Laparoscopy.pdf

Laparoscopic surgery in gynaecology is performed through small "keyhole" incisions, using instruments like a laparoscope, scissors, and graspers. It is used for diagnostic or operative purposes, such as investigating pelvic pain, infertility, or suspected ectopic pregnancy. The procedure involves making a 10mm incision in the umbilicus, inserting a Veress needle, and connecting it to a carbon dioxide insufflation tubing to distend the abdomen. A laparoscope attached to a video camera is then passed through the 10mm port, and instruments are inserted through 5mm ports to perform the surgery.

The advantages of laparoscopic surgery include less postoperative pain, quicker return of bowel function, and reduced chance of scar formation. It also offers a quicker return to daily activities, reduced infection rate, and smaller scars. However, possible postoperative effects include aching of muscles, discomfort, nausea, and shoulder pain.

Gynaecological surgeries that can be performed by laparoscopy include tubal ligation, ectopic pregnancy, investigation of infertility, removal of uterus, removal of fibroids, endometriosis surgery, and cancer of the endometrium or cervix. Conditions that may be difficult to perform laparoscopic surgery include history of bleeding, history of laparotomy, pregnancy, and large uterus. The doctor's skills and experience are crucial in determining whether laparoscopic surgery can be performed.