Laparoscopy

Operative Laparoscopy:

We have a dedicated hi-tech operation theater for endoscopy, located on the 4th Floor of the hospital. The operation theater is equipped with sophisticated instruments with advanced technologies.

Laparoscopically assisted vaginal hysterectomy (L.A.V.H)

In this method dual approach is adapted for uterine removal. Upper part of the uterus, fallopian tubes and ovaries are freed through laparoscope and lower part is approached through vagina accomplishing removal from below down. This sometimes is helped for correction of vaginal wall laxity i.e cystocele and rectocele repair.

T.L.H.(Total Laproscopic Hysterectomy)

This is a removal of uterus through laparoscope. Uterus is released from its attachments with the help of cautery and scissors and once it is freed the specimen is delivered through vagina. This may include even removal of both fallopian tubes and ovaries.

Endometriosis

There are mild to severe staging of endometriosis, which can be diagnosed, staged and treated Laparoscopically depending on stages by simple fulguration to adhesiolysis to removal of endometriotic lesions through Laparoscope.

T.O. Mass(Tubo Ovarian Mass Removal)

Chronic inflammatory tubo ovarian masses can be removed through laparoscope encouraging speedy recovery.

Pregnancy ( Pregnancy outside the uterine cavity)

This life threatening condition of abnormal pregnancy location can be diagnosed precisely by laparoscopy and treated simultaneously with excellent result.

Myomectomy

Small to huge an multiple leiomyomas can be removed safely with the use of morcellator and fertility conditions may be regained.

Adhesiolysis

Sometimes pelvic inflammation of specific [tuberculosis mainly] and non specific type leads to lots of adhesions. This can be treated efficiently relieving clinical symptomatology and re-establishing fertility status.

PCOD Drilling

Almost 30 % women face problem of PCOD. Before starting advanced infertility treatment like IVF - ICSI it always advisable to get salpingo-hystero-laparoscopy done which will give complete in depths knowledge of genital track. When a patient is having polycystic ovarian problem simultaneously ovarian drilling can be performed. This can be done with simple mechanical drilling, electro cautery drilling or laser drilling. This may have many advantages...

• Improved endocrine profiles
• Spontaneous ovulation
• Reduction in gonadotropin doses for ovulation induction and hence reduction in cost of further stimulated cycles
• Improvement in pregnancy rates
• Reduction in multiple pregnancy rates
• Reduction in first trimester abortions
• Reduction in ovarian hyperstimulation.

Drilling may lead to

• Possibility of adhesion formation [reduced with instillation of plenty of fluids after the procedure]
• Possible compromise to ovarian function and menopause at an earlier age but this is not confirmed
• Surgical and anaesthesia risk as with any surgical procedure.

Ovarian Cyst Removal

Ovary may have many pathological problems like.. innocent and malignant tumors. This tumors can be removed through laparoscope with the help of endo-bags.

Tubal Ligation(T.L.)

Female family planning surgery can be done as a day care operation. This may be done with Filshi clips, fallop rings or bipolar cauterization.

Fimbrioplasty

Adherent and block fimbriae can be open up.

Vault Suspansion

Post hysterectomy vault prolapse can be treated through laparoscope.

Sling Surgeries

This can be done through laparoscope for those patients having uterine prolapse willing for future child bearing.

Laparoscopic Enterocele Repair

Enterocele can be obliterated through laparoscopy.

Hysteroscopy

Operative Hysteroscopy : Uterine Synechia Dissection (Asherman Syndrome)

This is the condition where uterine -wall may get adherent antero- posteriorly leading to mild to sever problem. Adhesiolysis will restore menses and reproductive function. IUCD may be inserted post operatively to prevent re-adhesions.

Septal Resection

Some times there is presence of uterine septum which is congenital abnormality. Resection of septum will improve implantation index and will take care of recurrent pregnancy losses.

Polypectomy (Polyp)

Polyps are projecting pathology in the uterine cavity. They can be removed hysteroscopicaly.

Sub mucous myomectomy

Sub mucous varity of fibroid (less then 3 cm size and not more than 2 fibroid) can be removed through hysteroscope.

Foriegn Body Removal

One can removed fetal bone lost IUCD and calcified foci through hysteroscope.

Tubal Cannulation

Cornual block of the fallopian tube can be negotiated with guide wire and tuble patency can be established.

Metroplasty

Some times uterine cavity volume is less because of adhesions. Releasing these adhesions from fundus (fundal metroplasty) and from lateral wall (lateral metroplasty) will improve the chance of future pregnancy.

Hysteroscopy guided embryo transfer

Occasionally tuberculous like infection may cause patchy endometrial development. To place the embryo at best location. Hysteroscopic guidance may be of great help.

Salpingoscopy

Diagnostic salpingoscopy :

In infertile woman gradation of intrafallopion architecture can be visualised and future treatment can be planned.