A Look at Minimally Invasive Surgical Procedures for Women
A Look at Minimally Invasive Surgical Procedures for Women
An Overview of Laparoscopic Surgery
Laparoscopy allows a physician to view abdominal and pelvic organs through a tiny fiber optic telescope. Following anesthesia, a small incision is made below the navel to insert a laparoscope into the abdominal cavity. A tiny video camera projects the surgical site on to operating room TV monitors. Two or three small incisions on the lower abdomen allow the surgeon to insert and utilize specialized surgical instruments for a more detailed inspection of the pelvis. Laparoscopy is used in diagnosing and treating infertility, pelvic pain, endometriosis, adhesions, pelvic inflammatory disease, fibroids, incontinence, ovarian cysts, endometrial and ovarian cancers and other reproductive tract malignancies. Laparoscopic surgery affords much less postoperative scarring and pain and shorter recovery time. The main goals of laparoscopic surgery are to restore normal anatomy, remove abnormal tissue and prevent recurrence of pain-causing conditions.
Regardless of the planned procedure, diagnostic laparoscopy or hysteroscopy should always commence with a detailed examination of the abdominal and pelvic organs.
The following procedures can be performed laparoscopic ally or hysteroscopically: (a tiny fiber optic telescope inserted through the vagina to view the cervical canal and interior of the uterus for diagnostic or treatment purposes)
- Adenomyomectomy: removal of endometriosis within the muscle wall of the uterus
- Balloon therapy (see resection): endometrial lining is removed with a catheter-attached balloon, which is filled with a heated solution and inflated until it conforms to the walls of the uterus
- Burch procedure: to correct urinary incontinence a space between the bladder and pubic bone is opened and permanent stitches are used to anchor the neck of the bladder to behind the pubic bone
- Dilatation & curettage (D&C): scraping of the uterine lining without visual assistance
- Endometrial sampling: hysteroscopy assisted passage of intrauterine catheter to scrape and brush targeted endometrial section(s)
- Endometrial resection: lining of the uterus (endometrium) is removed or destroyed using a wire loop (resectoscope) powered by a high-frequency electrical current. Resectoscope is inserted through the cervix to remove endometriosis, fibroids and polyps.
- Fimbrioplasty: rebuilding fringed ends of partially blocked fallopian tubes
- Hysterectomy (Laparoscopically Assisted Vaginal Hysterectomy or LAVH): the uterus and cervix, sometimes fallopian tubes and ovaries, are removed through the vagina
- Lysis of adhesions: uterine, bowel or pelvic wall adhesions (scarring) or endometriosis are cut or vaporized with a thin laser beam
- Microwave endometrial ablation (MEA): endometrial lining is heated and destroyed hysteroscopically by using a low-energy microwave probe, which limits tissue destruction
- Myomectomy: uterine fibroids are detached from the uterine wall via laser or high-frequency electrical current.
- Neosalpingostomy: creates a new opening in the portion of blocked fallopian tube closest to the ovary
- Oophorectomy: is the removal of one or both ovaries and is sometimes performed at the same time as a hysterectomy
- Ovarian wedge resection: portion of the ovary is removed to treat polycystic ovarian disease
- Polypectomy: excision of cervical polyps
- Roller ball ablation: (resection) endometrial tissue is destroyed by applying heat with a thermal roller ball
- Salpingectomy: removal of one or both fallopian tubes
- Tubal ligation: sterilization, which involves laparoscopic techniques to block both fallopian tubes through tying, sealing or clamping
- Vault suspension: if pelvic organ-supporting ligaments begin to loose their tone, vaginal prolapse is corrected by stitching the vagina to the uterosacral ligaments
Conclusion
A patient may want a second opinion before going ahead with surgery. A doctor should be asked for a full explanation of any suggested procedure, including risks, benefits and success rates.
