Being diagnosed with an underlying diseases and undergoing a surgery can be overwhelming and involves a life time decision. Individuals including women, children and aged patients are taken by fear when a medical procedure is recommended. They seriously consider factors that may impact their overall lifestyle and the aftermaths of a high-end surgery. Advances in healthcare have seen laparoscopic screening and procedures benefitting individuals in many ways and making it a much easier decision and choice to successfully treat different diseases today. Dr. Mily V Nair, Specialist Gynecologist in Zulekha Hospital Sharjah and Dr. Moharam Abdelshahid Consultant General Surgery in Zulekha Hospital Dubai answer frequently asked questions to help us gain a clearer understanding on laparoscopic procedures.
Laparoscopy is a surgical diagnostic procedure used to examine the organs inside the abdomen. It’s a low-risk, minimally invasive procedure that requires only small incisions. Laparoscopy uses an instrument called a laparoscope to look inside the abdomen. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor. Laparoscopy allows your doctor to view the inside of your body real time, without an open surgery.
What types of surgeries can be laparoscopic in women?
In women laparoscopic surgeries can be diagnostic (to identify the cause) or therapeutic (treatment of the causative problem). Using the laparoscope, the doctor can directly view the outside of the uterus, ovaries, fallopian tubes, liver, pancreas, gallbladder, spleen, and stomach.
Your doctor might recommend a laparoscopy if other diagnostic tests — ultrasound and X-ray — cannot confirm the cause of a condition. Your doctor might use laparoscopy to: find the cause of pain in the pelvic and abdominal regions, examine a tissue mass, confirm endometriosis or pelvic inflammatory disease, look for blockage of the fallopian tubes or for other causes of infertility.
If a problem is found, it often can be treated during the same surgery. Laparoscopy also is used to diagnose and treat the following medical conditions: endometriosis, fibroids, ovarian cyst, ectopic pregnancy, pelvic floor disorders, and cancers.
For women who need a laparoscopy surgery, are there any precautionary/preparatory measures a doctor would advise?
What are the risks associated with a laparoscopic surgery for a women? Especially when women are on thyroid or BP medication?
Laparoscopy can take longer to perform than open surgery. The longer time under anesthesia may increase the risk of complications. Sometimes complications do not appear right away but occur a few days to a few weeks after surgery. Problems that can occur with laparoscopy include: Bleeding or a hernia (a bulge caused by poor healing) at the incision sites, internal bleeding, infection, damage to a blood vessel or other organ, such as the stomach, bowel, bladder, or ureters.
Conditions that increase your risk of complications include:
Pay close attention to your body during the recovery period. Write down any side effects you’re experiencing and discuss them with your doctor. Women with hypertension and thyroid are not at any specific high risk. If their condition is in control with medications, laparoscopic surgery can be easily carried out after anesthetic fitness. Routine medications for hypertension or thyroid can be taken even the morning before of the surgery with sips of water, as per your doctor instructions.
Is there a danger for the patient’s skin due to stretch the keyhole would be undergoing during this type of surgery?
There is no danger at all to the skin due to the stretch obtained during keyhole surgery. The stretch is obtained by gas inflated in the abdomen at the beginning of the surgery, which is removed at the end of the surgery.
Would there be any chances of infections/side effects internally when a telescope/ instrument is inserted inside the patient’s body for the laparoscopic surgery?
The chances of infection are very low especially with high quality instruments, environment sterilization, and strict guidelines of infection control followed by the operating team. Procedures are classified into four categories as per the infection levels, as clean wounds, clean contaminated wounds, contaminated wounds, and dirty wounds. Each of these are managed and treated well to heal completely post surgeries.
What are the most common types of complaints treated with a laparoscopic surgery?
The Laparoscopic approach today is a standard to different intra-abdominal and intra-thoracic surgeries such as laparoscopic cholecystectomy, laparoscopic appendectomy, hernias repair, hiatus hernia and antireflux procedures, myotomies for achalasia laparoscopic bariatric surgeries as sleeve gastrectomies, bypass and mini bypass procedures, gastric banding and management of hyperhidrosis by laparoscopic thoracic sympathectomy. In addition to this, management of different malignant conditions including colectomies for cancer colon, gastrectomies, adrenalectomy etc. and almost all types of different intraabdominal procedures can be treated with laparoscopy.
Do children undergo a laparoscopic surgery? If yes, what kinds of surgeries are done this way in pediatric patients?
With innovation of small sized tapered laparoscopic instruments, these tools are suitable to be used in children as well. Procedures such as appendectomies in children, groin hernias especially bilateral ones, cholecystectomies, diagnostic laparoscopy are successfully treated laparoscopically.
Can a person return to normal fitness activities and work life after a laparoscopic surgery?
Laparoscopic surgery has a lot of benefits as it is a minimal invasive surgery. It ensures minimal site infection and very low incidence of incisional hernia. It shortens the total hospital stay, and ensures rapid recovery and rapid return to normal activities and work, so, it has a good satisfactory cost-benefit rate. On the other hand, it improves patient satisfaction and improves overall quality of life. With introduction of laparoscopy, different procedures are easily done as one day care surgeries with light exercises also recommended for most patients on the second day.