The information provided by Advanced Healthcare for Women and E. Daniel Biggerstaff, III, M.D. is for informational purposes only. As each woman is unique, do not rely on this information for diagnosis and treatment. We cannot guarantee the accuracy of the content and advise that you see a qualified Health Care Professional for individual needs and care.
Video laparoscopy is commonly referred to as “laser surgery.” Although a laser is sometimes used during laparoscopy, other instruments may also be used. What makes the surgery unique is that it is performed through incisions much smaller than in traditional surgery; so, therefore recovery is much quicker. The surgery is usually performed under general anesthesia (patient is asleep) using a laparoscope, a surgical instrument that resembles a skinny telescope. First, the laparoscope is inserted through a small incision in the bellybutton. A tiny video camera is attached to it, and the doctor performs surgery while looking at the images on a video monitor. The abdomen is inflated with carbon dioxide to lift the abdominal wall and give the surgeon a better view of the internal organs. When treating endometriosis, the tissue can be magnified 10 times, increasing the precision of the surgery. The laparoscope can also help visualize areas that are very difficult to get to through a large incision. Small second, third and fourth incisions are often made at the pubic hairline to introduce other instruments, should additional surgical procedures need to be performed at the time. Other small incisions in the lower abdominal wall may be necessary, especially when suturing through the laparoscope.
The main advantages of laparoscopy over the traditional large abdominal incision are:
• Much less pain after surgery
• Quicker recovery time
• Better visualization during surgery (With laparoscopy, Dr. Biggerstaff can usually get closer to the affected area and perform more precise surgery than when working through a big incision.)
• Less risk of infection.
Recovery time depends on the procedures performed. Some patients are able to return to work within several days after surgery, and others may require several weeks. Your throat may be sore from the endotracheal tube used with general anesthesia, and this usually is better in a day or two.
Common procedures performed by gynecologists using laparoscopy include:
- Tubal ligation (having your "tubes tied")
- Diagnosis of pelvic pain
- Treatment of endometriosis
- Removal of ovarian cysts
- Removal of tubes and ovaries
- Treatment of ectopic or tubal pregnancies
A few physicians perform more advanced procedures such as:
Removal of severe adhesions and scar tissue involving the intestine
Removal of extensive endometriosis
Burch procedure to relieve urinary incontinence
Suspension of the vagina to treat severe prolapse
Removal of fibroid tumors
Tubal reanastamosis to rejoin the tubes after a tubal ligation
Hysterectomy to remove very large fibroids
Presacral neurectomy for treatment of severe midline menstrual pain
Laparoscopic surgery using a surgical robot is being promoted by some physicians and health care systems around the country. The surgical robot allows these physicians to perform certain procedures laparoscopically that they would normally have to perform with a large incision (laparotomy). This high tech approach adds significant cost to the laparoscopic procedures. The alternative is to find a physician who has the skills to perform advanced laparoscopic procedures without the use of the robot.
Occasionally, procedures cannot be performed laparoscopically, even by those physicians who perform the more advanced procedures. If this is the case, a larger abdominal incision needs to be made to complete the surgery. You should ask your physician how often he or she has to make a large incision. If you are having surgery and a large incision is planned, ask if there are any physicians in your area who are able to perform the surgery laparoscopically.