With the advent of refined laparoscopic instruments, it is possible to treat numerous operable gynaecological conditions. With laparoscopic access, we can operate even more complicated cases like severe endometriosis, cancers etc.
The common diseases which can be treated with laparoscopic surgery are following :
- Uterine Bleeding: An abnormal form of bleeding from the vagina is medically defined as “AUB / DUB (Abnormal /Dysfunctional Uterine Bleeding)”. The bleeding problem which is not responding to medicinal treatment can be dealt with Laparoscopy. Abnormal / Dysfunctional Uterine bleeding is due to an abnormality in the endometrium of the uterus which usually responds to medicinal treatment. In cases where medicine is not able to control the symptoms, uterus, along with both fallopian tubes +/- ovaries, can be removed laparoscopically. In another treatment modality, the endometrium (inside lining of uterine cavity) can be ablated to reduce the troublesome bleeding. The latter procedure is done by hysteroscopy.
- Fibroid Uterus: Fibroids are commonly found in the uterus. Most of the time they are diagnosed on ultrasound. Fibroids can cause a problem in the form of abnormal bleeding (heavy menstrual flow, irregular menstrual bleeding pattern), painful periods (dysmenorrhea), recurrent miscarriage/abortion, infertility etc. Uterine fibroids usually need surgical removal and can be removed laparoscopically as well as hysteroscopically. Any size of the fibroid can be removed with the laparoscopic approach.
- Ovarian Cysts: Ovarian cysts are also common finding on ultrasound. Ovarian cysts which persist for longer times, suspicious of cancer, symptomatic (e.g pain abdomen) can be removed laparoscopically.
- Endometriosis: Endometriosis can present as ovarian endometrioma (Ovarian cyst or chocolate cyst), endometriosis implants in the pelvis, Adhesions in the pelvis (involving uterus, fallopian tubes, ovaries, intestinal loops, rectum etc) or a cause of infertility. All these entities can be treated laparoscopically.
- Uterus Prolapse/ Vault Prolapse/ Pelvic Organ Prolapse: Uterus prolapse into the vagina, vaginal vault prolapsing into the vagina after hysterectomy can be treated with laparoscopic surgery.
- Uterine cancer, Uterine cervix cancer: Cancers of the uterus, uterine cervix, ovarian cancers after chemotherapy can be treated with laparoscopic surgery in which tumorous tissue can be removed with more precision.
- Ectopic pregnancy: Extrauterine pregnancy e.g. pregnancy in fallopian tube (tubal pregnancy), pregnancy in ovaries (ovarian pregnancy), pregnancy in cervix (cervical pregnancy) can be treated with laparoscopic approach, as per the indications.
- Ovarian torsion: Due to numerous factors, ovarian tissue twists around its own axis which leads to compromise in its blood supply ultimately leading to infarction of ovarian tissue. Laparoscopically ovaries can be untwisted and fixed to prevent further twisting.
- Recurrent miscarriage with incompetent cervix: With the incompetent cervix, there are chances of recurrent miscarriage. Few cases of incompetent cervix need cerclage from abdomen which can be performed through a laparoscopic approach.
- Blocked fallopian tubes: Fallopian tubes might get blocked due to infections, adhesion or pressure from the mass. In few cases, there is a requirement of tubal reconstruction in cases of tubal sterilization. All these fallopian tube blocks can be opened with laparoscopic surgery and hysteroscopically.