Minimally Invasive Surgery in Gynaecology

Minimally Invasive Surgery in Gynaecology

Minimally invasive surgery or laparoscopic surgery has become increasingly popular since the early 90s. In the early days, the only specialty performing laparoscopy on a widespread basis was gynaecology, mostly for relatively short and simple procedures such as fallopian tube ligation for contraception.

Together with improvements in technology, equipment, surgical skills and training, laparoscopic surgery has now become widespread and is the main approach for a wide range of conditions.

The main difference between minimally invasive surgery and open surgery is the way in which access into the abdominal cavity is obtained. In open surgery, a large incision of 520cm is needed.

In laparoscopic surgery, several small 0.5-1cm stab incisions are made to allow the procedures to be carried out. This is done with the aid of a fine telescope, a light source, a carbon dioxide insufflator and specialised long instruments. The actual surgery is the same as with the open procedure.

The many advantages of a laparoscopic procedure include: magnified views; reduced bleeding; reduced infection; faster recovery and much smaller scars.

As everything is done under magnification, there tends to be better visualisation during the surgery, and this may help to reduce bleeding. With less exposure of the internal organs to the external environment there is also less risk of infection. Furthermore, without a large painful incision, the patient can recover faster with less need for painkillers and return home earlier. And cosmetically the scar is much smaller.

Laparoscopic surgery can be performed on women with a wide range of gynaecology conditions. For women suffering from infertility in particular, laparoscopic surgery is very useful for diagnosing the cause and treating the condition.

Conditions which can lead to infertility and which may benefit from laparoscopic surgery include: polycystic ovary disease where laparoscopic ovarian drilling can be performed to allow ovulation to occur; blocked fallopian tubes where surgery can be performed to confirm the site of a blockage and unblock the tubes at the same time; endometriosis where surgery can be useful for clearing up of endometriotic spots and implants and ovarian cysts and uterine fibroids where surgery can be used for treatment while conserving the ovaries and uterus.