What is MIGS ?
As opposed to conventional surgery Minimally Invasive Gynecological Surgery or MIGS does not require large cuts on the abdomen. Small holes are made (Laparoscopic surgery) which heal very fast. Minimum periods of hospitalisation is needed and patients can join work within a week or so. Hysteroscopic surgery means operating inside the cavity of the uterus via a specialised optical device (Hysteroscope) to remove tumours, to cut uterine septum etc. which would otherwise require an open operation and the results would be far inferior to hysteroscopy.
Advantages ofMinimally Invasive Gynecological Surgery
Contrary to popular belief Laparoscopic view of the abdominal cavity is far superior to that at open operation. Most if not all Gynecological operations can be performed laparoscopically. The patients recover very fast and are in hospital for only a day or two. In the past all operations were performed by open technique resulting in prolonged hospital stay and weeks of abstinence from work.
Why is MIGS not practised widely ?
These procedures are very operator-dependent and require the surgeon to obtain specialised training for prolonged periods. Laparoscopic suturing , an essential skill, takes a long time to master. Also, the equippments are very hitech and hence costly.
Can Hysterectomy be done by laparoscopic approach ?
Total Laparoscopic Hysterectomy (TLH) is the best way to remove a diseased uterus. It can also be done by the vaginal route (NDVH) . Unfortunately not all hysterectomies can be performed vaginally whereas almost all can be done Laparoscopically.
What other operations are performed laparoscopically ?
Benign ovarian cysts including dermoids are removed in this way. Almost all ectopic pregnancies are operated laparoscopically. Fibroids (benign tumours of the uterus) are best removed laparoscopically . As expected the results are far superior to those of open surgery both in the short term al well as longterm.
Endometriosis is best treated by Laparoscopic excision.
Can Cancer Surgery be performed Laparoscopically ?
Yes. Total Laparoscopic Hysterectomy (TLH) with pelvic lymphadenectomy (removal of lymph glands from the pelvic region) is well established as treatment of low-risk Endometrial cancer. Laparoscopic Radical Hysterectomy is now well established treatment for early Cervical cancer. Many cases of Ovarian cancers can also benefit from laparoscopic approach (esp. to judge operabilty and to stage inadequately operated cases).
We are actively promoting Laparoscopic Oncological surgery in suitable cases and Laparoscopic Pelvic lymphadenectomies are undertaken on a regular basis.
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