The Center for Minimally Invasive Gynecological and Gynecological Oncology Surgery

Dr. Srisupa Lauhapagorn

Gynecologic Oncology and Laparoscopic Gynecologic Surgery

Laparoscopic Gynecologic Surgery

     Laparoscopic gynecologic surgery uses a small camera and light source to perform surgery through small incisions in the abdomen, through the vagina (leaving no abdominal scar), or through the cervix into the uterus. The camera transmits a magnified image to a monitor, allowing the surgeon to operate with precision.

Types of Laparoscopic Gynecologic Surgery

• Abdominal Laparoscopy: Through 3-4 small incisions (0.5-1 cm) or a single incision (2-3 cm).
• Scarless Laparoscopy: Performed through the vagina.
• Hysteroscopy: Performed within the uterine cavity.

Conditions Treated with Laparoscopic Surgery

• Uterine fibroids (Myoma uteri)
• Ovarian tumors
• Ovarian cysts, including chocolate cysts
• Endometriosis
• Pelvic adhesions
• Ectopic pregnancy
• Blocked fallopian tubes
• Infertility (diagnostic)
• Polyps or fibroids in the uterus
• Uterine adhesions (Uterine synechiae)
• Tubal sterilization
• Perforated IUD
• Hysterectomy (for certain conditions)
• Early-stage endometrial cancer
• Chronic or acute pelvic pain (diagnostic)
• Ascites (diagnostic)
• Abnormal uterine bleeding (diagnostic and treatment)

Laparoscopic Surgery vs. Open Abdominal Surgery

Potential Complications

• Shoulder/Back Pain: Caused by gas irritation; resolves in 48 hours.
• Bloating/Abdominal Discomfort: From gas or a slow-recovering digestive system. Moving around helps.
• Organ Injury: Possible during complex procedures, especially with pre-existing adhesions.
• Vascular Injury: May lead to significant blood loss.
• Subcutaneous Emphysema: Gas under the skin that resolves on its own.
• Vaginal Wound Issues: Inflammation or separation.

Note: In cases of complications, such as bowel or ureter injury, the procedure may need to be converted to open surgery.

Pre-Surgery Preparation

• Mental Preparation: Discuss any concerns with your doctor.
• Physical Preparation:
  • Inform your doctor about any underlying conditions or medications (e.g., Aspirin, Warfarin).
  • Get sufficient rest and avoid being sick.
  • Eat light, low-fiber meals for 3 days before surgery. Fast from food and water for at least 8 hours (or after midnight).
  • Practice deep breathing to prevent lung collapse after surgery.
  • Keep skin and navel clean.

Post-Surgery Care

• Eat soft, easily digestible food. Avoid fermented, raw, or hard-to-digest items, and carbonated drinks or coffee.
• Take all prescribed medication.
• Avoid strenuous exercise, heavy lifting, or swimming for 4-6 weeks (or 2-4 weeks for ovarian cyst removal).
• Keep the incision site dry and clean.
• Report any unusual symptoms like heavy bleeding, fever, or abnormal discharge immediately.
• Avoid sexual intercourse for 6 weeks, or until your doctor gives clearance.