Gynaecological laparoscopy - quick and effective surgical method
Gynaecological laparoscopy - quick and effective surgical method
At My Clinic Riga we run minimally invasive laparoscopic surgeries which are used in infertility treatment for females. Most modern equipment in the hands for experienced doctos allows to detect and examine throughoutly irregularities in internal organs, check tubal patency and remove polyps, fibroids, adhesions, ovarian cysts. We also perform radical surgical treatments which improve quality of life as for instance laparoscopic hysterectomy.
What does laparoscopy stand for?
Laparoscopy is surgical technique in which operation is done through few small cuts in the abdomen (5-7 mm). The procedure requires general anaesthesia and abdomen is inflated with carbon dioxide gas for better visibility and manipulations. During laparoscopy surgeon inserts through the abdomen 3 or 4 modern surgical instruments and on of them is laparoscope. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. This technique enables examination of the appearing changes (diagnostic laparoscopy) as well as intruduction of the operative treatment (surgical laparoscopy).
In compare to laparatomy, which is incision (cut) into the abdominal cavity, laparoscopy has particular advantages:
Diagnostic laparoscopy
During the diagnostic laparoscopy doctor may throughoutly study the interior of abdomen and lower abdomen and take the tissues for the histopathological examination. The procedure itself takes 30-45 minutes. If during the surgery abnormalities (which were discussed beforehand) were found and confirmed the surgical treatment may be introduced, in accordance with previous consent from the patient.
Kiedy zalecana jest laparoskopia diagnostyczna?
Diagnostic laparoscopy is carried out in cases as:
- unexplaind infertility, when the causes of infertility cannot be defined by convential methods;
- unexplained abdomen and lower abdomen pains;
- biopsy, collection of the material for the examination (from uterus, ovaries).
Laparoscopic myomectomy
Laparoscopic myomectomy is method of removing uterine fibroids. In the hands of qualified surgeon it is safe technique with the minimal effect on the uterus and female fertility. During the surgery doctor remove one or more fibroids with the help special surgical instrument called morcellator. Later the uterus is stitched and the original shape and appearance is shaped and the samples of the tissues was sent for the analyze. The examination allows to save uterus and improves quality of life. The surgery takes around 30-120 minutes.
When laparoscopic myomectomy is recommended?
Reasons why doctor may recommend myomectomy:
- irregular uterus bleeding which cause tiredness, anemia, dyspnea, fainting.;
- unexplained abdomen lower abdomen pains;
- pain during period;
- pressure on pelvis;
- symptoms in urinary system;
- painful intercourse;
- back pain in lumbar region;
- infertility, postpregnancy complications;
Salpingectomy
Salpingectomy, or tubal resection it is minimum invasive method of removal of damaged fallopina tubes (one or both) with the help of laparoscope. In case of women who decide not to have childern in a future, salpingectomy can be considered to be birth control method but also method to descrease risk of ovarian cancer. During the operation, surgeon removes one or both fallopian tubes and tissues samples are sent for the labaratory analyze. Operation lasts 30-60 minutes.
When salpingectomy is recommended?
Doctor may suggest salpingectomy in situations as:
- ectopic pregnancy if the pregnancy was developping in the fallopian tubes;
- tubes damaged by STD infections (for instance chlamydia, gonorrhoea);
- planned IVF fertilization (in case of damaged tubes);
- wish for permament contraception;
- ovarian cancer prevention.
Laparoscopic ovarian cystectomy
Laparoscopic cystectomy (oophorectomy) of the ovary is removal of ovarian cyst but saving the ovary, which is very important hormonal balance and female fertility. During the operation surgeon removes ovarian cyst from the abdomen and then the samples of the tissues are sent for the analyze. The surgery lasts for 30-120 minutes.
When the ovarian cystectomy is recommended?
Doctor can recommend oophorectomy in case of irregularities caused by ovarian cyst, as:
- irregular periods, when doctor finds the presence of the ovarian cyst;
- long or very abundant periods, when doctor finds the presence of the ovarian cyst;
- bleeding between periods, when doctor finds the presence of the ovarian cyst
- lower abdomen pains, when doctor finds the presence of the ovarian cyst
- infertility caused by the presence of the ovarian cyst;
- the risk of rupture of large ovarian cyst.
Hysterectomy
- Total hysterectomy
- Subtotal hysterectomy (amputacja macicy)
- Hysterectomy with removal of both tubes
Uterus is being removed from abdomen with the help of morcellator, later the loss in tissues is stitched. The samples of the removed material are sent for the analyze. Surgery usually takes 90-120 minutes.
The hysterectomy procedure is performed in cases as:
- large uterine fibroid, when the function of the uterus cannot be reversed after its removal;
- adenomyosis (endometriosis of uterine wall) which cause painful periods and heavy bleedings. (In case of women who do not plan to give birth);
- preoncological changes as atopic endometrium growth, preoncological stage of cervix CIN I (LSIL), CIN II / III (HSIL). (In case of women who do not plan to give birth);
- uterine prolapse if patient doesn't want to have vaginal pessary.
Which tests should be performed before laparoscopy?
Before the gynaecological laparoscopy the following tests should be performed:
| ✔ blood analyze: | ✔ ALT, | ✔ APTT, | ✔ INR, | ✔ prothrombine time(PT), |
| ✔ blood type, | ✔ Rhesus factor, | ✔ HCG, | ✔ Anti-erythrocyte antibodies, | |
| ✔ AST, | ✔ Urea, | ✔ creatinine, | ✔ full blood morphology(CBC), | |
| ✔ glucose, | ✔ TPHA, | ✔ RPR test, | ✔ Bilirubin, | |
| ✔ anti-HIV, | ✔ HBsAg, | ✔ anti-HCV, | ||
| ✔ urine test + panel STD examination; | ||||
| ✔ electrocardiogram; | ||||
| ✔ RTG of chest (after negative result for HCG). | ||||
The day before the surgery patient is recommended to keep diest prescribed by the doctor. On the day of laparoscopy you need to come early in the morning at the planned time. The patient should be on empty stomach, that means no food, no beverages few hours before the operation.
Well-being of the patient after laparoscopy
After surgery patient is being woken up slowly. Anaesthetic drugs may decrease the concentration and attention for some time. Usually patint is able to come back home in the evening of the same day. In extraordinary cases patient can be asked to stay at the clinic overnight under medical team observation.
Most common symptoms after laparascopy:
- slight discomfort in the abdomen,
- bloating (from the gaz which is used during the procdure),
- dizziness,
- pain in the chest (collarbone, shoulder).
Gynaecological laparascopy - price
Depending on the type of the performed operation, the price of the gynaecological laparoscopy in the My Clinic Riga is from 1200 EUR. The price covers general anaesthesia, surgery performed by the most experienced specislaists and one night stay at the clinic under medical team care.
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Frequently Asked Questions
Frequent questions
- 1
Is laparoscopy painful?
The laparoscopy procedure is not painful, because it is performed/conducted under the general anesthesia. Contrary to laparotomy, opening the abdominal cavity through a large incision, surgical laparoscopy leaves smaller wounds and brings a shorter recovery time.
- 2
May any complications after laparoscopy occur?
Laparoscopy, being compared to normal surgery, is less invasive procedure. At My Clinic Riga highly experienced doctors perform it with the greatest accuracy and care for the safety and comfort of all patients. Complications appear very seldom.
- 3
How to prepare for laparoscopy?
The initial and the most basic recommendation before laparoscopy is to stay on an empty stomach for several hours. The day before, patients should obey dietary recommendation given by the doctor. Moreover, patients can’t take acetylsalicylic acid for about 7 days before the surgery.
- 4
When is laparoscopy not possible?
Laparoscopy should not be performed if patient suffers from: cardiorespiratory failure, abdominal hernia, diaphragmatic hernia, peritonitis and intestinal obstruction.