At some point in their lives, many women will need surgery to treat common gynecologic conditions, such as abnormal bleeding, fibroids, ovarian cysts, chronic pelvic pain or endometriosis and pelvic organ prolapse. The thought of surgery can be daunting as women conjure up images of large abdominal incisions, a long painful recovery and considerable scar tissue.
But advances in the surgical realm, specifically in the area of minimally invasive surgical options with laparoscopic surgery, mean women have a lot less to be concerned about if they need surgery to treat a gynecologic condition.
First introduced in the early 1900s, laparoscopy became a much more viable surgery option in the 1980s when the computer chip television camera was introduced. This technology allowed surgeons to insert a camera and laparoscope through a very small abdominal incision. The laparoscope provides the means for the surgeon to “see” the area they are operating on by transmitting images on a video monitor in the operating room.
When laparoscopy was first introduced for gynecological procedures, it was limited to diagnosis of conditions and tubal ligations. But advances in technology, such as a safer laparoscopic lighting system, video-monitoring instruments and the application of fiber-optics, have made laparoscopy a viable option for many other kinds of surgery, not just for those related to gynecologic conditions. Today, laparoscopy is the most common form of surgery in the U.S.
There are various types of laparoscopic surgery, including conventional laparoscopy as well as robotic assisted laparoscopy, which utilizes robotic technology to assist in the surgery. Typically, in addition to the small incision used for the laparoscope, which is about the size of a thumbnail, laparoscopy involves several tiny incisions in the skin, usually about five to 10 millimeters long. This is safer and more efficient than open procedures, which require a longer incision.
A long, thin tube with a miniature camera attached to the end (laparoscope) is passed through one of the incisions. The laparoscope projects images onto monitors in the operating room to give surgeons a clear, magnified view of the surgical area. The surgeons use a series of other laparoscopic instruments that are passed through these incisions to perform the surgery. As a result of these technological advancements, surgeons are able to explore and repair the problems inside of the body with the minimally invasive technique through a small, safer passageway that is usually about a tenth the size of the underlying mass.
There are the obvious benefits for patients, such as much smaller incisions, but patients experience many other benefits, too. They have less pain, earlier discharge from the hospital (in fact, some laparoscopic procedures patients often go home the same day), and faster post-operative recovery. Also, because the incisions are small, there is less scarring from the small incisions in comparison to the extensive scars left from the staples used to close the larger incisions. For patients, these benefits mean they can get back to their normal routine much more quickly.
However, it is important to note that minimally invasive surgery may not always be the best approach. As health care professionals, we look at each individual case and decide what the best, least invasive approach for our patient’s certain condition will be. We strive to make for the most comfortable experience, with the least post-operative complications and discomfort. And minimally invasive surgery has become the standard in women’s health care.
Lindsay Goodman, M.D., represents Women’s Health Services at Newport Hospital, which provides this monthly column. To learn more, visit www.newporthospital.org.