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The Star Malaysia - Star2 - - YOUR HEALTH -

THE evo­lu­tion of sur­gi­cal tech­niques has re­sulted in a new field of surgery col­lec­tively known as min­i­mally in­va­sive surgery with which sur­geons use tools such as a la­paro­scope ( a small tube with a light source and cam­era) to both di­ag­nose and treat sur­gi­cal con­di­tions through small in­ci­sions.

Car­ried out by a team that typ­i­cally con­sists of one sur­geon and two as­sis­tants, min­i­mally in­va­sive meth­ods are be­com­ing more widely pre­ferred be­cause they are proven to be as ef­fec­tive as open surgery, but safer and more con­ve­nient.

Ac­cord­ing to Dr Tan Nu­groho Cipto, ob­ste­tri­cian and gy­nae­col­o­gist at Ori­en­tal Me­laka Straits Med­i­cal Cen­tre, la­paroscopy is most com­monly used in hys­terec­tomy ( re­moval of the uterus), ovar­ian cys­tec­tomy and the re­moval of the foe­tus in ec­topic preg­nan­cies ( when the foe­tus de­vel­ops out­side the uterus).

It is also use­ful in di­ag­nos­ing and treat­ing var­i­ous con­di­tions such as chronic pelvic pain, in­fer­til­ity, en­dometrio­sis and fi­broids. How is la­paroscopy per­formed? “First, a cam­era is in­serted into a 10mm to 12mm in­ci­sion, which al­lows us to vi­su­alise the pathol­ogy. Then, accessory ports of 5mm to 10mm are made on the left and right side, through which we in­sert in­stru­ments to op­er­ate un­der the skin,” says the cen­tre’s ob­ste­tri­cian and gy­nae­col­o­gist Dr Norhay­ati Awan.

Women who un­der­went a hys­terec­tomy ( uterus re­moval) in the past had to take months off to re­cover from surgery wounds. With la­paras­copy in the pic­ture, this is no longer the case.

“In a la­paro­scopic hys­terec­tomy, creat­ing a small in­ci­sion be­tween the cervix and vagina al­lows the de­tached uterus to be re­moved through the vagina,” ex­plains Dr Norhay­ati.

There is also a vari­a­tion called hys­teroscopy in which a hys­tero­scope ( sim­i­lar in func­tion to la­paro­scope) is in­serted through the vagina to ex­am­ine the cervix and uterus.

“Hys­teroscopy can be use­ful in di­ag­nos­ing con­di­tions such as ab­nor­mal uter­ine bleed­ing and for op­er­a­tive pur­poses such as polyps ( harm­less mu­cous mem­brane growth) re­moval,” says Dr Tan.

La­paroscopy wounds heal faster be­cause the smaller in­ci­sions bleed and scar less. Pa­tients are able to re­cover within a week as op­posed to the months they could take to fully re­cover from open surgery.

“With shorter hospital stays post surgery, pa­tients are able to re­sume their day- to- day lives sooner and at greater com­fort,” says Dr Norhay­ati.

As with all surg­eries, though, pa­tients must be aware of the risks of la­paro­scopic pro­ce­dures.

“Pos­si­ble com­pli­ca­tions in­volve bruis­ing around the skin in­ci­sions and ac­ci­den­tal dam­age to struc­tures inside the ab­domen,

Dr Norhay­ati Awan.

Dr Tan Nu­groho Cipto.

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