Laparoscopic Center-MINIMAL ACCESS SURGICAL CENTRE

Aashara Hospitals’ Laparoscopic centre. It is well equipped with state of the art technology gadgets(karl storz –germany) to offer a range of simple to advanced laparoscopic surgeries procedure simple and safe. Even the complex procedures like Laparoscopic Surgery for Myomectomy and hysterocopic septal resection and polypectomy etc are demystified with the skill and expertise of Dr. Mythily.

Dr. Mythily was trained in Paul hospital ,cochin for laporoscopic surgeries and is an expert in Laparoscopic Hysterectomy which requires great skill and expertise

Laparoscopic surgery for fertility enhancement,adhesiolysis,endometiotic cysts –chocolate cysts ,other ovarian cysts,PCOS,Lapaoroscopic sterilization –fallope rings for family planning which has least failure methods,hysterocopic septal resection,adhesiolysis,polypectomy,proximal tubal cannulation for blockedfallopian tubes.Moreover all these surgeries are done as day care surgeries. Even after major surgeries like removal of uterus and removal of fibroids laparoscopically,PATIENT CAN BE DISCHARGED THE VERY NEXT DAY.

Laparoscopy is otherwise called minimally invasive or Band-Aid surgery, where very small incisions are made.In laparocopic surgeries- Incisions may be only a few millimeters, n contrast to four to six inches for Traditional “open abdominal surgery”, which is termed as Laparotomy.

Diagnostic Laparoscopy is a type of surgical procedure that allows a doctor to visualize a woman’s internal organs in abdomen and pelvis including uterus, ovaries and a fallopian tube thru a camera port. It is often used to detect ovarian cysts, fibroids, scar tissue, and diagnose pelvic or abdominal pain, endometriosis, ectopic pregnancy or blocked fallopian tubes.

Many Laparoscopic surgeries are usually done as a day care procedure under general anaesthesia. The viewing tube (called the laparoscope) is equipped with a small camera on the eyepiece and is inserted through a small incision in the naval. The doctor can then examine the abdominal and pelvic organs on a video monitor connected to the tube. Other small incisions can be made to insert instruments to perform a variety of procedures. Laparoscopy is less invasive than regular open abdominal surgery (laparotomy).

Laparoscopy was first used by gynaecologists to diagnose and treat conditions relating to the female reproductive organs: uterus, fallopian tubes and ovaries. It is now used for a wider range of procedures, including operations that in the past required open surgery, such as removal of fibroids, cysts, uterus, tubal pregnancy and to find out the cause of Infertility. Laparoscopy can also be used to examine the appendix, gallbladder or liver.

The advantages of Total Laparoscopic Hysterectomy are

• Pain is less as the nerve fibres are not disturbed and the patient recovery is very fast
• The patient is out of the bed the same day evening and gets back home the next day.
• The chances of Vault prolapse (hernia of intestine) occurring is less and the depth of the vagina is also maintained
• Less sexual dysfunction.The patient returns to normal activities within a week and working women can get back to work within a week

LAP Recanalisation

For women who have already undergone permanent sterilization by cutting the tubes. Laparoscopic Tubal Recanalisation (Tuboplasty) can be done by joining the tubes back and the woman can still achieve pregnancy. But there are a small percentage of women developing ectopic pregnancy after tuboplasty which need to be kept in mind

Laparoscopic Ectopic Pregancy Removal

Some women develop pregnancy in the tubes and this becomes an emergency situation when the tubes rupture. Laparoscopically the tubal pregnancy can be removed where we can save the patient. If there is a delay in the surgery, the patient can lose lots of blood and it is very dangerous

Laparoscopic Pelvic Floor Repair

In women who have weak Pelvic Floor or who develop vault prolapse after open Hysterectomy. They can be treated laparoscopically by placing a mesh and by fixing the vault to the sacral promontory (bony pelvis)

LAP Myomectomy

Myomectomy is the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and for some women makes pregnancy more likely than before. Myomas (Fibroids) are one of the most common benign tumors. 25% of women over the age of 35 have myomas. Majority of myomas (Fibroids) are asymptomatic. The most common indicators for treatment are

• Menorrhagia (Heavy bleeding)
• Pelvic pain
• Pressure on adjacent organs
• Fertility
• Habitual Abortion.

Researches indicate that Laparoscopic surgery for myomectomy is the best treatment option for fibroids. Majority of these fibroids can be removed by our exclusive laparoscopic surgery for fibroid. Even in women above 40 years of age, who desire to keep their uterus – laparoscopic myomectomy surgery can be performed and uterus can be retained from removal.

Laparoscopic PCOD Drilling

Polycystic ovary syndrome (PCOS) is a health problem that can affect a woman’s menstrual cycle, ability to have children, hormones, heart, blood vessels, and appearance. With PCOS, women typically have: 1. High levels of androgens. These are sometimes called male hormones, although females also make them. 2. Missed or irregular periods. 3. Many small cysts in their ovaries and they are fluid-filled sacs. One of the ways of treating this disease is Laparoscopic Ovarian Drilling. “Ovarian drilling” is a surgery that brings on ovulation. It is done when a woman does not respond to fertility medicines. Patients of PCOD are taken up for surgery after strict pre-operative diagnostic work-ups that include ultrasound, blood test for FSH, LH, TSH, PRL and DHEAS. When a patient satisfies all the above investigation, the first line of management is diet advice, weight reduction, increase physical activity. For medical management, clomiphene citrate is used. Insulin sensitizers, metformin etc are used as basic outlay. In PCOS hyper insulinemia occurs as a result of insulin insensitivity which is treated with metformin. After a fair trial of medical management and if the patient still does not become pregnant, patients are then taken up for laparoscopic ovarian drilling. Most of the women will ovulate the very next month after PCOD drilling and are able to achieve pregnancy within 3-6 months of the surgery

Diagnostic Hystero Laparoscopy

Diagnostic Hystero laparoscopy is a small operation (Procedure) done under anesthesia ( GA ). It is a day care procedure and patients are discharged on the same day. In this operation a laparoscope is introduced into the abdomen, the uterus, tubes, ovaries, pouch of douglas and bowel is visualized. Tubal patency is confirmed by injection of dye. Small corrective operations are also done through laparoscope such as ovarian drilling, adhesiolysis excision of myomas, endometriomas, cauterisation etc. Through hysteroscope the uterine cavity is visualised. Polyps, fibroids, septum etc are diagnosed & treated. Tubal Ostia can be visualized and cornual block can be removed if needed. At the end of hysteroslaparoscopy ,the diagnosis of Infertility is definitely established and a treatment plan is made. It is better to do a hystero laparoscopy in all cases of Infertility before starting any strong treatment.

A Good Diagnostic Hysteroslaparoscopy is the golden standard for basic investigation and treatment in fertility, as it not only helps identify the cause of infertility but also provides a solution to the problem in the same sitting

Laparoscopic Cystectomy

Ovarian cyst can be removed by laparoscopic cystecomy. Before performing the procedure, the nature of the cyst is to be evaluated by doing an ultrasound of the abdomen,pelvis and blood test for CA125. During the procedure whatever is the size of cyst they can be removed laparoscopically by placing the cyst in an endobag. The patient can go home on the same day. Even huge cysts like Dermoid Cyst can be removed laparoscopically without spilling the content by placing in the Endo bag thereby saving the ovary.

Urogynaecology

The intake of beverages like Coffee, Tea, Soft drinks and fizzy drinks are reduced and we encourage you to drink at least 8-10 glasses of water. This will keep your kidneys active and the tissues healthy. If you reduce the water intake, it may make the urine more concentrated, which in turn irritates and damages the bladder.

Once we discussyour symptoms and history, you will be subjected to a urine test. Depending on the results, you may be referred for a Cystoscopy and an Ultrasound scan, in which the lining of your bladder is examined.