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| OPERATIVE LAPAROSCOPY |
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| (a) Tubal Surgery(Surgery on fallopian tubes) |
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| Family Planning or sterilization operation |
| In this operation the tubes are blocked to prevent passage of ovum thus preventing pregnancy. This is a permanent method of family planning |
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| Tubal reconstruction or re-canalization |
| In this surgery the damaged tubes can be repaired , blocked tubes opened or re-implanted . |
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| Operative treatment of ectopic pregnancy |
| Tubal ectopic pregnancy both ruptured or un-ruptured can be dealt with tubal excision or tubal conservation. |
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| TO mass, Peri- tubal Adhesions , Hydro-salpinx & pyo-salpinx |
| Which are a sequel of pelvic inflammatory disease can all be dealt with in an appropriate manner by the laparoscopic technique. |
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| (b) Uterus |
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| Myomectomy for fibroids in uterus |
| In patients where fertility is to be preserved laparoscopic removal of fibroids (myomectomy) single or multiple is done laparoscopically. Size of the fibroid is not a limitation as large fibroids can be removed with morcellation. |
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| Removal of uterus |
| TLH(Total Laparoscopic Hystrectomy)&LAVH(Lap. Assisted Vaginal Hystrectomy ) are both established procedures for removal of uterus and can be performed in almost all patients requiring hysterectomy, irrespective of whether the patient has undergone any caesarian or other pelvic surgery. |
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| Operation for cancer of uterus |
| Laparoscopic extended hysterectomy for malignant conditions (Werthime’s extended Hystrectomy) is performed laparoscopically respecting all the principles of cancer surgery with no compromise in outcome. |
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| Congenital annamolies |
| Metroplasty etc. |
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| (c) Laparoscopic surgery for conditions of Ovary |
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| Tubo Ovarian Masses |
| Laparoscopic removal of TO mass is the preferred modality of treatment. |
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| Ovarian Cyst Surgery |
| Ovarian cysts can be safely removed with laparoscopic technique while conserving the ovarian tissue or the complete ovary can be removed along with the cyst if required ,as when fertility is not a concern or in cases of torsion when the ovary has become nonviable. |
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| (d) Surgery for Endometriosis |
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| Early |
| Small endometrial implants, red flame like, clear vesicles, blue – black or white opacified peritoneal defects- fulgration of these peritoneal lesions of endometrosis can be done in a better way under laparoscopic magnification. |
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| Severe |
| Have varying degree of tubo-ovarian adhesions. Removal of endometrotic cysts, adhesiolysis and unilateral adenexectomy for large endometrioma is done laparoscopically. |
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| (e) Biopsy suspected carcinoma or Tuberculosis of the genital tract |
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| (f) Removal of misplaced IUCD or Copper- T |
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| (g) Sacro-colpopexy for vault prolapse |
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| Laparoscopic repair of post hysterectomy prolapse of vaginal vault is done by attaching a mesh to the vaginal vault and anchoring it to the sacrum. |
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