OBSTETRICIAN GYNAECOLOGIST SURGEON
151 Praxitelous Str. & Sotiros, Peiraeus, GR 185 35
￼THE LAPAROSCOPY IN GYNECOLOGY
Over the last decades, laparoscopy has been widely applied in Gynecology. Many inci- dents that in the past used to be treated with surgeries, where there was an opening of the abdominal wall (open surgeries), can nowadays be treated through these minimal invasive access techniques.
What is Laparoscopy
In laparoscopy we have the possibility of direct examination of the uterus and ovaries, as well as the hollow organs, even enlarged. We insert from the umbilical region, through a 1cm incision, a camera with optical fiber. Before this, we have special channeling gas (CO2), in order to inflate the abdominal wall and make room for necessary operations. Hence, through incisions from the right and left in the abdomen(two or three), special surgical instruments are inserted depending on the type of surgery.
In which cases the surgery is performed Laparoscopy could be either of diagnostic or invasive nature.
The diagnostic laparoscopy is done in order for any symptom to be investigated or to be put a definite diagnosis. A frequent indication is the Pelvic Pain. In many cases, the precise cause of the pain cannot be determined with imaging, so the sole way of di- agnosis is laparoscopy. In these cases, there is frequent evidence of endometriosis in the pelvic wall or the pelvic organs (intestine, bladder etc.) or adhesions that may be due to previous surgeries or inflammations of the fallopian tubes (salpingitis). The diagnostic laparoscopy is also selected for the investigation of infertility so to assess the integrity of the oviducts and their compatibility, but also the integrity and anatomy of the uterus.
Invasive laparoscopy is opted for treating cases such as:
Removal of fibroids and ovarian cysts
Ectopic pregnacy, if the woman is in good condition, that is extrauterine or bleeding in the abdomen are not the case
Endometriosis, are identified and outbreaks are cauterized
Removal of uterus, in other words hysterectomy, total or subtotal removal of the cervix (without the cervix).
Selective cases of gynecologic cancer (depending on stage).
However, a laparoscopy that starts as diagnostic can be progressed to invasive, so for the problem to be solved. For instance, in cases of pelvic pain where the existence of endometriosis is evident, the surgeon proceeds to cauterization of outbreaks during surgery. Respectively, in cases of infertility investigation in which they identify some obstruction in the fallopian tubes (e.g adhesions questioned to old inflammations), the surgeon restores failures immediately within the operating room.