If surgery is required to treat any condition, we will take you step-by-step through the procedure to ensure you are aware of the associated risks and benefits and can make an informed choice.
Where possible, Laparoscopic (keyhole) surgery is preferred as it combines the benefits of simplicity and short hospital stay with minimal abdominal scarring and faster recovery.
WHAT IS LAPAROSCOPY?
Laparoscopy involves inspecting or operating on the inside of the abdomen and/or pelvis through small ‘keyhole’ cuts, thereby avoiding open abdominal surgery (laparotomy) for which bigger abdominal cuts are necessary. The abdomen is inflated with gas (carbon dioxide), small cuts are made and a camera is passed into the body. The cuts normally only require skin glue to close them. Laparoscopy has major advantages over laparotomy, including shorter hospital admission, faster recovery, reduced post-op pain, reduced risk of post-op adhesion formation and a more aesthetically-pleasing abdominal scar.
OUR SCOPE OF ADVANCED LAPAROSCOPIC SURGERY PROCEDURES INCLUDES:
Laparoscopic reversal of sterilisation: reopening the fallopian tubes in women who were previously sterilised but now wish to try for natural pregnancy. Carries a high success rate of about 85%. The advantage of this kind of advanced laparoscopic surgery, over IVF treatment is that the woman can potentially have more children without the need for further medical intervention. It is a day-case procedure with about 2 weeks' recuperation.
Laparoscopic uterine cerclage: a permanent stitch is placed around the neck of the womb in women who have repeated mid-pregnancy miscarriages and for whom vaginal/cervical stitches have been unsuccessful. It is a day-case procedure with about 2 weeks' recuperation.
Laparoscopic tubal surgery: repairing/reopening the fallopian tubes in women with some types of tubal infertility (damage/blockage) to help them to conceive naturally. Again, this gives women a better chance of conceiving several more children without any further medical intervention. It is a day-case procedure with about 2 weeks' recuperation.
Laparoscopic excision of endometriosis:
At Aurora, we pride ourselves with being one of the leading UK centres offering excisional surgery for endometriosis.
This kind of operation can be used in cases of mild endometriosis, all the way to more complex procedures. Normally, this is a day-case procedure, requiring 2 weeks’ recuperation. More radical procedures may require up to 2 days of hospital stay, with about 4 weeks’ recuperation. Aurora has established a BSGE accredited specialist endometriosis centre called ‘Cheshire Endometriosis Centre’ which means we’re experts in this kind of surgery.
Laparoscopic excision of ovarian cysts: removing troublesome cysts from the ovaries, whilst retaining healthy ovarian tissue so that they continue to function normally. We deal with all types and sizes of ovarian cysts. This is a day-case procedure with about 2 weeks' recuperation.
Laparoscopic hysterectomy: the entire womb is removed (total laparoscopic hysterectomy) or the womb without the cervix (subtotal hysterectomy). Involves a 1/2-day hospital stay and 4 weeks’ recuperation.
Laparoscopic myomectomy: removal of uterine fibroids from the womb while conserving the womb and it is particularly beneficial for women with fibroids who wish to retain the option of future fertility. This normally involves a 1/2-day hospital stay and about 4 weeks’ recuperation.
Bands of scar tissue are sometimes associated with pelvic pain, which delay in conceiving and interference with bowel function. We remove them, normally in a day-case procedure with about 2 weeks' recuperation.
BENEFITS OF LAPAROSCOPIC SURGERY:
- Reduced blood loss and need for blood transfusion
- Shorter hospital stay
- Faster recovery and return to normal routines
- Reduced post-operative pain
- Smaller and more aesthetically-pleasing abdominal scars
- Reduced risk of adhesions and their long-term complications of infertility, pelvic pain and intestinal obstruction
- Greater post-operative satisfaction with the treatment
WHAT TO EXPECT FOLLOWING ADVANCED LAPAROSCOPIC SURGERY:
Anti-adhesion agents: Special gels and fluids are applied in the abdomen and on the surface of the tissue to reduce the risk of adhesions forming.
Abdominal wounds: normally closed with skin glue, which does not need any special treatment afterwards.
Passing urine: depending on the procedure you had, you may be able to pass urine on your own or you may need to have a bladder catheter in place for a few days.
Pain: the first 24 hours after laparoscopic surgery can be associated with significant abdominal and pelvic pains for which we provide strong painkillers. The pain usually becomes less troubling by the second day and thereafter resolves gradually.
Hospital stay: The vast majority of laparoscopic procedures are performed as a day-case. Operations needing inpatient hospital stay usually involve 1/2-day hospital stays. We advise women to continue with adequate bed rest and restricted activity for 1-2 weeks on discharge home.
Return to normal routines: We recommend staying off work for one week after a mild procedure, two weeks after an intermediate procedure, and up to six weeks after a major procedure.
Hospital follow-up: this might not be necessary for some women but where indicated, it is usually arranged about 4-6 weeks after surgery.
RISKS OF ADVANCED LAPAROSCOPIC SURGERY:
Laparoscopic surgery is not judged to be any riskier than traditional abdominal surgery; in fact it is often safer. However, no operation is completely risk-free and so we've listed the potential serious risks:
Bleeding: Bleeding can occur during the operation or afterwards and this could lead to a collection of blood in the pelvis; this is known as a haematoma. Excessive bleeding is unusual during/following laparoscopic surgery and when it occurs may necessitate a blood transfusion.
Injury to abdominal organs: The risks of injury are less than 1 in 100, and are usually treatable at the time of the operation. The organs at greatest risk of injury are: the bladder, ureters and intestines.
Adhesion formation: Adhesion formation complicates all types of surgery but evidence indicates that this is less with laparoscopic surgery. We take active measures to reduce this risk.
Infection: These can affect the pelvis, urinary tract or abdomen. Infections are rare (less than 1 in 100 operations). Women may develop a transient high temperature within 24 hours of an operation; this is usually not due to infection and does not require any special treatment. We normally use prophylactic antibiotics during the procedure to reduce the risk of infection, and those that develop later usually respond well to further courses of antibiotics.
Deep vein thrombosis (blood clots): the risk of blood clots in the veins is much lower with laparoscopic compared to abdominal surgery. Nonetheless, we put in place blood strategies to further reduce this risk.
Conversion to abdominal surgery: occasionally, we might decide it is safer to abandon the laparoscopic route and complete the surgery abdominally. The risk of this depends on the complexity of the procedure but averages less than 1 in every 100 operative laparoscopic procedures.