Q: Since the incisions are
so small, why can minimally invasive surgery not
be done with a local anaesthetic?
A: It
still is necessary for most operations,
including those on the abdomen and pelvic areas
to be done under general anaesthesia. That's
because the general anaesthesia does more than
block the sensation of pain; it also relaxes
muscles and makes it easier for the surgeon to
work inside the body and complete the operation.
Q: The doctor wants to do a
diagnostic laparoscopy to find out why I'm
having pelvic pain, the surgery will take less
than an hour, and I can go home right away and
back to work the next day. If it is really that
simple, why do I have to bring someone to the
surgery center to drive me home?
A:
Because of the effects of general anaesthesia.
You may feel groggy for a few hours after you
awake and you may not be in complete control of
the reflexes needed to drive a vehicle. It is
safer to have someone else who is fully alert do
the driving.
Q: Why does the doctor want
to videotape my surgery? Is that standard for
laparoscopic operations?
A: A videotape
gives the most detailed possible record of the
operation. Surgeons normally dictate an account
of the operation and a paper record goes into
the patient's file, but the amount of detail
varies from surgeon to surgeon. Almost every
operating room with modern laparoscopic
equipment can videotape each procedure, creating
a visual document of the operation. A record of
the operation clearly shows what the surgeon
found during the first operation, what
difficulties were encountered, and what
procedures were done. The record is very
important for other doctors who may be involved
in your care at some point.
Putting It All Together
Here is a summary of the
important facts and information related to
laparoscopy:
-
Laparoscopy is surgery on the
abdomen performed through very small incisions
in the body. It is used to diagnose and treat
many different conditions and diseases.
-
Doctors perform laparoscopy
with a pencil-thin instrument called a
laparoscope. It has a strong light and a
miniature camera that sends images of the
surgery area to a video monitor above the
operating table.
-
Laparoscopy is called
minimally invasive surgery because the
incisions are so small. Common non-technical
names for the procedure are belly button
surgery and Band-Aid surgery, a key
hole surgery.
-
For minimally invasive
operations on the abdomen, incisions may be only
half an inch long, compared to four to six
inches for traditional "open"
surgery.
Minimally invasive surgery has
many advantages. Individuals remain in the
hospital for a shorter period, experience less
discomfort, heal quicker, and can return to
daily activities faster than is possible with
traditional "open surgery."
Laparoscopic
Hysterectomy
What is Laparoscopic Hysterectomy?
What are the advantages of Laparoscopic
Hysterectomy over conventional surgery?
Who can undergo Laparoscopic Hysterectomy?
Can
a person who has undergone operations in the
past go in for Laparoscopic
Hysterectomy?
Can
associated ovarian, tubal or uterine disease all
these be treated in the same operation
laparoscopically?
Do I need any special investigations
for Laparoscopic Hysterectomy?
Do we need any preparation / medicines
before undergoing Laparoscopic Hysterectomy?
Can a person having disease like Diabetes
or Hypertension undergo this procedure?
Where should one get the Laparoscopic
Hysterectomy done?
Do I have to get admitted a day before
the surgery?
Under what type of Anaesthesia is itcarried
out?
How is the surgery performed?
After how many days can I go back home
after the surgery?
What are the usual precautions I have
to take after I reach home?
When do I see the doctor again after
the operation?
When can I resume my normal activity
/ go back to work?
What is Laparoscopic Hysterectomy?
It is a procedure by which Hysterectomy
(removal of uterus) is carried out laparoscopically.
It is a broad term which includes the removal
of Uterus with the aid of Laparoscope and
very fine instruments, without making a
big incision on the abdomen.
What are the advantages of Laparoscopic Hysterectomy
over conventional surgery?
Its advantage over the conventional hysterectomy
are that it gives rise to minimal tissue
handling and thus much less trauma to other
adjacent normal organs resulting in very
less pain and lesser chances of adhesion
formation; after the operation. 2-3 very
small incisions of 0.5-1.0 cm (as compared
to 10-15 cms in conventional procedure)
are given on the abdomen resulting in less
blood loss and lesser chances of wound infection
with decreased hospital stay and early recovery
time as compared to conventional surgery.
Who can undergo Laparoscopic Hysterectomy?
Usually all the patients who have
been advised for hysterectomy can undergo
Laparoscopic Hysterectomy.
Can
a person who has undergone operations in
the past go in for Laparoscopic Hysterectomy?
Yes, a patient who has undergone operations
in the past can undergo this procedure and
if there are adhesions because of previous
operations, they can be removed along with
the laparoscopic hysterectomy, in the same
sitting.
Can
associated ovarian, tubal or uterine disease
all these be treated in the same operation
laparoscopically?
Yes, it is very much possible to treat/remove
the ovaries and tubes while carrying out
laparoscopic hysterectomy.
Do
I need any special investigations for Laparoscopic
Hysterectomy?
The usual routing tests are required as
for any other operative procedure and no
special investigation is required for laparoscopic
hysterectomy.
Do
we need any preparation / medicines before
undergoing Laparoscopic Hysterectomy?
To make the operation easier, the recovery
after the operation faster and resumption
of normal work/activity earlier, some medicines
along with diet restriction is started 2
days before the operation.
Can
a person having disease like Diabetes or
Hypertension undergo this procedure?
Yes, after controlling the Diabetes and
Hypertension a person can undergo this procedure,
and in fact the advantages of lesser chances
of infection and early recovery are much
beneficial for them.
Where
should one get the Laparoscopic Hysterectomy
done?
It is an advanced laparoscopic
surgery procedure, and its always advisable
to get it done in an advanced care institution,
where the whole set of equipment is present
along with complete backup facilities.
Do
I have to get admitted a day before the
surgery?
If you are fully investigated and
have undergone Anaesthetic checkup, you
can get admitted the morning of the operation.
Under
what type of Anaesthesia is it carried out?
This procedure is carried out under
general anaesthesia.
How
is the surgery performed?
A small incision (about one cm)
is made at or near the navel.
Through this a laparoscope is introduced
inside the abdomen. It is a tube having
lenses inside and a special camera attached
to the outside end. This is then connected
to a television monitor and allows the surgeon
to see inside the abdominal cavity. After
that two / three small half to one cm incisions
are made on either side on the abdomen,
to allow the introduction of thin long instruments,
with which the operation is carried out.
After
how many days can I go back home after the
surgery?
On an average the total hospital
stay is for one – two days, after
which you can go back home.
What
are the usual precautions I have to take
after I reach home?
On an average, two hours after
lunch and eight hours rest after dinner
is what is usually recommended. You can
climb stairs for two to three floor slowly,
walk to one km slowly and carry out sedentary
work at home without much difficulty. One
can have bath as the dressing is waterproof.
When
do I see the doctor again after the operation?
Routinely, the patient is called
seven days after the operation for the change
of dressing and then after four weeks for
a routine checkup.
When
can I resume my normal activity / go back
to work?
You can resume normal activity
like walking, jogging, cooking, driving,
sitting in front of the computer within
few days. Intercourse, strenuous exercise,
lifting of heavy weights, swimming etc.
has to be avoided for a period of twelve
weeks.
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