What is Laparoscopy?

Laparoscopy"No more large incisions ... a new and exciting way to perform advanced surgical techniques."

Historically, laparoscopy dates back to the mid-1850s. The word “laparoscopy” simply means visual examination of the abdomen by means of a laparoscope. A laparoscope is tiny telescope-like instrument (one-half to one centimeter in diameter) inserted into the abdomen through the navel to view the interior of the peritoneal cavity. Through the use of a sophisticated video camera and bright lights shining directly onto the operative field which is then greatly magnified onto high resolution TV monitors, the heightened visibility permits the surgeon to operate with precision and minimal trauma to the tissues.

Laparoscopy has been around for several decades, primarily used for making diagnoses. If used in surgery, it was only for minor procedures. Fortunately, recent technology has all but changed the practice of modern gynecology. Since 1990, advanced surgical procedures, including laparoscopic surgery, are routinely performed at specialized centers.

The advantages of laparoscopic surgery are numerous, including the following:

  • Greater precision because of the magnification of the operative field. 
  • Diminished blood loss.
  • Tiny incisions rather than opening the entire abdomen. 
  • Less post-operative pain and discomfort.
  • Fewer complications. 
  • Shorter hospital stay.
  • Quicker recovery time. 

Generally, the patient is discharged within 23 hours of surgery and is able to resume light to normal duties after one week.

Robotic Surgery

Robotic surgery is a form of laparoscopic surgery in which a robotic mechanism consisting of two to three interactive mechanical arms, a camera arm, a three-dimensional (3D) image processing system and a remote control unit, is used. In 2005, the daVinci robotic system was approved by the US Food and Drug Administration for use in gynecological surgery. The advantages of robotic surgery are that 1) the surgeon and patient do not have to be in the same room or same town, 2) the surgeon has a 3-dimensional image view of the operative field, and 3) the robot makes it easier for the less experienced surgeon to perform laparoscopic suturing.  However, robotic surgery is more expensive due to the cost of the machine, the operating room set up, and relatively short life of robotic surgical instruments.  In general, an experienced surgeon can perform the same surgery without the robotic mechanism more quickly and less expensively, but certain surgeries such as tubal reanastomosis (sterilization reversal) do benefit from robotic surgery. 

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