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Laparoscopy

Laparoscopy and Hysteroscopy

Nowadays, it is possible to look inside the abdomen and even perform surgery inside the human body without making a large cut or incision on the abdomen. With technological advancement and innovation, many of our traditional surgeries can be safely performed under this "Minimally Invasive" technique. Under the field of gynaecology, the 2 main types of surgery are: Laparoscopy and Hysteroscopy.

Laparoscopy

Laparoscopy is a procedure to look inside of the abdomen and pelvis using a laparoscope. This helps to see the ovaries, outside of the tubes and uterus and other organs inside the abdomen. The laparoscope is a special telescope to which a light source and camera is attached. It is about as thick as a pen and about 12 cm long.

Laparoscopy is commonly used to:
1. find the cause of symptoms such as abdominal pain, pelvic pain
2. as part of investigation of infertility.

In addition to simply looking inside, a doctor can use fine instruments to perform surgery inside the abdomen. This laparoscopic surgery is also called 'key-hole surgery' or 'Minimal Invasive Surgery' and maybe used to treat cysts, endometriosis, fibroids, perform hysterectomy and even pelvic floor reconstruction.

In general, compared to traditional surgery, with laparoscopic surgery there is usually:

1. Less pain following the procedure.
2. A shorter hospital stay.
3. A quicker recovery.
4. A much smaller scar
Hysteroscopy

This involves putting in a telescope to see the inside of the womb Hysteroscopy is a form of minimally invasive surgery. The surgeon inserts a tiny telescope (hysteroscope) through the cervix into the uterus. The hysteroscope allows the surgeon to visualize the inside of the uterine cavity on a video monitor. The uterine cavity is then inspected for any abnormality. The surgeon examines the shape of the uterus, the lining of the uterus and looks for any evidence of intrauterine pathology (fibroids or polyps). The surgeon also attempts to visualize the openings to the fallopian tubes (tubal ostia).

What are the benefits of hysteroscopy?
The recovery time is very quick. Almost all the patients go home the same day following hysteroscopic surgery. There is no abdominal wound so the postoperative pain is minimal and there are no wound infections.

What procedures can a gynecologist perform with a hysteroscope?
Many gynecologists will use the hysteroscope to inspect the lining of the uterus and look for intrauterine pathology such as fibroids or polyps that may be causing irregular or heavy menstrual bleeding. Assessment of the cavity is also performed for women having difficulty becoming pregnant. Other conditions suitable for hysteroscopy include

1. Removal of endometrial or cervical polyps
2. Removal of fibroids
3. Biopsy of the endometrial lining
4. Cannulation (opening) of the fallopian tubes
5. Removal of intrauterine adhesions (scarring)
6. Removal of a lost IUCD (intrauterine contraceptive device)
7. Endometrial ablation- destruction of the uterine lining, a treatment for
8. Irregular or heavy menstrual bleeding

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