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Keyhole Surgery

The small way in Keyhole surgery can be used to treat a wide range of gynaecological problems with shorter recovery times.

Laparoscopic surgery, also known as keyhole surgery, is today considered the gold standard for diagnosing and treating many gynaecological problems. The method uses a laparoscope, a slender, lighted telescope. A small incision in the navel is made to insert the laparoscope, and pump gas into the abdomen to make it easier for the surgeon to look around the body cavity and operate. Aditional small cuts are made to intoduce small surgical tools for surgery – cutting, coagulating and vacuuming out fl uid and tissue. The procedure is carried out under general anaesthetic. The laparoscope transmits images to a screen to give your doctor a clear view of your organs. This helps a doctor make an accurate diagnosis of conditions such as endometriosis, adhesions, fi broids, ovarian cysts, tumours, damaged tubes, ectopic pregnancies and even cancers.

Endometriosis is an often painful disorder in which the tissues that normally line the inside of the uterus (the endometrium) grow outside it.

Uterine fibroids are noncancerous growths that develop from the smooth muscular tissue of the uterus. While fi broids are not associated with an increased risk of uterine cancer, they can cause discomfort and may lead to complications such as anaemia from heavy blood loss. Rarely, they cause infertility or pregnancy loss because they distort or block your fallopian tubes.

Ovarian cysts are fl uid-fi lled sacs or pockets of fl uid that grow in or on the surface of an ovary. Most ovarian cysts are harmless and cause little or no discomfort, and many disappear on their own without treatment. These are called functional cysts and form after ovulation and disappear after a menstrual period ends. However, ruptured ovarian cysts sometimes produce serious symptoms and pain, if there is internal bleeding.

Ectopic pregnancies are pregnancies in which the fertilised egg stays in your fallopian tube instead of travelling into the uterus. Ectopic pregnancies require emergency surgery to remove the pregnancy and often the tube.

The laparoscopic method can also be a form of treatment. The strength of the laparoscopic procedure is that it can be converted from a diagnostic procedure into an operative procedure immediately after it is decided that the problem diagnosed needs removal/excision. When that happens, several more small incisions may also be made to insert similar slender miniaturised instruments to perform a variety of surgeries. These include:

  • removal of growths such as ovarian cysts, tumours, fibroids
  • tubal ligation (surgical contraception)
  • removal of growths such as ectopic pregnancies, ovarian cysts, tumours, fibroids
  • removal of the uterus or ovaries due to endometriosis/ adenomyosis, growths, infection or cancer

Keyhole benefits

Gynaecological surgeries performed using laparoscopic techniques are benefi cial because the recovery time is shorter compared to open surgery, the risk of bleeding and pain is reduced, and scarring is much less. Microlaparoscopy is a newer approach that uses even smaller scopes. One benefi t is that this procedure can be done with local anaesthesia.

CARE AFTER KEYHOLE SURGERY

In most cases, patients are expected to go home within 24 hours. There may be two to four small incisions sutured with dissolvable stitches. The dressing is left untouched for fi ve to six days after surgery, at which point it is checked and changed. Earlier changes in dressings are only needed if the wound is oozing or in contact with clothing. There may be some abdominal or shoulder pain but this will gradually disappear.