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Laparoscopic Surgery
Professor Dr. Pongsakdi
Chaisilwattana
What is Laparoscopic Surgery?
Laparoscopic surgery is a surgical procedure, using a microscopic
telescope to see the intra-abdominal or pelvic organs and
perform surgery. It is different from the old- fashioned
surgeries (conventional methods) which approach the abdominal
cavity or pelvic cavity through a wide skin incision (approximately
10 cm.). This new method uses a technique of inserting a
microscopic telescope into the abdomen or pelvis through
a tiny skin incision (1 cm.) at the umbilicus. The telescope,
then, projects the pictures to a number of monitors for
the surgeon and the assistances to watch. Afterward, other
microscopic surgical instruments are inserted through another
2-3 five-millimeter skin incisions at the lower portion
of abdomen. The surgeon can do their work by watching the
monitors. Therefore, this new technology is minimal invasive
surgery and is called key-hole surgery.
Advantages of Laparoscopic Surgery
Small skin incisions ranging from 0.5-1 centimeter in
size
Lesser pain after surgery
Early mobilization
Shorter recovery period
Lesser adhesion formation and complications
Disadvantages of Laparoscopic Surgery
There are some limitations to this minimal invasive surgery
such as:
Unable to operate on a large tumor (larger than 15 cm.)
Patients with heart or lung diseases are prohibited from
this technique.
Surgeons must be well trained and have good experiences
in this new surgical technique.
Diseases Suitable for using this
New Surgical Technique
Endometriosis (chocolate cyst and adenomyosis)
Ovarian cyst, ovarian tumor
Myoma uteri or fibroids
Ectopic pregnancy
Pelvic pain (cramps) due to adhesions
Tubal sterilization
Infertility
Diseases in the uterine cavity such as submucous myoma
and abnormal menstruation.
Other gynaecologic diseases under the supervision of
gynaecologists
Laparoscopic Surgical Process
The patient is operated under general anesthesia.
The abdominal wall and vagina are cleaned.
A small skin incision (about 1 cm.) is performed at the
umbilicus for a microscopic (little) telescope insertion,
and other 2-3 small skin incisions about 0.5 cm. are performed
at the lower pelvis for the insertion of the operative instuments.
When the operation is finished, the patient recovers
from the anesthesia and can take liquid diet as long as
he/she does not experience nausea and/or vomitting.
The patient may have mild to moderate degree of pain,
which can be relieved with pain-killer medication.
The patient may move and walk with ease on the first
day after the operation.
The patient is able to leave the hospital on the second
day after the operation.
Post-Surgery Advice for Patients
Strictly adhere to the doctor's instructions and recommendations.
Drink more fresh water and do not hold voiding of urine.
Keep moving and walking to prevent adhesions.
Contact the doctors and/or nurses when questions and/or
problems arise regarding abnormal symptoms.
Return to the hospital on the date of appointment or
come earlier in case of any disorders.
Post-Surgery Complications
The majority of patients feel well and happy after the
operation. However, some unwanted annoying symptoms may
occured in few patients such as shoulder pain. This pain
is caused by the accumulation of the air under the diaphragm,
the occurrence is not a serious issue. This shoulder pain
will fade away within 1-2 day.
Laparoscopic Surgery and Quality of Life
This new surgical technique is the minimal invasive surgery,
which improves patients' quality of living. Patients operated
with this new technique resume their normal life styles
sooner and better than those operated under conventional
surgery.
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Common Diseases of The Female Genital Organs required Surgery
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