Endoscopy

Laparoscopy is normally performed under a general anaesthesia in the operating theatre. Instruments may be inserted into the vagina to assist in the procedure. A small cut is made in your belly button. The abdomen is inflated with gas and a laparoscope is inserted to look at the internal organs. Further small cuts may be made in your abdomen if any abnormalities require treatment. After the procedure, the instruments are removed, the gas released and the cuts are then closed with dissolving stitches. The procedure itself takes approximately thirty minutes or more, but you can expect to be in theatre and recovery for a number of hours. You will be discharged on the same day but may need overnight stay for few operations.

You should be aware that every surgical procedure has some risk although the risks associated with laparoscopy are minimal.

There are some specific risks to be aware of in relation to this operation:

The procedure may not be able to be completed laparoscopically, and you may require a laparotomy (an open operation with a larger cut) and an increased hospital stay.

Deep bleeding may occur inside the abdomen. This may need fluid replacement, blood transfusion or further surgery. It may also mean a longer stay in hospital and a longer recovery time.

Damage to other organs, such as bladder or bowel, which may need further surgery. This may mean a longer stay in hospital and a longer recovery time.

In rare cases the gas, which is passed into the abdomen, causes heart and chest complications.

Infected fluid may collect in the abdominal cavity. This may need surgical drainage and antibiotics.

Adhesions (bands of scar tissue) may form, usually only after major or multiple surgeries, and cause a bowel obstruction. This can be a short or long term complication and may need further surgery.

For some people, healing of the wound may be abnormal and the wound can be thickened and red. The scar may be painful.

A weakness in the wound may develop into a hernia. This may need further surgery.

There is a possibility this procedure may not find the reason for the symptoms you have been experiencing.

There are some general risks inherent to all operations - Small areas of the lungs may collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy. Clots may form in the legs leading to pain and swelling. In rare cases part of this clot may break off and go to the lungs which can be fatal. You may suffer a heart attack or stroke because of strain on the heart. Death is an extremely rare possibility for anyone undergoing an operation. Some women are at an increased risk of complications: Women who are very overweight have an increased risk of wound infection, chest infection, heart and lung complications and blood clots. Smokers have an increased risk of wound and chest infections, heart and lung complications and blood clots.

It is important that you have all the tests, which we have ordered along with fitness by physician doctor, prior to coming to hospital. If you are taking any blood thinning medications they may need to be stopped prior to surgery. It is necessary that you have nothing to eat or at least six hours before your operation. It is important for you to shower and dress into clean clothes prior to coming into hospital. Please follow instructions and medicine prescriptions given by us.

You will stay in the recovery room within the theatre suite after the operation while you wake up from anaesthesia. You will then be transferred in your bed to the Day Procedure Unit. During your recovery nurse will take frequent observations of your vital signs (e.g. temperature, pulse, blood pressure) for several hours after the surgery. As you become fully recovered, these observations become less frequent but remain regular until you leave hospital later the same day. It is common to feel drowsy, have some abdominal discomfort or bloating, some mild nausea and experience pain on the tip of your shoulder (related to the gas used in the procedure). These symptoms can last from a few hours up to a few days following the operations. You will be provided with pain relief as needed. Doctor will discuss your follow-up appointment and any discharge arrangements that have been made with you. You should be eating and drinking normally, and be mobilizing. You have to follow discharge advice strictly.

Laparoscopy has many benefits.

There is less pain after laparoscopic surgery than after open abdominal surgery, which involves larger incisions, longer hospital stays, and longer recovery times. Recovery from laparoscopic surgery generally is faster than recovery from open abdominal surgery. The smaller incisions that are used allow you to heal faster and have smaller scars. The risk of infection also is lower than with open surgery.

The 3D view provides depth perception and correct measurement of the dimensions of the anatomical spaces contributing to increasing the skills of the laparoscopic surgeon to turn tissues, dissect, design surgical strategies and perform intracorporeal sutures.

1. Depth perception
2. Tactile feedback retained
3. Accuracy
4. Safety
5. Surgical precision
6. Improves hand–eye coordination
7. 3D laparoscopy is now better than 2D laparoscopy.

• Significantly less pain
• Less blood loss
• Fewer complications
• Less scarring
• A shorter hospital stay
• A faster return to normal daily activities

Compared to conventional laparoscopic surgery, robotic assistance minimizes conversions as well as the need for total abdominal hysterectomy. The excellent visualization (3D HD vision), dexterity (Endowrist instrumentation) and control (intuitive motion) provide surgeons with a surgical option to approach pathology minimally invasively, safely, reproducibly & even in high risk patients with adhesive disease, obesity. Robotic surgical instruments are designed with 7 degrees of freedom. The end points of those instruments can rotate around themselves with 540 degrees of motion and mimic the dexterity of human wrist. However, those instruments are smaller ingn human hands which allow them to reach points where human hands cannot.

• Benign hysterectomies (fibroids, AUB)
• Surgeries for prolapse, SUI (sacrocolpopexy, hysteropexy, burch colposuspension)
• Endometriosis, fibroids removal (myomectomy)
• Gynaecological cancers (ca cervix, ca endometrium, ca ovary)
• Tubal microsurgeries (tubotubal anastomosis, fimbrioplasty)