Laparoscopic Surgery in Ahmedabad for Gynecological Conditions

What Is Laparoscopy? Keyhole Surgery in Plain Words

Laparoscopy means looking inside the abdomen with a slim telescope and camera, and operating through small openings. The telescope goes in close to the navel. I work while watching a magnified view of the pelvic organs on a monitor. Compared with an open operation, most women have less pain afterwards, fewer days in hospital and smaller scars. They also get back to home life and work sooner. For many routine gynecological operations it has become the standard way I work.

Hysteroscopy is the other keyhole method I use. There I pass a fine camera through the cervix to work within the womb, so the abdomen is not cut at all. Both are done in the operation theatre of the hospital, which is NABH-certified.

Gynecological Laparoscopy, Step by Step: What I Do

• You are given a general anaesthetic, so you sleep through the whole operation.
• I make the first small opening in or just under the navel and fill the abdomen gently with carbon dioxide. The gas lifts the abdominal wall clear of the organs so that I can see and work without touching them unnecessarily.
• A laparoscope roughly 5–10 mm wide, attached to a camera, is passed in through that opening.
• Two or three further small openings lower down take the instruments I use to hold tissue, cut, seal blood vessels and place stitches.
• At the end I let the gas out and close each opening with fine stitches or skin glue. You wake up in the recovery area.

How long it takes depends on what is being done. A diagnostic laparoscopy is usually 20–30 minutes and removing a cyst about an hour. A myomectomy or hysterectomy takes two hours or more, and longer if there is scar tissue from earlier operations.

Laparoscopy for Women: The Conditions I Treat

• Ovarian cysts, including dermoid cysts and endometriomas - I remove the cyst and save the healthy part of the ovary wherever I can.
• Fibroids within the uterine wall - laparoscopic myomectomy removes them while the uterus stays in place.
• Endometriosis - I cut out or treat the deposits and free the adhesions that cause pain.
• Ectopic pregnancy - removed by keyhole surgery, saving the tube when that is a reasonable option.
• Ovarian torsion - an emergency operation to untwist the ovary and, whenever possible, save it.
• Infertility assessment - a dye test during laparoscopy shows whether the tubes are open.
• Hysterectomy - when a woman's family is complete and other treatments have not helped.
• Permanent sterilisation (tubal ligation) - for women who are sure they do not want more children.
• Hysteroscopic procedures - removal of polyps and fibroids that sit in the cavity (submucosal fibroids), division of a uterine septum and release of adhesions inside the uterus.

Laparoscopic & Hysteroscopic Surgery in Ahmedabad: How the Routes Compare

I operate by laparoscopy and hysteroscopy. I do not perform open surgery; it appears in the table below only so that you can compare the routes.

When Laparoscopy Suits You, and When I Refer for Open Surgery

Most gynecological operations can be done by laparoscopy. Having had a caesarean before does not usually rule it out, although scar tissue can make the operation take longer.

Open surgery may be the safer route if there is:

• A very large uterus or fibroid.
• Heavy scarring from several previous operations.
• A heart or lung condition that makes keyhole surgery less suitable.
• A suspicion of cancer. Surgery by a specialist gynaecological oncology team is then the right route.

Open surgery is not part of my practice. If my assessment shows that it is the safer route for you, I explain the reasons and refer you to a surgeon who performs open operations.

Rarely, an operation that begins by keyhole cannot be finished safely that way and has to be changed to open surgery. In general this happens in a few of every hundred operations, because of bleeding, adhesions or anatomy that is hard to see. It is a step taken for your safety. I do not perform open surgery myself. So before you sign consent, I explain how this would be managed at the hospital, so that it does not come as a surprise.

Preparing for Your Laparoscopic Operation

• Blood tests: haemoglobin, blood group, sugar, kidney function, thyroid where relevant, and screening for hepatitis B, hepatitis C and HIV.
• Heart and anaesthesia check: an ECG and a review by the anaesthetist; a chest X-ray or other tests depending on your age and health.
• Anaemia: if your haemoglobin is below about 10 g/dL, I prefer to correct it first with iron tablets or an iron infusion.
• Your medicines: blood thinners, some diabetes tablets and herbal or ayurvedic products may need to be paused - bring everything you take.
• Fasting: usually nothing to eat for 6 hours beforehand; clear fluids such as water are allowed until 2 hours before.
• Timing: I plan the date around your cycle, and anyone who could be pregnant has a pregnancy test on the day.
• Consent: we go through what the operation aims to do, the alternatives and the risks. We also discuss what I would do if I find something unexpected, including whether any tissue might need to be removed.

Laparoscopy Risks and the Steps I Take to Reduce Them

Laparoscopy is a common operation and serious complications are uncommon. The RCOG puts the figure at about 2 in every 1,000 women for a serious complication after a diagnostic laparoscopy. Longer, more complex operations carry a higher risk, and I discuss your own risk with you individually.

• Shoulder-tip pain and bloating from the gas - very common and harmless; it usually settles within 1–3 days.
• Infection or bruising at the small wounds - treated with dressings and sometimes antibiotics.
• Bleeding - rarely enough to need a transfusion or a return to theatre.
• Injury to the bowel, bladder, ureter or a major blood vessel - uncommon. I reduce the chance with a careful first entry. An injury recognised during surgery is repaired at the time, by keyhole where possible, otherwise with the help of a general or vascular surgeon.
• Clots in the legs or lungs - made less likely by getting up and walking early, drinking well, compression stockings and, for women at higher risk, blood-thinning injections.
• Hernia at a wound - uncommon; the larger openings are closed in layers to prevent it.

Most problems, if they happen, show themselves in the first few days after surgery.

Laparoscopy Recovery Time: The First Weeks at Home

Most women need one or two days in hospital and then one to four weeks at home, depending on the operation.

• You can sip fluids and walk within a few hours of waking.
• After a diagnostic laparoscopy or cyst removal, many women go home the next day; after a myomectomy or hysterectomy, usually after 1–2 days. Hysteroscopy is often a day-care procedure.
• Feeling tired for 1–2 weeks is normal. After the first day or two, paracetamol is usually enough for pain.
• A shower is fine after 24–48 hours; avoid sitting in a bath until the wounds have healed.
• Walking and light housework can start in the first few days.
• Desk work: about 1–2 weeks after a diagnostic laparoscopy or cyst removal; 2–4 weeks after a myomectomy or hysterectomy.
• Driving: often after 1–2 weeks, once you can brake hard and turn without discomfort.
• Heavy lifting, the gym and strenuous exercise: usually after 4–6 weeks.
• Intercourse: after about 2 weeks for most procedures, and around 6 weeks after a hysterectomy.

Laparoscopy, Fertility and a Later Pregnancy

• Tissue is handled gently and is less exposed to air, so keyhole surgery tends to leave fewer adhesions than open surgery. This matters if you hope to conceive.
• When I remove a cyst, my aim is to keep as much healthy ovary as I can.
• After a laparoscopic myomectomy I usually suggest waiting about 3–6 months before trying to conceive. If the fibroid was deep in the wall, a caesarean may be advised for the delivery.
• After an ectopic pregnancy treated by keyhole surgery, many women go on to conceive again. In the next pregnancy, an early scan checks that it is in the right place.

Your Laparoscopic Surgeon in Ahmedabad: How I Plan the Operation

• I first see you in clinic and go over your scans, repeating them if needed. We decide together whether you need surgery at all before any date is set.
• You receive a written plan covering the operation, the expected hospital stay and the recovery time.
• I operate at Divine Women's Hospital, Gota (NABH-certified). Its emergency service is staffed 24×7, so a twisted ovary or a ruptured ectopic pregnancy can be taken to theatre for emergency laparoscopy at any hour.
• We can talk in Gujarati, Hindi or English.
• At the follow-up visit I go through what I found, the operative photographs (where taken) and the tissue report with you.

Laparoscopic Surgery Cost in Ahmedabad: What the Estimate Depends On

The cost depends mainly on which operation you need, because "laparoscopy" covers operations as different as a 20-minute diagnostic look and a hysterectomy lasting two hours or more. So there is no single price. What decides the estimate:

• Which operation you need - a diagnostic laparoscopy, a cyst removal, a myomectomy, endometriosis surgery and a hysterectomy each differ. Theatre time, instruments and sealing devices all vary.
• Anaesthesia - general anaesthesia and the anaesthetist's charge are part of every laparoscopy.
• Days in hospital - usually 1–2 days, longer after a bigger operation or if you have another medical condition.
• Tests before surgery - blood tests, ECG and any scans still needed.
• The tissue report - anything removed is sent for histopathology.
• Medicines and follow-up - pain relief, any iron correction beforehand, and the review visit.

Once we agree that surgery is needed and which operation it is, the hospital prepares a written estimate. Current charges are given by Divine Women's Hospital on request. A planned laparoscopy is an admission, so if you have health insurance, ask the hospital desk how your policy handles it before the date is fixed.

Your Laparoscopy Journey in Five Stages

1. Consultation and scanswe discuss your symptoms, any past surgery and your pregnancy plans, and I review your ultrasound or MRI.
2. Pre-operative checkblood tests, an anaesthetic review, correction of anaemia if needed, and written instructions about medicines and fasting.
3. The operationunder general anaesthesia; you are usually walking and drinking within hours.
4. Going homeusually after 1–2 days, with pain relief, wound-care advice and a direct number to call.
5. Follow-upat about 1–2 weeks, to check healing and go through the findings and tissue report.

Reasons to See a Laparoscopy Doctor in Ahmedabad

See a laparoscopy doctor when a scan finding or a symptom may need an operation, or when you want to know whether it can be avoided. Common reasons:

• A scan has shown a cyst or fibroid and you are not sure whether it needs an operation.
• Your periods are heavy or painful enough to affect work, school or sleep.
• You have pelvic pain, pain during intercourse or painful bowel movements - symptoms that can point to endometriosis.
• Twelve months of trying (six from age 35) have not led to a pregnancy and your tubes have not been checked.
• You have been advised a hysterectomy and want to understand all the options.
• You would like a second opinion before an operation that has already been planned.

Laparoscopy Misconceptions I Hear Often

Questions Patients Ask Me About Laparoscopy