Laparoscopy is usually performed through a small (1 centimeter) incision into
the belly button with the patient under general anesthesia in the operating room. A camera is mounted to a long tube
about as big around as one's first finger, which is placed into the incision in the belly button and into the abdominal cavity. Once
inside carbon dioxide gas is used to expand the abdominal cavity so the internal organs can be visualized. The gynecologist either looks
through the tube, or, more commonly, looks at a video monitor via the attached camera.
A careful survey is made of the liver,
appendix, and the top layer of intestines, bladder, kidney tubes (uterus), and the gynecologic organs. Specifically, the
gynecologic surgeon is able to fully visualize the uterus (womb), ovaries, fallopian tubes, rectum, and the bottom part of the cervix
(the opening to the uterus) called the cul-de-sac. As one might imagine, this technique allows gynecologists to diagnose a large variety of
important medical conditions.
Gynecologists use laparoscopy to treat a variety of female health problems. General surgeons also now use laparoscopy to perform surgeries
such as appendectomies and removal of the gall bladder (cholecystectomy). Indications for gynecologic laparoscopy include the following:
Tubal ligation (tying tubes).
Tubal (ectopic) pregnancies.
Pelvic inflammatory disease.
Repairing damaged fallopian tubes.
Lysis of adhesions (removing scar tissue).
Laparoscopic assisted vaginal hysterectomy.
Removal of ovarian cysts or the entire ovary. (watch video under “ case gallery”).
Evaluation and removal of pelvic lymph nodes.
Diagnosis and treatment of some uterine anomalies.
Destroying or removing some uterine fibroid tumors.
After laparoscopy most patients go home that evening with a prescription for pain medications and advise to "take it easy" for about
a week. Each patient will heal differently.
In summary, laparoscopy is a wonderful tool for performing gynecologic surgery. Yet, despite the complexity of the surgery,
most women go home without difficulty the same day. Whether or not laparoscopic surgery is advisable to diagnose or treat a particular gynecologic
problem requires a careful consultation with an experienced gynecologist, who can help the patient weigh the pros and cons of laparoscopy versus other options.
Instructions before Laparoscopic Surgeries
Because you have been scheduled for ambulatory-or out patient surgery/Day Care Surgery, you are responsible for taking certain precautions before you arrive. Specially….
You must not have anything to eat or drink after midnight/10 pm on the night before you arrive at the hospital.
You have to eat light diet on the previous day evening
In some major laproscopy surgeries you have to take Pegelac powder with one litre of water in the early morning on date_____ on the day of surgery. I.e. six hours prior to surgery.
Do not take any aspirin or other anti-inflammatory medicine for 10 days before surgery or you must tell to your doctors about all medicines that you are taking. Occasionally these drugs can interfere with the blood’s ability to clot & can actually increase the amount of bleeding during and after surgery.
If you are on any medications- including over the counter drugs- be sure to ask your doctor whether or not you can continue taking that medication and if not, how far in advance of surgery you should stop.
Finally, you must also arrange for transportation to and from the place you are arriving and our Hospital Different patients reacts differently to even simple surgical procedure and there is no way you can predict how you will be feeling after the procedure .So don’t forget, following surgery, you will not be allowed to drive.
Remember; don’t hesitate to ask any questions about any of the information that they’ve just provided. Mention all about all the drugs for which you have noticed drug
reaction in the past.
You must have to come on_____time on date _____at hospital.
Brief about surgery:
On the day of your operation, you will be asked to put on a surgical gown. You relatives should remain present for the consent for the operation.
An intravenous line may be put in.
You will then be transferred to the operating table.
Your doctor will scrub thoroughly & will apply an antiseptic solution to the skin around the area where the incision will be made & place a sterile drape around the operative site.
The anaesthetist will begin to administer anaesthesia –most probably general anaesthesia.
After a few minutes of anaesthesia, a small incision is made in the umbilicus.
Then a hollow needle will be inserted through the abdominal wall, and the abdomen will be inflated with carbon dioxide. An umbilical port is created for the laproscope.
Doctor visualizes the internal picture on special medical Monitor (T.V.). One or more incisions will be made, with care taken to keep the openings as small as possible. During
the procedure, the surgeon will use the laproscope to find and identify the areas of your inside body of interest as well as to guide any other instruments required for the completion
of the procedure. The whole surgical procedure is recorded in computer for offering DVD to all patients. Then the instruments are withdrawn, the carbon dioxide is allowed to escape. Most
of the times no need to take any stitch at umbilical port. Sometimes stitch is necessary to take on other incisions. Finally one or more sterile dressings are applied.
Brief about procedure:
On the day of your operation, you will be asked to put on a surgical gown. You must have to give consent for operation. An intravenous line may be put in. Patient is
then transferred to operating table. Your doctor will scrub thoroughly & apply an anti-septic solution to the skin around the vulva. And place a sterile drape around the
operative site. The anaesthetist will begin to administer anaesthesia-most probably general anaesthesia. After that vagina is cleaned with anti-septic solution. Then surgeon
will insert a Hysteroscope in endometrial canal through vagina and cervical canal. After visualization of cavity if it is normal then doctor will withdrawn the hysteroscope.
Dr. Jigishaben & Dr. Krishnaben will explain in detail about pre-operative counseling and your all quarries as follows:
For Cashless services/ For Medi-claim Facilities
Please bring First Consultation paper, USG Report and Xerox copy of last two years Insurance policy OR TPA I.D.card.
Patient has to sign for pre-hospitalization Request form to their TPA for cashless approval letter 24 hours prior to proposed date of surgery for
availing cashless services from our hospital.
Prior Check Up reports :
Previous counseling papers, USG reports, Check Up reports, Laboratory Investigations (Investigations for major/minor operation –Includes : Blood & Urine complete ; Platelet count ; APTT ; Bl.Urea ; Bl.Sugar/FBS&PPBS ; S.electrolyte(S.Na) ; HbSAg ; HIV) ; Special investigations for patient with Medical disorder, T.B. & Infertility.
Drug reaction report or previous surgery/medical reports/ anesthesia records
Previous Consultant’s reference letter :
Complete letter with all investigations and USG reports
Pre-operative work up :
Physian’s pre-operative check up report(If the age is more than 35yrs)
Bowel preparation : For Minor Surgery : Nil by mouth from previous day 10 p.m. ; For Major Surgery : liquid diet for two days, peg lag (1 sachet r dissolved in liter of drinking water and taken either on previous evening or six hours prior to operation till clear stool passed indicate good bowel preparation.
Most of the Laparoscopic/Hysteroscopic surgeries are done from 4th to 10th day of Menstrual cycle(The day she gets her period is considered as her first day of menstrual cycle)
Examination before operation is advised to rule out lower genital infection by doctor.
Blood/PCV should be arranged on previous day if Hb is less.
In doubtful cases second opinion with Color Doppler/CT scanning/MRI should have been done before operation to avoid unknown surprise during operation.
Shaving of local parts and preparation before operation
Instructions after Laparoscopy Surgeries
After Laparoscopy :
Heaviness in abdomen
Mild pain at operative site or in lower abdomen
Mild right shoulder pain due to the body’s reaction to the carbon dioxide used to inflate the abdomen & it will clear up in a matter of
a few days
As Laparoscopy / Hysteroscopy done under anesthesia :
Feeling sensations like mild vomiting and giddiness, smell of medicines in breath
Uneasiness in throat or rubbing sensation in throat (Dryness of mouth)
This entire problems are for a one/two days only, after that patient will feel better
Advise for stitch / dressing
Normally laparoscope is inserted in abdomen through umbilicus by a small incision.
To examine all intraabdomaninal organs or for doing surgeries we put 1, 2 or 3 other small 3 or 5mm incisions.
There is no need to take stitch on incision but sometimes we have take stitch for 5mm incision, so you have to ask to sister or doctor whether stitch is their or not.
These stitch/stitches to be removed after 6 to 8 days.
For stitch removal you can come at “Bavishi Fertility Hospital” or you can go any other hospitals. After removing a stitch keeps Band-Aid dressing for 1 day. And after
2 days remove dressing by yourself and you can take bath.
You can take bath after applying polythin on dressing. In case dressing becomes wet you should remove dressing from site and clean and dry and then put fresh Band-Aid dressing on
You will be responsible for keeping the dressing intact & clean. You should be alert for signs of infection near the incision-i.e. increased swelling, redness,
bleeding or other discharge. If you experience any of such unusual symptoms, you should report them to your doctor right way.
You may also notice some bruising in the general area of incisions. The discoloration may be extensive, but as with any bruise it should heal on its own.
Advice for Diet
2 hours after surgery, you can take sips of water, and than 1 cup of ice cream or cold milk shakes.
After 4 hours, you can take light diet like all types of liquids, dal-rice, Khichdi, Kadhi, fruits, khakhra, mamra etc.
On second day onwards all foods (Normal diet) like dal-rice, chapatti, subjies etc can be taken.
It is better to not to take more spicy, fried or sour and not heavy in digest food for 5 days.
You can take curd, butter milk, tomatos or lemon etc.
For daily activities :
You can do your regular work from the next day
You can do your job/work after one day except heavy work.
You can do intercourse when mild bleeding like discharge stops.
Before going to home :
Take your file and understand medicines.
Take your DVD and reports. If you have not understood, you can ask to any Doctor/nurse.
Understand for next visits or follow up
Take your entire thing with you without missing anything.
► Follow-up on DT __________on __________day /or during 2nd to 5th day of menstrual period with appointment.
Warning signals :
If there is excessive pain, excessive bleeding p/v, weakness or any serious complaint forever etc problem then come immediately to us.