The word Laparoscopy is Greek and means abdominal overview. It is essentially a surgical technique that has been used for over 30 years in many medical specialties, such as gynaecology, general surgery and urology.
This procedure involves 3 or 4 small incisions in the abdomen, measuring 0.5-1 cm, and inserting a video camera and surgical instruments. The two surgeons performing the operation look at high-resolution screens and operate virtually outside the patient’s abdomen.
The large spread of laparoscopy is mainly due to the enormous development of biotechnology both in the field of optical fibers and the tools used during surgery. With modern camcorders and screens, the image from the inside of the abdomen is excellent and the magnification can be 10 times larger than the naked eye, making the smallest details visible. This allows very fine-grained manipulations to be performed precisely, resulting in as little traumatic surfaces as possible, less bleeding and therefore better surgical outcome. In addition, our technology now provides safe and effective laparoscopic surgical tools, such as lasers, ultrasound sections, staples, etc., that allow surgeons to laparoscopically perform all the procedures performed with the classical “open” method.
The advantages of laparoscopy are many and derive from the very nature of the technique. Avoiding a classic cut on the skin, post-operative pain is significantly less, recovery faster and therefore hospital stay much shorter. In the vast majority of interventions, the patient returns home on the same day or the next morning and can usually return to work and daily activities, including fitness, within 7-10 days. Because the incisions are very small and stitched with plastic, the aesthetic effect is excellent and usually the scars are not visible after a few months.
Another major advantage of laparoscopy is that it minimizes the possibility of complications that may cause fertility disorders. In particular, the risk of postoperative adhesions is significantly reduced. Adhesions are small or large scars that are created inside the abdomen after surgery. Adhesions cause the abdominal organs to stick together, disrupting their normal anatomy and severely restricting their mobility. This results in various complications, such as bowel obstruction, fallopian tube obstruction, chronic pelvic pain, difficulty performing future operations, etc. Because laparoscopic manipulations are very fine and precise, the damaged surface area and blood loss are significantly smaller and postoperative adhesions are significantly reduced. Increasingly, studies by large laparoscopic centers confirm a significant reduction in adhesions, a decrease that although not immediately visible to the patient, however, is one of the major advantages of laparoscopic technique.
Laparoscopy, like most abdominal surgeries, needs some preparation for bowel cleansing. Essentially avoid legumes, fruits, vegetables, and dairy for 2-3 days before surgery, and a watery diet and a laxative at noon are recommended the day before.
Laparoscopic procedures are always performed with general anesthesia, as the use of epidural anesthesia is not possible. All gynecological procedures are now performed laparoscopically. Removing ovarian cysts, fibroid removal, total and subtotal hysterectomy are now routine procedures in laparoscopic surgical centers. In addition, surgical treatment of endometriosis should only be performed laparoscopically, due to the significantly better results of this procedure, both in improving the symptoms of endometriosis (pain) and in improving the fertility of women with endometriosis. With regard to gynecological cancer, more and more oncological surgeries are performed laparoscopically, with excellent results in survival rates. Especially lymph node cleansing of the pelvis and abdomen is becoming increasingly laparoscopic, due to the much better visibility offered by the cameras than the naked eye.
A contraindication to laparoscopic surgery is mainly the ability of the laparoscopic surgeon to perform this operation. Because learning about laparoscopic surgery is extremely demanding and time consuming, the limits and possibilities of surgery vary greatly from doctor to doctor.
Specialized laparoscopes can now handle most of the gynecological procedures that used to be “contraindicated”, such as removal of large fibroids, multiple pelvic adhesions, surgery in obese patients, etc.
The safety of laparoscopic surgeries is now excellent and readily comparable to that of open surgeries. This coupled with the clear advantages of the method in terms of recovery and the aesthetic effect have led to a wide spread of laparoscopy in recent years. It is up to each physician to analyze the choices a woman has, who is going to have to undergo surgery, giving her the right t
