian tube obstruction and endometriosis, as well as to remove adhesions, polyps and tumours. Moreover, laparoscopy may have a diagnostic application. It allows the physician to assess the status and structure of the genital organs, and examine ectopic pregnancy. Gynaecological laparoscopy is an invasive method of treating infertility.
Laparoscopy – what does it involve?
Laparoscopy is referred to as an invasive diagnostic and therapeutic method, but it is one of the safest methods. It involves making a small incision in the skin, through which a very fine endoscope is inserted into the abdominal cavity. The endoscope comprises:
- optics,
- a tube with a needle delivering carbon dioxide to extend the internal layers, to facilitate manoeuvring and improve visibility,
- microsurgical equipment – for surgical laparoscopy.
During the procedure the patient is under general anaesthesia. The operator can see the image from the abdomen on a computer screen. Endoscopes are equipped with cameras that allow to make close-ups, which are very useful for detection of small lesions, invisible to the naked eye.
Laparoscopic surgery of the fallopian tubes – an effective method of treating infertility
In their thinnest section, fallopian tubes are approximately 0.5 mm wide, whereas an embryo may be as much as 0.2 mm wide. Therefore, even a minor additional narrowing may effectively disturb the transport of the embryo to the uterus, making obstruction of fallopian tubes a very common cause of infertility. Endoscopes are equipped with microsurgical tools that enable removal of adhesions or polyps preventing a natural transfer of embryos to the uterus. A laparoscopic surgery to restore the patency of the fallopian tubes does not require a long hospitalisation. Usually the patient stays in for one day, and her organism’s reaction to general anaesthesia is observed.
Gynaecological laparoscopy – indications
One of the most common indications for a laparoscopic surgery is infertility (sterility). Laparoscopy helps to assess the structure and location of the organs in the lesser pelvis, to evaluate the patency of the fallopian tubes, location of adhesions, or to diagnose endometriosis. Currently, the majority of gynaecological surgeries are minimally invasive procedures. Therefore, the laparoscopic method or transvaginal approach are most commonly used.
Contraindications for laparoscopy
Laparoscopy is a very safe procedure, but there are certain contraindications for conducting it in some patients. They include:
- circulatory and respiratory insufficiency,
- chronic bronchitis,
- advanced asthma,
- a history of myocardial infarction,
- pregnancy.
Gynaecological laparoscopy – complications
Complications of a laparoscopic procedure are very rare. The most common ones include:
- complications associated with anaesthesia,
- tissue injury due to insertion of surgical tools into the abdominal cavity,
- post-surgical bleeding,
- abdominal hernias around the trocar introduction sites,
- post-surgical bleeding,
- abdominal hernias,
- pain at the incision site and in the abdomen.
It is important to remember that if the health problem appears to be more serious than doctors expected, the laparoscopy may become an indication for a full surgical procedure.
What are the benefits of laparoscopy?
The greatest advantage of a gynaecological laparoscopic procedure is its limited invasiveness, associated with a much faster recovery compared to a classical surgery. The pain experienced immediately after the procedure is also reduced. Due to a very small risk of complications, the mental burden for patients undergoing laparoscopic procedures is much smaller.
Laparoscopic incisions are small; the biggest ones are up to 1 cm long. The wounds heal fast, so patients do not need to worry about scars. In the case of diagnostic laparoscopy, the patient may already leave the clinic a few hours after the procedure, whereas surgical laparoscopy is associated with a one day stay in the hospital.