Gynaecology

What is Laparoscopic Gynaecologic Surgery?

Laparoscopic Gynaecologic Surgery is done through a small telescope. There are many different types of laparoscopic surgery for women. Some of the most common procedures include:

• Hysterectomy

- small or large uterus

• Vault Suspension

- for vault prolapse

• Myomectomy

- fibroid removal

• Uterine Suspension

- for prolapse, IVF procedure

• Bladder Support

- for incontinence (leaking urine)

• Cyst Removal

- endometriosis, dermoid cyst

• Diagnostic Laparoscopy and diathermy

- PCOS and other benign gynaecological conditions

*This list is just a small portion of the total amount of laparoscopic procedures that can be performed for women.

How Does Laparoscopic Hysterectomy Surgery Work?

Laparoscopic surgery is minimally invasive. This means that these procedures are designed to be done with small incisions, as opposed to traditional open surgery. During a typical laparoscopic procedure:

• A small incision is made in the abdomen.
• The laparoscope, which includes a light and camera, is inserted in through the incision.
• This tool allows the surgeon to view the surgical site, and then make adjustments with surgical tools as needed. Other small incisions will be made as necessary.

The rest of the procedure will vary depending on which specific type of surgery is being performed.

Some positive aspects of laparoscopic gynaecology include:

• Smaller incisions
• Less pain and faster recovery
• Shorter hospital stays
• Potential for outpatient procedures
• Less blood loss
• Reduced scarring
• Faster healing time within two weeks of surgery

Laparotomy (the technique by which most gynaecologic procedures are done) involves an incision in the abdomen usually measuring 5 to 11 inches long. This incision is horizontal (the so-called "bikini" incision) or vertical (from the pubic bone to the belly button). This large incision is required for gynaecologists to use standard surgical instruments. This significantly larger incision is associated with a much longer recovery, more postoperative pain, longer hospital stays, and more potential complications than the same procedure performed by laparoscopic techniques.

Why are so few major gynaecologic procedures performed laparoscopically?

The answer is relatively simple. Major laparoscopic surgical procedures are difficult for most gynaecologic surgeons to master. The gynaecologist must perform many simple laparoscopic procedures to develop the skill necessary to perform the more complex surgeries. They must perform these procedures on a regular basis to develop and maintain expertise. As a result, unfortunately, most gynaecologic surgeries for benign disease are still performed abdominally, although experts throughout the world agree that the vast majority could safely and efficiently be performed laparoscopically. However, it is important that the patient understand that these procedures should be performed by a qualified gynaecologic oncologist who has experience in the proposed procedure either using traditional surgical methods or Laparoscopic surgery.

The surgeries shown in the video clips are entirely done by me and my experienced team at KPJ Klang Specialist Hospital. Dr. Vijayavel is the best Gynae Oncology doctor in Malaysia.