Whenever the surgery that is considered can be performed equally well and equally safely by either laparoscopy or laparotomy, the decision as to the type of incision to be used can (and in my opinion really should) include the patient.
Laparoscopy and Hysteroscopy
Questions on Laparoscopy & Hysteroscopy
Many gynecologists will remove laparoscopically ovaries/ovarian cysts and treat ectopic pregnancies as well as endometriosis. Hysterectomies, bladder suspension surgeries and pelvic floor repair can also be treated by laparoscopy but these procedures are more advanced and may require additional training.
Laparoscopy is a form of minimally invasive surgery. The surgeon inserts a tiny telescope (laparascope) though a small incision at the umbilicus (belly-button). The laparoscope allows the surgeon to visualize the pelvic organs on a video monitor. Several additional smaller incisions are made in the abdomen for the surgeon to place specially designed surgical instruments, which help the surgeon carry out the same procedure as in open surgery.
Laparoscopy, looking inside the abdomen through a tube placed through a small incision, is a procedure commonly used by gynecologists to diagnose and treat a number of medical conditions. Since the early 1900's when rudimentary laparoscopes were used to visualize, but not treat, abdominal diseases, advancements in this technique have led to the ability to perform complex surgical procedures through a few small incisions, rather than the larger incisions used in the past.
Fibroids that are attached to the outside of the uterus by a stalk (pedunculated myomas) are the easiest to remove laparoscopically. Many subserous myomas (close to the outer surface) can also be removed through the laparoscope.
Hysteroscopy is a form of minimally invasive surgery. The surgeon inserts a tiny telescope (hysteroscope) through the cervix into the uterus. The hysteroscope allows the surgeon to visualize the inside of the uterine cavity on a video monitor. The uterine cavity is then inspected for any abnormality. The surgeon examines the shape of the uterus, the lining of the uterus and looks for any evidence of intrauterine pathology (fibroids or polyps). The surgeon also attempts to visualize the openings to the fallopian tubes (tubal ostia).
Hysteroscopy uses a hysteroscope, which is a thin telescope that is inserted through the cervix into the uterus. Modern hysteroscopes are so thin that they can fit through the cervix with minimal or no dilation.
Hysteroscopy is a gynecologic procedure that involves placing a small tube with a camera on one end and a light on the other into the uterus to tell if there are problems within the uterine cavity. This procedure has developed over the years to become one of the more common and useful gynecologic tools. The tube, called a hysteroscope (say “hyst-er-oh-scope”), is about as big around as one’s little finger, and is slipped into the uterus after slowly dilating the cervix. Once inside the uterus a gynecologist can diagnose a number of problems and can often treat them during the same procedure.
Over the past decade, a technique has been developed that can reduce or stop your periods without a hysterectomy. This surgery can be done in women who have flooding either with or without fibroid tumors. Dr. Dott was one of the surgeons who introduced this minimally invasive procedure in Atlanta. He has performed this procedure many times and is certified by the Accreditation Council for Gynecological Endoscopy in Advanced Hysteroscopic Surgery. He has taught this procedure in training institutions both in the United States and Russia.