ADVANCE LAPROSCOPIC GYNAE SURGERY

ADVANCE LAPROSCOPIC GYNAE SURGERY


Adenomyosis (pronounced A - den - oh - my - oh - sis) is a medical condition characterized by the presence of ectopic glandular tissue found in muscle. The term adenomyosis is derived from the terms adeno- (meaning gland), myo- (meaning muscle), and -osis (meaning condition). Previously named as endometriosis interna, adenomyosis actually differs from endometriosis and these two disease entities are found together in only 10% of the cases.

It usually refers to ectopic endometrial tissue (the inner lining of the uterus) within the myometrium (the thick, muscular layer of the uterus). The term "adenomyometritis" specifically implies involvement of the uterus.

The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have painful and/or profuse menses (dysmenorrhea & menorrhagia, respectively). However, because the endometrial glands can be trapped in the myometrium, it is possible to have increased pain without increased blood. (This can be used to distinguish adenomyosis from endometrial hyperplasia; in the latter condition, increased bleeding is more common.)


TREATMENT OPTIONS: LAPAROSCOPY:

Diagnostic Laparoscopy:-


A laparoscopy forms the cornerstone for the surgical evaluation of the pelvis of an infertile woman after a basic infertility investigation is completed. In some cases where endometriosis, pelvic inflammatory disease, or pelvic pain needs evaluation, it may be indicated earlier in the evaluation. The laparoscopic procedure is sometimes combined with a hysteroscopy when indicated.

LaparoscopyLaparoscopy is performed under general anesthesia in a surgical center. A small needle is inserted into the abdominal cavity and C02 gas is introduced. The laparoscope (a telescope with a strong light and camera) is introduced through the navel. A variety of instruments can be inserted into the pelvis, through other small incisions, to perform diagnostic and corrective surgery.

This procedure allows Dr. Kustin to visualize the internal organs where reproduction occurs. In every case, he undertakes a meticulous surgical evaluation of the pelvis documenting his findings by video (it is routine for Dr. Kustin to review this video with his postoperative patients so that they may gain a first hand understanding of their surgical problems).


Operative Endoscopy:-


Endoscopy is a minimally invasive medical procedure used to examine the interior surfaces of an organ or tissue. It is Divided into Two :- Hysteroscopy and Laparoscopy ( both done for the purpose of diagnosis & Operative or combined diagnostic and operative procedure where the cause is found.

Hysteroscopy means visualizing uterine cavity(womb) from inside by inserting small telescope via vagina and cervix which is attached with camera & then to monitor. Hysteroscopy allows us to examine the endometrium (lining of the uterus), tubal ostia (small channels on either side which lead to the fallopian tubes), and assess the shape and size of the uterine cavity to make sure it is normal for pregnancy. sometimes find polyps, fibroids, adhesions (scar tissue), septa (a midline division).



GYNAECOLOGY:


We pay very careful attention towards the fact that the entire gynecological procedure is carried out without inflicting minimum of discomfort on the patient. To achieve this purpose we ensure that our treatment has perfect blend of technological superiority and compassionate treatment. Furthermore, we also undertake all cases related to gynaecology which transforms our place as one stop destination for all your gynaecology needs.

We offer a series of sub-specialties areas like Maternal-fetal Medicine, Gynaecologic Oncology, Gynaecological Urology, Reproductive Medicine and Community Gynaecology. Moreover, we use minimal invasive procedures to guarantee swift recovery of our patients.

Over the years we have successfully undertaken a number of cases, quite a few of them being challenging and have achieved almost 100% success. Our clinic has the services of one of the best doctor and other medical staff all of whom excel in their designated roles.

Further adding attraction to the service provided at Gynae Laparoscopy is the fact that despite offering the best of treatment the charges levied here for the services provided is extremely reasonable. No wonder we have emerged as one of the most sought after places for all gynaecological treatments.

Apart from providing world class facilities for gynaecology requirements we also provide consultancy services to the patients where in they are educated about their problems and made aware about the remedial process. This removes doubts and inhibitions from the minds of patients and they approach and respond to the treatments completely.


LAPAROSCOPY GYNAECOLOGY:-

What is Laparoscopy ?

Laparoscopic surgery is also known as-

  • Minimally invasive surgery
  • Endoscopic surgery
  • Key hole surgery

It is the latest and best form of treatment available for Gynecological disorders requiring surgery (operation).


HOW IS LAPROSCOPIC SURGERY CARRIED OUT ?


A small incision (cut) about 1 cm is made at the lower end of the navel through this a trocar (a sharp edged pipe type instrument) is introduced into the abdomen the carbon dioxide gas is inserted into the abdomen through the trocar (the gas is removed at the end if surgery) following which the laparoscope (Telescope) is inserted this catties with it a fibre optic light source with a powerful LED which lights up the area to be operated. The laparoscope is also connected to a camera, and a T V monitor the surgeon then looks at the T V monitor and operates thru, 2 – 3, 1/2 cm size cuts made on the abdomen.


WHO SHOULD GET LAPAROSCOPIC SURGERY DONE ?


Hysterectomy Total Laparoscopic: Hysterectomy for various disorders of the uterus where the uterus has to be removed.

Myomectomy:For removal of fibroid (non cancerous ball like growth) from the uterus in case where uterus has to be preserved for future child bearing.(This is our super speciality surgical procedure.)

Adhesiolysis: Is removal of adhesions. Adhesions are bands of tissue which make organs stick to each other and cause a lot of pain and are responsible for many cases of infertility and chronic pelvic pain these are best removed laparoscopically.

Ovarian Cystectomy Is removal of cysts from the ovary.

Endometriosis:

Ectopic pregnancy: Is pregnancy outside the uterus in the tube or ovary is best handled Laparoscopically especially when future child bearing is desired by the patient.

Polycystic Ovarian Drilling: PCOD is soon becoming an epidemic in India and is a major cause of infertility drilling these large ovaries (in selected cases) often restores fertility.

Diagnostic Laparoscopy for infertility.

Diagnostic Laparoscopy: for Chronic pelvic pain.

Redical hysterectomy Today even Cancer surgery is best done laparoscopically as in cases of cervical (mouth of uterus) cancers.


THE ADVANTAGES OF LAPAROSCOPIC SURGERY OVER OPEN SURGERY:


For the Patient: Pre operatively only 8 hours of fasting is required by the patient and no enema or bowel preparation except in high risk cases this makes patients very comfortable preoperatively. Patients need to get admitted into the Hospital only on the day of surgery and can be at home one night before so are more comfortable facing the surgery.


  • It gives rise to minimal tissue handling and much less tissue trauma to the other adjacent normal organs resulting in very minimal pain after the operation.
  • G2-3 very small incisions of 0.5 – 1.0 cm are given on the abdomen resulting in less amount of blood loss, less post operative pain, less chances of wound infection, early healing of wound.
  • Blood loss is very less because even the smaller blood vessels are directly visualized on the T V monitor with the magnified view provided by laparoscope.
  • As the abdominal incision is very short and the operative work is very specific with minimal blood loss, the chances of post operative infection are very less.
  • The hospital stay is usually 1 – 3 days even for the major operations like Hysterectomy while in case of conventional surgery the same procedures will require 5 – 7 or even more days of Hospital stay.
  • The recovery time for the patient is very less and they can resume their normal day to day activities in a period of 1 – 2 weeks while in case of conventional surgery the recovery period is quite long and can extend to 6 – 8 weeks or more.
  • For infertility patients laparoscopic surgery has come as a boon as with minimal tissue handling, minimal bleeding and much less chances of adhesion formation after the operation, the chances of achievement of pregnancy are much greater then that attained by the conventional surgery.
  • As far as the total expenditure of the patient is concerned, laparoscopic surgery is more cost effective than the conventional surgery.
  • Very small incisions on abdomen are much more cosmetic with very little scarring.

  • For the Surgeon


  • The powerful xenon light source inserted with the laparoscope lights up the area to be operated and helps the surgeon operate better.
  • The laparoscope (Telescope) magnifies the area to be operated 5 – 20 times and so very specific area can be seen very clearly (much better then the naked eye can see at open surgery) and the surgeon can operate better.
  • Even very small bleeders can be checked at the end of the surgery by the surgeon. As no blood is left behind at the end of the surgery patient feels very little pain and the chances of infection are also minimal.

Where Should One Get The Laparoscopic Surgery Done ?


Before getting the Laparoscopic surgery done, it is always advisable to see that your Gynaecological Laparoscopic Surgeon being a Gynaecologist is well qualified and fully trained in the field of Operative Laparoscopy.

How Can One Get The Laparoscopic Surgery Done ?


If one has been advised an operation for some Gynaecological disorder, it is better to consult a Gynaecological Laparoscopic Surgeon for undergoing Laparoscopic surgery. An appointment can be taken with the Gynaecological Laparoscopic Surgeon. Before the consultation, it is always advisable to take all the relevant papers, investigation reports along with the Ultrasound / X-Ray report if available, and the previous treatment reports (if any) to show to her, so that your proper treatment can be planned accordingly. After thorough examination of the patient and carrying out relevant investigations, the operative laparoscopy technique is decided for the patient and it is explained to the patient and her relatives in detail. All the queries regarding the operation are discussed with the patient and a specific date (depending upon various factors like the menstrual cycle status of the patient etc.) is finally set for operative laparoscopy.


Laparoscopy Surgery :


  • Minimal discomfort
  • Full recovery in 1 week
  • Back home in 1 – 2 days
  • Less expensive
  • No obvious scar
  • High blood pressure

Open Operation:


  • Painful
  • Full recovery in 6 weeks
  • Glucose drip for 2 – 4 days
  • Hospital stay for number of days
  • Expensive
  • Big obvious scar

Hysterectomy:

What is Hysterectomy?


Hysterectomy is a procedure (operation) performed for removal of the uterus (womb) It is the most common surgery performed by gynaecologists. Hysterectomy can only be performed when future child bearing is not desired by the patient.

Open Operation:


This procedure can be performed for women with any of the below mentioned problems

  • Fibroid Uterus: Fibroids can be symptomatic leading to excessive periods or pressure symptoms.If not treated fibroids can become very big and can lead to ureter (tubes carrying urine from kidney to bladder) & kidney damage.
  • Adenomyosis: This condition leads to heavy prolonged periods and severe pain during periods.
  • DUB: This condition leads to heavy prolonged or irregular menstrual problems which if not responsive to tablets (drug treatment) or other small surgical procedures like TCRE and may then need a hysterectomy.
  • Prolapse of the uterus: This condition is very commonly present in our Indian population. The uterus descends down into the vagina and is felt as a mass vaginally.
  • Pelvic Inflammatory Disease / Chronic Pelvic Pain: These conditions are present as a result of repeated infections and these conditions may also need a hysterectomy
  • Big obvious scar
  • Uterine / Cervical / Ovarian Cancer: Cancers are now becoming increasing common but the life expectancy and quality of life can both be improved when a complete surgical removal of these cancers is done with minimal cancer tissue being left behind. In several studies it is now proved that the most complete removal of cancer tissue is done when the surgery is performed laproscopically.

  • Which route of hysterectomy should a patient choose?


    There are three methods by which a hysterectomy can be performed

    • 1. Abdominal
    • 2. Vaginal
    • 3. Laparoscopic


    • Open Abdominal Hysterectomy is now considered to be an obsolete procedure which should be abandoned.
    • Vaginal hysterectomy is chosen for patients who have a prolapse of the uterus. In places where
    • Laproscopic Hysterectomy is the most preferred route for performing this surgery, the entire abdomen can be inspected with the laproscope and any other pathologies (diseases) present can be handled at the same time Also the availability of new equipment like Harmonic Scalpel has made this surgery a very quick and painless surgery. There is minimal blood loss (less that 50ml)during this procedure, there is minimal pain following this procedure, hospital stay for this procedure is only for 1 day, and also patient can return to work within 3-4 days, post operative problems like pain during intercourse, are less with this procedure, there is less chance of formation of a hernia after this procedure since a very small scar (1cm) is formed after this procedure.

    Myth Buster:


    Myth: Ovaries are routinely removed at the time of hysterectomy leading to menopausal symptoms and weak bones (Osteoporosis) after hysterectomy.

    Fact Ovaries are not removed at the time of hysterectomy unless


    • Any ovarian disease is present along with the uterine disease for which hysterectomy is being performed.
    • Or if a family history of ovarian or breast cancer is present in the patient’s family.

    Hysteroscopy:


    We can proudly claim that ours is the best hysteroscopy clinic in the area.. After all we provide such comfort to women like effective and accurate diagnosis and swift treatment. Apart from the obvious skill and experience of the doctor that goes a long way in making our services world class, we are also assisted by latest equipments and technology that further adds to the quality of excellence that we stick to.

    Apart from the medical supervision and assistance we also guide our patients appropriately about what they should do and what they should abstain from in such a situation. This educates the patient about the behavioral patterns they should stick to during this period. Such sessions also enlightens the patients about the procedure to be adopted and frees their mind about any confusion and inhibitions and prepares them mentally for the job.

    World class treatments that we offer almost certainly remove any type of fear of complication. Add to it the fact that fees charged by us is extremely reasonable and the reason why we are amongst the few most sought after medical clinic in the city gets amply proved. We can proudly claim that ours is the best hysteroscopy clinic in the area.. After all we provide such comfort to women like effective and accurate diagnosis and swift treatment. Apart from the obvious skill and experience of the doctor that goes a long way in making our services world class, we are also assisted by latest equipments and technology that further adds to the quality of excellence that we stick to.

    Apart from the medical supervision and assistance we also guide our patients appropriately about what they should do and what they should abstain from in such a situation. This educates the patient about the behavioral patterns they should stick to during this period. Such sessions also enlightens the patients about the procedure to be adopted and frees their mind about any confusion and inhibitions and prepares them mentally for the job.

    World class treatments that we offer almost certainly remove any type of fear of complication. Add to it the fact that fees charged by us is extremely reasonable and the reason why we are amongst the few most sought after medical clinic in the city gets amply proved.