We provide the latest of laparoscopic intervention to treat a range of health problems. The laparoscopic procedures offered include:
- Laparoscopic Myomectomy– This is indicated when the female is young and wants to preserve her uterus. Through this keyhole surgery the myoma or the fibroid is removed. This procedure leaves a small aesthetic scar, so better cosmetic results are obtained. Conception after laparoscopic myomectomy in fertility treatment has been comparatively higher in our series of patients.
- Total Laparoscopic Hysterectomy– TLH is done for patient with previous two or more LSCS, previous pelvic surgeries and previous multiple abdominal surgeries offering the comfort of laparoscopy to women. If the women has completed her family & is having multiple fibroids, then the uterus is removed along with the fibroids. Large uteri which weigh around 2.5 kgs are also operated laparoscopically at our hospital. Uteri which extend well above the umbilicus are also removed laparoscopically.
- Hysteroscopic Myomectomy– If the fibroid is encroaching the uterine cavity (i.e. submucous in position), then this procedure is opted where a small telescope with instruments is introduced from below into uterus and the fibroid is shaved off , this can be done for submucous fibroids and there is no incision on the abdomen. Patients can go home the same day and get back to normal the next day.
- Laparoscopic Hysterectomy – It is the surgical removal of the uterus (womb) and is performed when a woman has uterus related problems after her child bearing is complete. If the woman has completed her family has uterine problems like CIN, symptomatic fibroids, AUB, Adenomyosis, Endometriosis etc., Total Laparoscopic Hysterectomy is performed.
- Utero/Cervicopexy Operation – Occasionally marked uterine prolapse may develop in a young patient due to inherent weakness of suspensory supports. The basic principle behind these operations is to fortify the supporting ligamentary structures. Mesh repair is also done on these patients. This operation is possible through laparoscopy. These are used in patients who are young and keen for future fertility.
Laparoscopic Removal Of Ectopic Pregnancy:
Some women develop pregnancy in the tubes and this becomes an emergency situation when the tubes rupture. Laparoscopically the tubal pregnancy can be removed where we can save the patient. If there is a delay in the surgery, the patient can lose lots of blood and it is very dangerous. We use special vessel sealers to reduce the loss of blood which ensures safety of the patients as well as hastens their recovery. In cases of unruptured Ectopic , salphingectomy and milking of sac can be done laparoscopically and tubes can be concerved.
Laparoscopy For Ovarian Cyst / Hydrosalpinx
Laparoscopic management is the gold standard for benign ovarian diseases. Ovarian cysts like simple mucinous cysts, chocolate cysts, dermoid etc., can be removed laparoscopically without any spill using endobags. This offers the patient the advantage of early recovery and minimal invasion for larger cysts.
Hydrosalpinx: Laparoscopic removal is done for hydrosalpinx in women who have completed family and linear salpingostomy with clipping done in women who desire future fertility. The clipping is done with least vascular damage.
Hysteroscopy: In cases of infertility, it is always combined with laparoscopy. Problems of the cavity like septum, polyp and fibroids are treated at the same sitting. In cases of heavy menstrual bleeding hysteroscopy has an advantage that diagnosis can be made accurately along with treatment at the same sitting.
Laparoscopic Fertility Enhancement:
There are many conditions in infertile couple where fertility enhancing laparoscopic surgery helps.
- Tubal cannulation – Patients with proximal tubal block can undergo cannulation with a success rate of 40-50%. Only those tubes which are permanently blocked should go for IVF. Successful cannulation can open tubes for natural conception and IUI.
- Endometriosis – One of the increasingly common cause of infertility in young patients is endometriosis. Laparoscopy is the proven panacea for diagnosis of endometriosis, pelvis is accessed and disease classified into mild, moderate and severe. In mild and moderate cases meticulous surgery is done to restore anatomy as close to normal as possible and patient is counselled for controlled ovarian hyperstimulation with IUI. Chances of fertility success has always been higher after successful surgeries in mild and moderate cases reducing the risk of recurrence.
- Fibroids – After laparoscopic myomectomy (removal of fibroids) the pregnancy rate in woman almost comes to that of a normal woman. Hysteroscopic myomectomy increases the pregnancy rate in infertile women and increases birth rate in women with recurrent pregnancy loss.
- PCO – In case where medical therapy has failed Laparoscopic Ovarian Drilling of the enlarged ovaries, greatly increase the chances of the ovulation and pregnancy
- Hysteroscopy surgeries like septum (where there is a wall inside the uterus) polyps or fibroids (benign growth inside the womb) can be taken out easily during hysteroscopy surgery.
- Laparoscopic Tubal Sterilization results in mechanically blocking or interrupting the fallopian tubes to prevent sperm from fertilizing the egg. (Hence is a permanent method of contraception) Tubal sterilisation is done as a day care mini laparoscopy procedure with 2-5mm ports. It adds to the reason for preferring Sunrays for your family planning as it is recognised as a Family Welfare Centre by Government of Tamilnadu.