Diagnostic Hystero Laparoscopy
Diagnostic Hystero laparoscopy is a small operation (Procedure) done under anesthesia ( GA ). It is a day care procedure and patients are discharged on the same day. In this operation a laparoscope is introduced into the abdomen, the uterus, tubes, ovaries, pouch of douglas and bowel is visualized. Tubal patency is confirmed by injection of dye. Small corrective operations are also done through laparoscope such as ovarian drilling, adhesiolysis excision of myomas, endometriomas, cauterisation etc. Through hysteroscope the uterine cavity is visualised. Polyps, fibroids, septum etc are diagnosed & treated. Tubal Ostia can be visualized and cornual block can be removed if needed. At the end of hysteroslaparoscopy ,the diagnosis of Infertility is definitely established and a treatment plan is made. It is better to do a hystero laparoscopy in all cases of Infertility before starting any strong treatment. A Good Diagnostic Hysteroslaparoscopy is the golden standard for basic investigation and treatment in fertility, as it not only helps identify the cause of infertility but also provides a solution to the problem in the same sitting.
Total Laparoscopic Hysterectomy
Laparoscopic hysterectomy involves removing the entire uterus with minimally-invasive techniques, using a narrow telescope-like instrument (laparoscope) to see the inside of the abdomen. Under complete general anesthesia, the abdomen is first inflated with carbon dioxide gas to create space for operating. Four or five incisions (1/4 to ½ inch each) are made in the navel and lower abdomen to allow insertion of both the laparoscope and long, narrow instruments through tubes called “ports.” (When using the robot, the incisions are higher up, at the level of the belly button and higher up towards the head.) A normal sized uterus, once it is detached from its supports, can be removed through the vagina. A large uterus can be reduced to smaller pieces using a laparoscopic morcellator. With our long experience and high volume, we are comfortable removing a uterus as large as a 30 week pregnancy. Once the uterus is removed, the inside edges of the vagina are brought together using suture, which is readily done laparoscopically
The advantages of Total Laparoscopic Hysterectomy are:
• Pain is less as the nerve fibres are not disturbed and the patient recovery is very fast
• The patient is out of the bed the very next day and gets back home
• The chances of urinary incontinence (leakage of urine), Vault prolapsed (hernia of intestine) occurring is less and the depth of the vagina is also maintained
• Maintaining its depth is very important for normal sexual activities
• The pelvic floor is not disturbed
• The patient returns to normal activities within a week and working women can get back to work in 2 weeks time
During Total Laparoscopic Hysterectomy, we believe in not removing the ovary unless it is diseased, as the ovary produces a hormone called ‘androgen’, even after Hysterectomy, which is important for a normal sexual functioning and for the well being of the woman.