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Laparoscopy has been steadily replacing laparotomy because the abdomen does not have to be opened up, resulting in faster recovery and reduction of complications. In laparoscopy, only three small incisions are made for the entry of a small camera and other instruments. Thus, the operation that is taking place inside the abdomen/pelvis can be viewed on a video screen placed next to the operating table.

An ectopic pregnancy is a pregnancy implanted in an abnormal location (outside of the uterus). During the past 40 years its incidence has been steadily increasing concomitant with increased STD rates and associated salpingitis (inflammation of the Fallopian tubes). Such abnormalities of the tubes prevent normal transport of the fertilized egg to the uterus.

Endometrium refers to the tissue lining the uterus. The primary function of the endometrium is to participate in the implantation of the fertilized ovum and the subsequent formation of the maternal portion of placenta.

The word Laparoscopy simply means visual examination of the abdomen by means of a laparoscope. Laparoscopy (often called "belly button surgery", endoscopy, or key hole surgery) is a surgical technique involving small incisions in the abdomen through which major surgical procedures can be performed. One of the incisions is made in the umbilicus ("belly button").

Even though the anterior repair is the most commonly utilized operation for correction of a cystocele, it is probably not the most effective, nor is it the correct operation for restoring a woman's anatomy and maintaining vaginal length and function. The problem with using this operation in young healthy sexually active woman with a paravaginal defect (cystocele) is the surgeon does not really surgically support the bladder, but instead reduces the bulge by "scrunching " the fascia under the bladder together.

For pelvic floor repair we use the following principles.1. Site specific repair i.e. repair of the defect only. 2. Restrictive use of a mesh i.e. when necessary only. A mesh by definition carries a little risk of complications such as infection, of mesh erosion and more complicated subsequent surgery when necessary. 3. The use of a mesh when the vaginal wall is opened should be avoided.

Pathophysiology of visceral pain

Hysterectomy is the most frequently performed operation in women, with a life time risk varying from country to country from less than 20% to more than 40%. Overall these differences reflect more medical practice than differences in pathology between countries.

The FDA recently approved a new genetic test, called Inform Dual ISH, that helps determine whether women with breast cancer have the human epidermal growth factor receptor 2 (HER2)-positive type.1 In about 20% of breast cancers, the cancer cells produce an excess of the protein HER2 because of a gene mutation. HER2-positive breast cancers tend to be more aggressive and respond less well to hormone therapy.

Laparoscopy is now an option for many gynecological conditions. This overview discusses specific laparoscopic procedures and the conditions they treat.

Whenever the surgery that is considered can be performed equally well and equally safely by either laparoscopy or laparotomy, the decision as to the type of incision to be used can (and in my opinion really should) include the patient.

The ideal doctor would be one who is : competent; compassionate with a caring attitude ; experienced; with a well-organized practice - and has all the time in the world for you! While you may never find someone who meets all these criteria, how can you find a good doctor to take care of you?

Chronic pelvic pain and/or associated intestinal disturbance are a major cause of misery for thousands of patients. Often in constant pain, the patient experiences loneliness, hopelessness, frustration and desperation with thoughts of suicide. Family and work relationships are strained to the limit. Although ADHESIONS are often (but not always) the cause of this pain, treatment for adhesions is not performed either because the surgeon does not believe that adhesions can cause the problem, or because lysis of adhesions is considered too difficult or futile.

The goal of laparoscopic repair of female organ prolapse is to restore normal functioning by correcting female organ supporting defects in the pelvis. The supporting system in the female pelvis is quite complex; however, it is dynamic rather than static. There are basically two systems in the pelvis that provides the active and passive support of pelvic organs to their proper places.

FAQs on Infertility from Malpani Infertility Clinic

I had an interesting email come in the a few weeks ago from a woman looking for advice on finding a doctor:

Fibroids are the most common benign tumors of the uterus. These noncancerous growths are present in 20-40% of women over the age of 35. In some women, the fibroids can become enlarged and cause symptoms of excessive bleeding and pain. While the classic treatment of symptomatic fibroids has been surgical removal of the fibroids (myomectomy) or the uterus (hysterectomy) recent advances now afford a nonsurgical treatment.

Ovarian cysts are enlargements of the ovary that appear to be filled with fluid. They can be a simple fluid filled bleb or contain complex internal structures. The term cyst is used to differentiate them from solid enlargements. Simple cysts have no internal structures and are less worrisome than those with complex structures or solid components. A sonogram or ultrasound test can determine if a cyst is simple or complex.

A significant number of women experience infertility due to surgically correctable causes. Most cases are a result of endometriosis and/or adhesions (scar tissue) from previous surgery or pelvic infection. Endometriosis and adhesions cause distortion and blockage of the fallopian tubes, thus causing infertility. Infertility surgery tries to unblock, release and restore normal anatomy of the fallopian tube.

What could be easier? You arrive in the morning, have your procedure then leave later the same day. This is called out patient surgery. One of the most common and preferred choices of both physicians and patients. This is made possible by less invasive techniques that still facilitate the same, if not better surgery. Everything from anesthesia to recovery is taken care of in a matter of hours. Preparing for such a surgery goes beyond reading the pamphlets your physician hands you. Do your homework and ask questions! The success of both your procedure and recovery depends on YOU.

Cystitis is defined as an inflammation of the bladder, and may be caused by such things as bruising, as in the case of ‘Honeymoon Cystitis’, sexually transmitted diseases, or even a reaction to ‘personal care’ products.

Laparoscopic hysterectomy (LH) is an optimum approach to the second most common surgical procedure in the United States. There are close to 600,000 hysterectomies performed annually in the US, with the majority performed via the abdominal route.

Video of Laparoscopic Hysterectomy

Around 153 million women around the world have chosen to be sterilized for contraceptive purposes, of these 138 million are in the developing countries. 1 Approximately fifty percent of all female sterilization is performed during the puerperal period or a cesarean section, and the other fifty percent is called “interval sterilization” when there has been no pregnancy for the previous six weeks.

Uterine fibroid is a slowly growing benign smooth muscle tumor. Approximately 25% of women after the age of 35 years harbor uterine fibroid. Most of these women are asymptomatic and in general, they do not need any treatment

Because endometriosis is a common disease entity among infertile patients with a prevalence of up to 50%, one could argue that without laparoscopy clinical work-ups can not completely rule out all of the causes of infertility. The decision to perform laparoscopy on patients with infertility is very complex owing to a number of factors, such as maternal age, semen parameters, tubal patency, pelvic symptoms, insurance coverage, surgical risks, and availability of surgical expertise.

Endometriosis is one of the most common gynecologic disorders and is significantly more prevalent in the setting of infertility. The prevalence of endometriosis in infertile women ranges from 25% to 50% compared to 5% in fertile women. Successful laparoscopic management of all stages of endometriosis was reported as early as 1986. This has revolutionized the management of endometriosis. The benefits of surgical therapy for infertility associated with endometriosis have been well documented.

For the past three decades, gynecologists have been utilizing the hysteroscope in the office to diagnose a variety of conditions that can be responsible for symptoms such as abnormal uterine bleeding, recurrent miscarriage, infertility, and post menopausal bleeding. The most common lesions found during diagnostic office hysteroscopy include cervical and uterine polyps, submucous myomata, uterine septae, intrauterine adhesions, endometrial hyperplasia and endometrial cancer.

Video of Hysteroscopic Polypectomy

It is advantageous to perform surgery in the least invasive way possible while still getting optimal results. Although I usually prefer to do surgery through a laparoscope rather than through a larger incision, I have felt limited by the lack of wrist-like movements of the instruments. I felt that deeper myomas (that couldn’t be removed by a hysteroscope) were better removed through a regular incision.