Keyhole
surgery allows very small scars less pain, less duration
of hospital stay, and faster recovery.
Common applications in gynecology
Hysterectomy i.e. removal of the uterus
is one of the commonest surgeries performed in gynecology.
It may be removed through the vagina and in some cases
through the abdomen. But in present times a substantial
number of abdominal cases are done through the laparoscope.
Fibroids, adhesions, endometriotic
cysts and ovarian cysts are also by and large tackled
with the laparoscope.
Common applications
in Infertility
Endoscopic surgery has revolutionized
the management of various conditions that affect fertility.
The most significant results have been seen in the areas
of Polycystic Ovarian Syndrome (PCOS,) Hydrosalpinges,
Endometriosis and Uterine anomalies.
PCOS is one of the most common cause of anovulatory
infertility. The current lines of treatment for PCOS
are weight loss, insulin sensitizing agents, ovulation
induction drugs and assisted reproductive techniques.
In certain cases there is a benefit from laparoscopic
ovarian drilling. The cycles become regular and acne
and hirsutism improves The pregnancy rate and delivery
rate also improves significantly.
Tubal disease is also an important
factor in female infertility. Patients with hydrosalpinx
have a decreased clinical pregnancy rate and an increased
miscarriage rate. The presence of hydrosalpinx has a
deleterious effect on the outcome of IVF-ET.
Operative laparoscoic excision of hydrosalpinges
is very effective in the treatment of hydrosalpinges
and improves the pregnancy rate after IVF-ET.
Endometriosis is the presence of endometrium
like tissue outside the uterine cavity. It is an important
cause of infertility. Laparoscopy is used for diagnosis
of endometriosis. Laparoscopic treatment is very effective
in relieving pelvic pain, in dealing with endometriomas
and adhesions. Laparoscopic management can lead to improvement
in fertility and pregnancy rate.
Uterine Malformations albeit rare do
occur and can cause infertility and recurrent pregnancy
loss. Acquired uterine anomalies (submucous myomas and
polyps) can also result in infertility. Hysteroscopy
meets with both the diagnostic and therapeutic needs.
Hysteroscopic surgery is now the treatment of choice
over abdominal procedures because of various benefits
– reduced morbidity, decreased costs, hospital
stay, no scar on abdomen, improved reproductive performance,
and shorter interval to conception after operation and
avoids caesarean section. Septum in the uterus is the
commonest anomaly and hysteroscopic resection, which
is done in few minutes of operating time, gives very
good success.
Dr Sangeeta has access to state of
the art equipment and an experienced team at the hospitals
that she visits. This enables her to offer keyhole surgery
to her patients.
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