The procedure involves a telescope measuring 5 to10mm in diameter. This telescope is inserted in the tummy through the umbilicus. This certainly helps to procure a clear picture of the reproductive organs. In this picture the uterus, tubes, ovaries and the rest of the pelvis and abdomen can be seen on the screen.
ADVANCED LAPAROSCOPIC SURGERY INCLUDES:
- Laparoscopic Myomectomy (removal of fibroids)
- Laparoscopic Adhesiolysis
- Laparoscopic Ovarian drilling (PCOD treatment)
- Laparoscopic Ovarian cystectomy (removal of fluid filled sac from the ovary)
- Laparoscopic Excision of endometriosis, including chocolate cysts
- Laparoscopic Salpingectomy (removal of tube)
- Laparoscopic Salpingolysis (Tubal fertility surgery)
- Laparoscopic Tubal recanalisation (rejoining the tube)
- Laparoscopic Hysterectomy (womb removal)
The general instructions are laid down for successful laparoscopic treatment. According to the situation the doctor will decide your situation and advise you personally:
Fitness checkups are to be done before going for an operative laparoscopic treatment. This fitness tests are done to establish the fact that you are able to cope with the after effects of the surgery.
Instructions before admission to hospital:
Fasting for 6 hours prior to the operation is necessary for effective operative procedure. If the operation is scheduled in the morning than it is suggested to skip meals since midnight and if it is scheduled in the afternoon than a light breakfast in the morning is enough to keep the stomach empty till afternoon.
Thing to bring along when getting admitted to the hospital:
It is advised to keep the jewellery and other valuables aside at home. The hospital and the staff is not responsible for any loss and theft of your valuables.
Bring along your personal clothes and items for your use.
In case it is overnight stay then keep your toothbrush, toothpaste, comb, hand towel handy for use.
The bedding will be provided by us however your relative accompanying you need to carry their pillow covers and bed sheets.
THE DAY OF OPERATION:
The day of operation is scheduled as per the diagnosis requirement and doctor availability. The day and time of operation is informed to you in advance so come to the hospital accordingly. It is requested to be seated till our hospital staff makes the further arrangement.
Once you are called by the hospital staff you are expected to change your hospital gown. After that the anaesthetist will attend for further treatment. They will insert a needle into the arms to inject the anaesthetic drugs and slowly you will go to sleep.
You can walk into the theatre. There the hospital staff is ready to help you. The hospital staff will is well attired in their caps and masks. Once you are asleep the laparoscopy procedure is done. After a while you will wake up, depending on the dose of the drug. The food is fed as per the information from the hospital staff. Once you wake up after the procedure you can go to the toilet and empathy your bladder.
The possible complications are listed below:
Laparoscopy is the operative procedure is commonly performed procedure. The possible complications can be
- Bowel Injury
- Bladder Injury
- Vessel Injury
- Situation may be created for need of Laparotomy; however there is rare chance of the complications.
Rest and relax after the procedure:
After the procedure it suggested to rest for 24 hours completely. The more you rest and early you will recover from the operative procedure. Generally it is suggested to wait for 48 hours for the recovery. The recovery period is expected to help you to feel better. In this time you can walk, eat and drink in accordance with the schedule given by the hospital staff. However if you are feeling the pain and getting chills and fever then certainly you need to connect your hospital staff immediately . They will assist accordingly. Sometimes in various accesses the recovery period extends above 48 hours and would take up to 10 days towards further healing from the operative procedure. This depends on the cases to cases and is variable.
INSTRUCTIONS AFTER DISCHARGE:
This is important part of the procedure as you need to follow the instruction strictly.
Putting pressure on the tummy should to be avoided. For first 72haours extra care should be taken to avoid any extra pressure on the stomach .Avoid heavy weight lifting and walking on the stairs and standing for long time. These actions will put extra pressure on the tummy so it is suggested to avoid them.
The diet restrictions are minimal however it is suggested to have less oily and spicy food. The easily digested food should be consumed as this helps in fast healing.
Dissolvable stitches are easy as there is no need to remove those post operative procedures. However smaller wounds left after the operation need regular dressing. Under guidance of the hospital staff only you can take bath after 72 hours of operative procedures. It is suggested to keep the wounds covered and away from sunlight.
WHEN CAN I GO TO WORK?
It is suggested to stay out of work for next 48 hours. Seven days after the operative procedure should be rest time. However if it is urgent then after 72 hours you can resume back to work.
LAPAROSCOPY DETAILS FOR LARGE FIBROIDS:
This is complex procedure which requires at least four small cuts (5mmx3 and 10mm x1) after putting the person to sleep. If the fibroids are of larger size and are significant in the picture then there is a 95% chance of removal with the key hole surgery. However in 5% of cases, there is a possibility of open surgery (8-10cm cut on the tummy). Since this operative surgery so chances of blood loss can be there and in such cases you may need blood transfusion. To avoid the operative procedure the experts can give two shots of injections (one per month) that will help to shrink the fibroid and reduce the blood supply. Zoladex injection shots can be given.
Since fine telescope (5mm) size needs to be inserted inside the body so cuts are made on the lower part of the tummy and one is inside the naval. This procedure is termed as endoscopy. It is considered safe and the complications risks are minimal. It is suggested to plan your stay in the hospital for at least 3 days stay however extra couple of days in some cases can be pre-planned. Initially discomfort can be felt during the recovery period however full recovery can be seen within a month. After the operative procedure you can leave the hospital after a week.
This procedure involves telescope in it. Herein telescope 5 mm in diameter is inserted through the cervix into the uterus. After that the screen is watched out for detailed pictures of the uterus. This is an easy procedure wherein no cuts are involved so this is safe procedure.
ADVANCED HYSTEROSCOPIC SURGERY INCLUDES:
- Hysteroscopic Polypectomy
- Hysteroscopic Myomectomy
- Hysteroscopic TCRE
- Hysteroscopic Septum removal
- Hysteroscopic Tubal canulation
- Hysteroscopic treatment for Asherman’s syndrome
Since this is an operative procedure so the fitness level of the individual is checked before the procedure. Depending on the reports of fitness the procedure is continued further.
Instructions before admission to hospital:
If the operative procedure is to be done in the morning than avoid eating right in the midnight. This will help to empty the content of the stomach. If the operative procedure is in afternoon then consume a light and easy breakfast in the morning. It is suggested to fast for at least six hours.
At the time of admission:
- At the time of the admission take care of your valuables. It is suggested to keep the jewellery and other personal belongings at your home. The hospital staff is not responsible for any loss or theft of your property.
- Bring along your clothes and item of your use along with you. In case you have to stay overnight for the operative procedure than carry your towel, toothbrush, toothpaste, comb and soap.
- Bedding will be provided for the patient. However the relative has to carry there pillow cover along with there bed sheets and blanket. However for those going on the same day of the procedure, the soap and hand towel will be given.
ON THE DAY OF OPERATION:
The day of the operation is pre-planned by your doctor. The date and time is discussed with you and then it is fixed as an appointment for that day. You are requested to come directly to the hospital on the fixed appointment with all your reports ready. On coming just inform the hospital staff and wait in the waiting area patiently till your turn comes.
Preparation before going to the theatre:
The hospital admission of the patients will be done by the hospital staff. The staff will suggest you to change and get ready for the operative procedure. Just change the clothes to theatre gown provided by the hospital. After that you will be taken to the operative room and there the anaesthetist will give the anaesthetic drug. This will give through an injectable and after some time you will go to sleep.
In the operative theatre:
In some cases the patients is able to walk in the theatre. However the tummy is sensitised to do the operative procedures. The hospital staff is present in the operative room is well equipped and addressed in proper attire with masks and caps. They are there to assist you. Once the operative procedures start you will feel asleep till the time of completion. You may wake up after shifting to the ward, that’s after the operative procedure.
Once the operative procedure is done you will be wheeled back to your bed. You will feel drowsy and sleepy due the influence of anthestic drugs. However after few hours of the operative procures you will feel fine and energetic. In some cases people are nauseate and gets throwing up feeling. However here it is important to note that you starts will your oral intake after the hospital staff permission. You can go to toilet and clear off your bladder however make sure that some on is there to help you out. Once you can tolerate the oral intake the hospital staff will check you and later on every report is analysed by the expert and than you can go back home after hospital permission.
This is commonly used operative procedure for early detection of the fibroids and other ill conditions. However certain complications can arises after procedure in some cases. Some of the possible complications are listed below:
- Bowel injury
- Bladder injury
- Vessel injury
- Possibility of Laparotomy
These are rare complication which arises in 1 in 1000 cases.
REST TO BE TAKEN:
The first 24 hours are crucial and you need to take care. You will put under observation by the hospital .lot of rest and acre is required to recover from the operative procedure. In general 48 hours is enough to get complete recovery from the procedure however this recovery period depends on case to case. After the operative procedure you would be eat and drink well. You can walk around comfortably and you can be on your own for doing things. In certain cases chills and fever come up in the recovery period however this can be taken care by the hospital staff. You need to inform them about the effects of the procedure. If chills and fever are seen in the post operative phase than it takes longer time to heal.
INSTRUCTIONS AFTER DISCHARGE:
Avoid pressure on the tummy after the procedure. For at least first 72 hours avoid heavy load of work. The strict suggestion is given to avoid weight lighting and climbing up the stairs.
In fact standing for longer time also should be avoided. There is no diet restriction however it is suggested to consume light food. Small wounds on the tummy need regular dressing and attention from the hospital staff.
So avoid bathing for first 72 hours however after that you can cover the wound and take bath but dry it immediately and keep it away from sunlight.
WHEN CAN I RESUME TO WORK?
The hospital staff suggests taking rest and relaxing for awhile. At least first 48 hours after the procedure, the advice is to stay way from work. Seven days of recovery time is advised. In case of urgency after first 72 hours individual can resume back to work with some precautions.