Department of Laparoscopy & Hysteroscopy

LAVH – Laparoscopic assisted Vaginal Hysterectomy
TLH Total Laparoscopic Hysterectomy

Removal of the uterus can be done by two types-

• LAVH – Both cornua are cauterized by the help of a laparoscope. Rest method is used of Vaginal Hysterectomy.

• TLH – Uterus is removed totally by laparoscopy. Uterus is delivered through vagina.

Myomectomy

Uterine fibroid is one of the causes of menorrhagia. Even fibroids of bigger sizes can be removed by laparoscopy operation. Morcellator is used for big sized fibroids – it peels the fibroid and makes small pieces to bring out from port.

Ectopic Pregnancy

Ectopic pregnancy means implantation, which occurs outside uterus. Generally tubal ectopic is seen, wherein products are removed from the tube, if it is not ruptured. Part of the tube or whole is removed in case of ruptured ectopic.

Tubectomy (TL) –

TL reversal

This is a laparoscopic microsurgery where the tubes are recanalized. The old TL’s site is cut and healthy tissue – tubes are re-anastomosed using 6-0 prolene. The chances of success depend upon remaining length of healthy tube.

TCRE

Trans Cervical Resection of Endometrium – Resectoscope and loop is inserted in the uterine cavity through cervix, to remove the endometrium from its root. It is opted in case of menorrhagia, to avoid removal of uterus. Menstrual bleeding reduces to minimum or only spotting. 90% patients recover by this method. The benefit is no scar on abdomen.

Suspension operation for prolapsed

Prolepses of uterus also effects bladder and rectum. It is repaired by laparoscopy method.

Stress Urinary Incontinence (S.U.I.)

Urine incontinence is corrected by laparoscopy method.

Adhesiolysis

If uterus, fallopian tubes and ovaries are stuck with other organs, it can be separated by blunt / sharp dissection.

Operation for endometriosis and endometrioma

Growth of ectopic endometrial tissues outside the uterus is called endometriosis. This is a progressive disease. It is cauterized by cautery endometriosis, cyst wall is tried to be removed and if not possible it is also cauterized with bipolar cautery.

Ovarian cyst removal

Ovarian cyst wall is removed to prevent recurrence.

PCO drilling

A special needle is used for drilling on ovary, when pt. is suffering from polycystic ovarian disease. Tubal Patency – Patency of the tubes can be confirmed by injecting methylene blue dye through the cervical canal, and spill of the same through the fimbria being visualized through the laparoscope.

Myomectomy

Uterine fibroid, of even bigger size, can be removed by laparoscopy operation. Morcellator is used for big size fibroid – it peels the fibroid and makes small pieces to bring out from the port.

Adenomyoma removal

Adenomyoma is removed by laparoscopic myomectomy, but it is quite difficult because adenomyoma is encapsulated and dissected by sharp dissection.

Salpingiolysis – Hydrosalpinx

Inflammation of distal end of fallopian tubes is called hydrosalpinx. Debris is removed from the tube and is repaired.

Septal resection

Resectoscope is used to cut intrauterine septum.

Lateral Metroplasty

It is performed in ‘T’ shaped uterine cavity, which is the cause of infertility or abortion. Intrauterine walls are cut with resectoscope to get enough space.

Adhesiolysis for Asherman’s Syndrome

This condition usually is the result of curettage following pregnancy, resulting in intrauterine scarification. Adhesions may be partial or complete and can also occur following uterine surgery. These patients can present with amenorrhea, hypo menorrhea, dysmenorrhea, abortions. It is called Asherman‟s Syndrome. Adhesions are removed with the help of hysteroscopy.

Polypectomy

Intrauterine polyp can be removed.

Submucous myomectomy

Resectoscope is introduced through hysteroscopy and fibroid is peeled with the help of loop.

Cornual Cannulation

Cornua is the opening of fallopian tubes in uterine cavity. Malleable catheter is introduced through hysteroscopy in the blocked cornua to open it.

Foreign body removal

Sometimes remaining bones of the foetus from a previous abortion or displaced IUD is found in the uterine cavity. This foreign body is removed under guidance of hysteroscopy.

The service is well-supported by the most modern operating instruments and state-of-the-art operation theaters. The equipment’s are kept updated with the advent of new technologies.