Why should i choose Laparoscopy?
Why should i choose laparoscopy instead of open surgery?
Most of the gynecological procedures these days are performed through the laparoscopic route (keyhole surgery). The number of open procedures has significantly decreased during the last years. There are many differences between these two techniques, the cosmetic result is one of them but not the most important one.
There is much research in this field which indicates that laparoscopy is a superior surgical method in comparison to the open surgery with safer and better post-operative results. Some of the advantages of the laparoscopic surgery are as below:
All surgical procedures ,no matter the route, cause discomfort or pain of different level in different patients. The pain a patient experiences after laparoscopic surgery is significantly less than the one she would experience in case of a laparotomy. As a result the administration of painkillers is less and the patient can return faster to her daily routine.
The evolution of technology was followed by advancement in medicine and in particular surgery. Nowadays in the laparoscopic procedures we use high definition cameras with great modification capabilities which give us the advantage to see better while operating in comparison to the classic open surgery.
One characteristic example is the surgical procedure of pelvic clearance due to Deep Infiltrative Endometriosis (DIE). In this case it is of great importance to spare specific nerves which are responsible for the function of the bladder and also for sexual arousal.
Laparoscopy enables us to find these very little nerves and protect them during the operation. This would be highly unlikely to happen if the operation was performed through the open approach.
Formation of adhesions inside the abdomen is a fact regardless of surgical technique (laparoscopy or laparotomy). Nevertheless it is also a fact that after open procedures adhesion formation is more extensive than in case of laparoscopy. Direct contact of inside organs and tissue with the air is known to be a causative agent for adhesions to grow.
In laparoscopy there is virtually no contact of tissues (which lie inside the abdomen) with the air and as a result there is a kind of protection against thick adhesions. Prevention of adhesion formation is of major importance as sometimes these can cause a lot of pain and lead the patient back to theatre.
There are also cases where adhesions can displace organs from their normal position.They can also interfere with normal fallopian tube’s course causing obstruction and infertility.
The help of high definition cameras during the laparoscopic surgery is of great importance. The previous along with the very fine instruments used in laparoscopy enables the surgeon to access parts of the pelvis where it would be impossible to work with his hands and be guided by his naked eye. Identification and dissection of nerves ,small vessels and other anatomical structures is a basic advantage of laparoscopic surgery. As a result the complication rate is less in laparoscopy than in laparotomy (open surgery).
In contrast to open surgery where the incision is big and extremely painful after the operation, in laparoscopy incisions are extremely small. Usually three or four small cuts of 0,5-1 cm are sufficient even for the most challenging case to be performed.
The cosmetic result is much better and these tiny cuts need less post operative care as there is minimal chance of them getting infected. This is not valid when the procedure is performed through the open route where the incisions are bigger and of course they need a lot of care.
