Palam Vihar - Minimally Invasive Gynecology

The Department of Obstetrics and Gynecology at Columbia Asia Hospital – Palam Vihar, Gurgaon has a team of highly qualified and experienced consultants, who specialize in Minimally Invasive Surgeries. We aim at excellence in patient care through practice of evidence based medicine and internationally accepted protocols. The consultants performing these procedures are trained in some of the most renowned institutes across the globe and our surgical outcomes are excellent due to advanced skills in minimally invasive surgery

Contemporary infrastructure with highly advanced diagnostic equipment has been the hall mark of the service.

What is Laparoscopic Surgery?

Laparoscopy is an innovative way of performing a surgical procedure without the use of large incisions. Also called KEY HOLE SURGERY because instead of a large cut, laparoscopy usually requires small cuts about 0.5-1cm. It helps in diagnosis and treatment.

Advantages of Laparoscopic Surgery

  • Small incisions offering better cosmesis
  • Less pain needing less postoperative pain medication
  • Less blood loss
  • Minimal medication
  • Faster mobilization
  • Shorter hospital stay
  • Significantly faster recovery
  • Can get back to the work earlier
  • Less chances of wound infection
  • Less formation of scar tissue or adhesions inside the abdomen
  • That may cause pain, or bowel obstruction
  • Lesser chance of incisional hernias

What Kinds of Operations Can Be Performed Using Laparoscopy?

Almost all surgeries that were formerly done by open surgery are nowadays being performed laparoscopically.

  • Diagnostic Hystero- Laparoscopy is a safe procedure to look inside the abdomen and pelvis to diagnose conditions related to the ovaries, uterus and fallopian tubes. It is a common procedure used in the management of infertility and chronic pelvic pain
  • Laparoscopic Ovarian drilling is a surgical treatment to trigger ovulation in women who have polycystic ovarian syndrome where weight loss and medication haven’t worked
  • Ovarian Cystectomy is done for a cyst, which are fluid filled sacs, in the ovaries
  • Laparoscopy for ectopic pregnancy which is when the embryo implants itself anywhere other than in the womb. Laparoscopy is done even for ruptured ectopic pregnancy with significant blood loss, which can be life threatening
  • Laparoscopy for diagnosis and treatment of mild to moderate endometriosis, which is a condition in which the tissue lining the uterus, grows outside the uterus on the ovaries, bowel or anywhere else in the abdominal cavity
  • Laparoscopic fertility preserving surgeries
  • Family planning surgery
  • Laparoscopic hysterectomy (removal of the uterus) for all sizes of uterus upto 30 cms size, as heavy as 2-3 kgs, even for patients with previous cesarean sections & previous multiple surgeries
  • Laparoscopic oophorectomy is removal of the ovaries
  • Laparoscopic myomectomy is done for removal of fibroids
  • Laparoscopic tubal recanalization is done for women who want to conceive after tubectomy. Also done for clearing tubal obstruction to enable conception
  • Laparoscopic Burch colpo suspension for stress incontinence
  • Laparoscopic paravaginal defect repairs for cystocele, which is a prolapse of the bladder
  • Laparoscopic surgeries for nulliparous prolapse and vaginal vault prolapse
  • Laparoscopic cervical encerclage, which is a stitch around the upper part of the cervix to keep it closed in case of cervical incompetence
  • Laparoscopic surgeries during pregnancy
  • Laparoscopy for staging and treatment of gynecological malignancies

How Safe is Laparoscopic Surgery?

Laparoscopic surgery is quite safe if done by an expert who is specially trained to do these procedures.

What Are the Risks of Laparoscopic Surgery?

Risks and complications though not common are lesser than in conventional surgeries. Some of the risks include:

  • Infection
  • Bleeding
  • Blood clot in the leg (DVT), rarely part of which may break off and move to the lungs
  • Bowel injury
  • Injury to bladder and ureters
  • Hernia formation at the trocar site
  • Adhesion formation
  • Sometimes, due to various reasons, laparoscopy may not be possible and the surgery will have to be done by the conventional method

Hysteroscopy

This is a procedure that enables your doctor to look inside the uterus in order to diagnose and treat causes of abnormal bleeding, using a special instrument called a hysteroscope. This is a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. The hysteroscope transmits images of the uterus onto a screen. The difference between laparoscopy and hysteroscopy is that the former is able to view outside the uterus and the latter visualises inside the uterus and fallopian tubes. A hysteroscopy may be done along with a laparoscopy or a dilatation and curettage. It is generally done under local, regional or general anesthesia.

Hysteroscopy is normally done after a period prior to expected time of ovulation.

How is Hysteroscopy done?

  • A speculum is inserted into the vagina and cervix visualised
  • The doctor will dilate the cervix to be able to insert the hysteroscope into the uterus.
  • A liquid is inserted into the uterus to expand it and clean out all blood or mucus
  • A light is shone through the hysteroscope
  • If any procedure has to be done, instruments are passed through the hysteroscope

Diagnostic Hysteroscopy

Hysteroscopy is done for diagnostic purposes including taking samples of tissue for a biopsy. It is also used to confirm results of other tests like hysterosaphingography, which is a dye test to check the uterus and fallopian tubes. It may also be done to find the cause of severe cramping or repeated miscarriages.

Therapeutic Hysteroscopy

This is done to treat the condition detected during a diagnostic hysteroscopy. Hysteroscopy is done for the following:

  • Fibroid removal
  • Polyps removal
  • Septal resection is the removal of a congenital septum inside the uterus
  • Endometrial resection for abnormal bleeding, where endometrial ablation is done with a hysteroscope to destroy the endometrium
  • Cannulation for proximal tubal block
  • Removal of Copper T which cannot be removed through the cervix
  • Adhesiolysis is done for adhesions also called Asherman’s syndrome, which are bands of scar tissue inside the uterus, which can cause infertility and problems with menstrual flow

Benefits of Hysteroscopy

  • Quicker recovery
  • Shorter hospital stay
  • Less medication required after surgery
  • Avoiding open surgery or hysterectomy

Risks of the procedure

  • Infection
  • Heavy bleeding
  • Injury to the cervix, uterus, bowel or bladder
  • Intrauterine scarring

 

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