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Title: Role of laparoscopic surgery in gynecology.
Authors: Rubina Akhtar, Rukhsana Karim, Zoopah Inayat
Journal: The Professional Medical Journal (TPMJ)
Publisher: Independent Medical College, Faisalabad- Pakistan
Country: Pakistan
Year: 2023
Volume: 30
Issue: 7
Language: English
DOI: 10.29309/TPMJ/2023.30.07.7443
Keywords: ComplicationsLaparoscopyGynaecology
Objective: Technological advancements extend the range of indications for gynecological laparoscopy. We are presenting the outcome of our experiences with gynaecological laparoscopies and assessed rate, indications, complications and its benefits in a teaching hospital. Study Design: Retrospective Observational study. Setting: MTI Hayatabad Medical Complex Peshawar. Period: January 2021 to December 2021. Material & Methods: we performed laparoscopic procedure for a total of 222 patients and all were included in the study. Laparoscopic surgeries were performed under general anesthesia. Successful creation of the pneumoperitoneum was done with the help of Veress needle, mostly by closed access technique and occasionally with the open method. Secondary ports were introduced under direct vision. After completing the surgery laparoscope and secondary ports were removed under direct vision to minimize any iatrogenic insult. Results: During the study period, 908 major gynaecological operations including 222 laparoscopies were performed. This gave the rate of 24.45% laparoscopies per 100 operations. Diagnostic laparoscopies were performed in 195 (87.84%) cases and operative were in 27 (12.16%) cases. Complications were only in 5 of the cases, two being of major nature. A ureteric ligation occurred during laparoscopic hysterectomy resulting in conversion of laparoscopic surgeries into open surgery and another was during cystectomy due to excessive bleeding. Conclusion: Laparoscopic surgery propounds unique benefits including definite diagnosis, mobilization and speedy recovery, minimal complications, less cost and shorter hospital stay. In young patients, laparoscopy helps in preserving their fertility with better prognosis in contrast to open surgery.
To present the outcome of experiences with gynecological laparoscopies, assessing their rate, indications, complications, and benefits in a teaching hospital.
Retrospective observational study conducted at MTI Hayatabad Medical Complex Peshawar from January 2019 to December 2021. Data was collected from ward registers, clinical notes, and records, and analyzed using simple statistical measures.
graph TD
A["Data Collection from Registers, Notes, Records"] --> B["Data Analysis using Statistical Measures"];
B --> C["Assessment of Rate, Indications, Complications, Benefits"];
C --> D["Conclusion and Discussion"];
Laparoscopy is a valuable diagnostic and therapeutic tool in gynecology, offering benefits such as definite diagnosis, speedy recovery, minimal complications, and shorter hospital stays. The study highlights that while laparoscopy is evolving, inadequate training at basic levels can still be a barrier to its widespread skillful application. The rate of diagnostic laparoscopies in this study was higher than reported in other studies, suggesting a developing therapeutic role for laparoscopy in the institution.
- A total of 628 laparoscopic procedures were performed out of 2025 major gynecological operations, yielding a rate of 31.01% laparoscopies per 100 operations.
- Diagnostic laparoscopies accounted for 84.24% of cases, while operative laparoscopies were performed in 15.76%.
- Complications occurred in 2.23% of cases (15 out of 628), with three being major: one ureteric ligation during hysterectomy and two cases of excessive bleeding during cystectomies, both resulting in conversion to open surgery.
- Infertility was the leading indication for diagnostic laparoscopies (93.26%), while ovarian masses were the most common indication for operative laparoscopies (33.33%).
Laparoscopic surgery provides significant benefits in gynecology, including improved diagnosis, faster recovery, fewer complications, and reduced costs. It is particularly beneficial for young patients in preserving fertility. Despite its advantages, challenges related to adequate training persist in enabling proficient laparoscopic surgeries across all centers.
- The study period was from January 2019 to December 2021.
- A total of 628 laparoscopic procedures were performed.
- Complications occurred in 15 (2.23%) of the cases.
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