LAPAROSCOPY

Laparoscopy is the gold standard method is when performing a diagnostic operation. Diagnostic laparoscopy is used for the investigation of chronic pelvic pain and infertility. It is a minimal invasive procedure with the use of one only umbilical port that allows to visualize the lower pelvis in a great extent. Also with the introduction of more than one ports and the use of the proper instruments and technique to treat the problem that is discovered.( FIGURES) (YOUTUBE LINK) During Diagnostic laproscopy, Uterine shape & mobility, Fallopian tube shape & patency, Tubo ovarian relation, Ovarian shape, endometriotic shape, if any, Pouch of Douglas, etc are properly examined.

Tubal ligation is a popular and reliable method of contraception for women usually over 30 years old who have completed their family (FIGURE ). The procedure can be executed by creating either one single umbilical port hole, if using an operative laparoscope, or usually by creating two port holes.

Among gynecological disorders, endometriosis is second only after uterine myomas in frequency, and accounts for 25% of all laparotomies performed by gynecologists. Endometriosis seems to be responsible for most pathological cases of chronic pelvic pain and also for the highest percentage of cases who are referred with primary and secondary infertility[9]. Laparoscopy holds a special place in the diagnosis of this problem as it is the gold standard diagnostic test in clinical practice for the accurate diagnosis of endometriosis. ( FIGURE) LINK

Incidence of PCO is increasing day by day. Laproscopy is very useful tool for treat patients of PCO by Ovarian drilling. At Pooja Hospital we do procedure on day care bases. It increases chances of Pregnancy. (FIGURE) LINK

Hysterectomy is the commonest surgical operation in non-pregnant women. Laparoscopy was firstly performed in order to assist vaginal hysterectomy. Laparoscopic assisted vaginal hysterectomy (LAVH) increases the visualization of the upper pelvis and allows difficult operations to be performed, where extended adhesions or large ovaries consist. That is followed by TOTAL LAPAROSCOPIC HYSTERECTOMY (TLH), in which complete hysterectomy is done by Laproscopy only. It requires lots of laparoscopic skills. At POOJA HOSPITAL, TLH serves our patients byshorter hospital stay. Lesser blood loss, early mobilisation and fewer complications. We have experience of years for dealing many complicated TLHs.FIGURE-LINK

Uterine fibroids required to be removed when it is obstructing fertility or causing menorrhagia.Laparoscopic myomectomy constitutes a satisfying solution especially for women who wish to maintain fertility potential. The technique looks similar to laparotomy and is used in cases of myomas larger than 5 cm. Pedunculated uterine myomata usually are removed safely with either electrosurgery or harmonic scalpel. The removal of subserosal and intramural fibroids seem to be more challenging and requires surgical skills. The uterine incision is performed with electrosurgery and the myoma capsule is dissected in its entirety. At POOJA HOSPITAL we use advance Electrosurgery, morcellation and sharp dissection for successful laparoscopic myomectomy. The myometrium should be closed with 0 or 2-0 absorbable suture and the serosa with 4-0 suture. At POOJA HOSPITAL (FIGURE) LINK

In recent years, minimally invasive laparoscopic surgery has changed the therapeutic management of adnexal masses to such an extent, that it can be considered the standard therapeutic option.
1. Functional Ovarian Cysts: Follicular Cysts, Corpus luteum Cysts
2. Epithelial Cysts: Serous Cysts, Mucinous Cysts, Endometriomas
3. Germinal Cysts: Dermoid Cysts, Ovarian Struma
4. Inclusion Cysts: Parovarian, Tubal Cysts,
5. Inflammatory Cysts: Pyosalpinx, Hydrosalpinx, Tubo-Ovarian Abscess (TOA), Ovarian torsion.
.6. Solid Ovarian Masses: Ovarian Fibroma, Benign Brenner Tumor
For treatment of these adnexal masses, Laparoscopic Aspitation( LINK), Cystectomy( LINK), Oophorectomy( LINK), Adnexectomy( LINK) At POOJA HOSPITAL, ENDO BAG is used for adnexal masses..

In the case of ectopic pregnancy, Laaprosocpy is widely used by salpingostomy or salpingectomy. Salpingostomy is done by creating a linear incision on the dilated part of the fallopian tube and then using forceps to remove the ectopic pregnancy tissue. The fallopian tube does not need to be closed afterwards. In some occasions the fallopian tube is totally removed ( salpingectomy) in order to exclude the ectopic pregnancy.It is important to use and irrigation-aspiration system to remove as much blood as possible from the peritoneal cavity in order to avoid adhesions and pain post op. Haemostasis should be properly checked. ( FIGURE) LINK.