The evolution of surgery has now moved from open surgery to minimally invasive procedures with small incisions, to the high-definition endoscopic camera, which helps us to see the inside of the abdomen and the internal genitals of the woman in magnification with great precision.
Laparoscopy is divided according to the reason for which it is performed, into diagnostic and interventional.
Diagnostic is very simple, and we can observe the inside of the abdomen through one or two small holes in the navel and the anterior abdominal wall. It is useful in the diagnosis of many gynaecological conditions, especially those related to infertility.
Through this it is easy to determine:
-Morphology of the uterus, fallopian tubes and ovaries.
-Carrying capacity of the fallopian tubes
-Existence of endometriosis
-Causes of chronic pelvic pain
-Uterine congenital anomalies
Invasive laparoscopy requires more holes (3 to 4) of a few millimeters each. Then with special tools each case is treated.
The most common cases of gynecological diseases in which invasive laparoscopy is applied are:
Removal of the fallopian tube, in whole or in part, due to ectopic pregnancy
Removal of ovary
Removal of ovarian cyst
Removal of fibroids
Removal of the body of the uterus (hyphal hysterectomy) with or without removal of the ovaries and fallopian tubes
Removal of the uterus and cervix (total hysterectomy) with or without removal of the ovaries and fallopian tubes
Treatment of endometriosis (removal of endometriosis cysts, removal of endometriosis tissue)
Removal of adhesions
Lifting of the uterus or vaginal cavity in cases of prolapse
Surgery for early stages of uterine and cervical cancer
The advantages of laparoscopic surgery over conventional surgery are:
-Great detail in anatomical elements that would not be easy to distinguish with the open method.
-Less postoperative pain.
-Minimal blood loss during surgery.
-Excellent aesthetic result.
-Faster recovery compared to open surgery.
-Reduction of possible postoperative complications (hernias, wound breakdown, infections).
Laparoscopy is usually performed under general anaesthesia. Otherwise the gas in the abdomen would make breathing difficult. Local anaesthesia is also not indicated because of the duration and extent of the surgery.