Laparoscopic Gynae Colposcopy

Colposcopy is a specialized diagnostic procedure that allows detailed examination of the uterine cervix using a colposcope. This instrument is critical in diagnosing abnormalities in the lower genital tract by analyzing the surface epithelium, connective tissue (stroma), and vascular patterns.

Evaluation Of Lower Genital Tract

  • Lugol Iodine
    Colposcopy is a specialized diagnostic procedure that allows detailed examination of the uterine cervix using a colposcope. This instrument is critical in diagnosing abnormalities in the lower genital tract by analyzing the surface epithelium, connective tissue (stroma), and vascular patterns.
  • Acetic Acid
    Applying 3-5% acetic acid highlights metaplastic and dysplastic areas, turning them into distinct aceto-white regions.
  • Green filter
    Improves visualization by absorbing red tones, making blood vessels appear as black streaks for better assessment.
  • Directed Biopsy
    Tissue samples are collected from the most abnormal areas under colposcopic guidance for accurate diagnosis. This is the gold standard for identifying cervical pre-cancerous conditions.

Treatment Modalities

  • Cryocautery
    This procedure involves freezing abnormal tissue to -20°C or lower using a cryoprobe, resulting in tissue destruction (cryo-necrosis). The dead tissue is naturally replaced with healthy tissue.
  • LEEP (Loop Electrosurgical Excision Procedure)
    A minimally invasive procedure to remove deeper cervical lesions. The excised tissue can be sent for histopathological examination, serving as both a diagnostic and therapeutic method.

Laparoscopic Gynae Hysteroscopy

Hysteroscopy is a procedure used to directly visualize the uterus using an endoscope, enabling both diagnostic and therapeutic interventions.

Diagnostic Applications

  • Abnormal Uterine Bleeding (AUB/DUB)
    Hysteroscopy helps detect conditions like normal endometrium, submucous myoma, endometrial polyps, hyperplasia, or cancer, which may cause abnormal bleeding.
  • Lost or Misplaced IUCD
    Enables precise location and safe removal of misplaced intrauterine devices.
  • Infertility Evaluation
    Provides a detailed view of the cervical canal, uterine cavity, tubal ostia, and intramural segments of the fallopian tubes. Common issues like adhesions, fibroids, polyps, or septae can be identified.

Therapeutic Applications

  • Endometrial Ablation
    A proven treatment for abnormal uterine bleeding.
  • Polyp and Fibroid Removal:
    Submucous fibroids and polyps are safely removed during hysteroscopy.
  • Adhesion Treatment (Asherman’s Syndrome):
    Effectively treats intrauterine adhesions and restores normal uterine structure.
  • Foreign Body Removal:
    Ensures the safe removal of any foreign objects within the uterus.
  • Fallopian Tube Catheterization and Biopsy:
    Allows for opening blockages and obtaining tissue samples for analysis.

Diagnostic Laparoscopy

Diagnostic laparoscopy is a minimally invasive procedure used to visualize and evaluate abdominal and pelvic organs.

Applications in Infertility:

  • Tubal Patency Evaluation:
    Assesses whether fallopian tubes are open and functional.
  • Ovarian Drilling (for PCOS):
    Treats polycystic ovarian syndrome by reducing ovarian cysts and improving fertility.
  • Adhesion Assessment and Treatment:
    Identifies and removes pelvic adhesions caused by infections or endometriosis.
  • Endometriosis Detection:
    Confirms and treats endometrial tissue growth outside the uterus.

Other Diagnostic Uses:

  • Investigating unexplained pelvic pain, suspected ectopic pregnancy, or ovarian cancer.
  • Follow-up evaluations for cancer treatment.

Operative Laparoscopy

Laparoscopy offers solutions for various gynecological conditions with precision and minimal recovery time.

A) Tubal Surgeries:

  • Family Planning (Sterilization):
    Permanent birth control through tubal ligation to prevent ovum passage.
  • Tubal Reconstruction/Recanalization:
    Repairs damaged fallopian tubes, addressing blockages or injuries.
  • Ectopic Pregnancy Management:
    Removes ectopic pregnancies via tubal conservation or excision.

B) Uterine Surgeries:

  • Myomectomy for Fibroids:
    Removes fibroids laparoscopically while preserving fertility. Large fibroids are removed using morcellation techniques.
  • Hysterectomy:
    Total laparoscopic hysterectomy (TLH) and laparoscopic-assisted vaginal hysterectomy (LAVH) are safe and effective methods for uterus removal, even in complex cases like previous surgeries or caesarean deliveries.
  • Cancer Surgery:
    Advanced laparoscopic procedures like Wertheim’s hysterectomy for uterine cancer adhere to strict cancer surgery protocols.

C) Ovarian Surgeries:

  • Ovarian Cystectomy:
    Safely removes ovarian cysts while conserving the ovary if fertility is desired.
  • Tubo-Ovarian Mass Removal:
    Treats masses resulting from pelvic infections or other conditions.

D) Endometriosis Treatment:

  • Early Stages:
    Small lesions are identified and destroyed under laparoscopic magnification.
  • Advanced Cases:
    Adhesiolysis, cyst removal, and other interventions address extensive damage caused by endometriosis.

D) Other Procedures:

  • Removal of misplaced IUCDs
  • Sacro-colpopexy for vaginal vault prolapse

Vaginal Surgery

Common Procedures:

  • Repair of uterine prolapse and perineal tears
  • Vaginal hysterectomy (NDVH/VH) combined with cystocele or rectocele repair
  • Removal of cervical polyps and vaginal wall cysts
  • Treatment of stress urinary incontinence using TVT/TOT tapes
  • Vaginoplasty for vaginal agenesis
  • Vulvectomy and urinary fistula repair