Laparoscopic Surgery

Laparoscopic Surgery in Orange, Bathurst, and Central West NSW

Advanced Laparoscopy

Lotus Medics has established a complex laparoscopic service in Orange, Parkes, Bathurst and the Central West region of NSW.

Laparoscopic services include performing complex level 4 endometriosis surgeries, laparoscopic hysterectomies, and myomectomies (removal of fibroids laparoscopically). Keep reading for more information on laparoscopic surgery and its applications.

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Laparoscopic hysterectomy

This is a major surgery involving removal of the womb for certain conditions like fibroids, heavy menstrual bleeding, endometriosis, and adenomyosis (endometriosis in the womb) for which conservative treatments have failed.

Laparoscopic surgery for hysterectomy

Many obstetricians and gynaecologists perform this procedure via “open” surgeries which involve a cut in the abdomen (laparotomy). In comparison to that, a laparoscopic (keyhole/miminally invasive) hysterectomy which I routinely perform , offers distinct advantages;

  • less bleeding
  • safer surgery than open
  • less pain
  • early recovery
  • lesser infection risk
  • less long term pain
  • early mobilisation
  • early return to work (useful for working women and cheaper for them in the long run as they can return to earning capacity sooner)
  • ability to drive and commence activities sooner.

How long is the recovery for laparoscopic hysterectomy?

Most women go home within 24 hrs after the operation (compared to 3-5 days with open surgery) with minimal analgesia needs and are driving within 7-10 days (compared to 6weeks with open surgery). This service has been established by Lotus Medics in Orange (public and private) and Parkes(public) hospitals.

Dr Sachin Kotasthane is a member of the AGES (Australiasian Gynaecological Endoscopy and Surgery) and the AAGL – (American Association of Gynae laparoscopists) both of which are international organisations that strive to promote and develop minimally invasive surgical techniques to benefit women’s health.

Endometriosis

This is a significantly debilitating condition that involves tissue similar to the lining of the uterus (endometrium) growing in the abdominal and pelvic cavities. Whilst this is not cancer it does behave like cancer in the fact that it can recur, and causes significant deterioration of a woman’s quality of life and an impact on her fertility potential. Often it can cause painful periods, causing women to double up, miss work or school, and present to hospital emergencies and require them to take regular analgesia-opioid and non-opioid).

Endometriosis can also cause painful intercourse (which can negatively impact relationships) and impede efforts by a couple to get pregnant. It can also cause painful bladder and bowel and chronic pain-which can ultimately result in chronic depression and anxiety and social withdrawal.

How can laparoscopic surgery help Endometriosis?

The advanced laparoscopic surgery Lotus Medics perform for endometriosis, not only treats the mild cases but also the severe cases where the pelvis is littered with the disease and bowel, bladder, uterus, tubes and ovaries are stuck to each other (a condition called the frozen pelvis). This treatment for which women are referred to Sydney gynaecologists by local GPs is now available locally. Laparoscopy involves burning (superficial lesions of endometriosis) and excision (of deeper lesions of endometriosis-called Deep infiltrating Endometriosis or DIE), both of which are performed by Lotus Medics. This treatment improves patient symptoms, pain, and also enhances fertility.

Chronic Pelvic pain

This is an association with Endometriosis and involves not just treating the disease but having a multidisciplinary approach to pelvic pain, which involves medication, suppression of any potential new endometriosis, focussing on other aspects of pain, involving other disciplines like urology, colorectal surgeons, dieticians, General practitioners, psychologists, pain specialists and pelvic floor physiotherapist to offer the best outcome and prolonged freedom from recurrent disease and pain.

As a part of our treatments for conditions like endometriosis apart from surgery, we also focus on alleviation of chronic pelvic pain using a number of strategies. Dr Sachin Kotasthane is a member of the Pelvic Pain Foundation of Australia and a part of the Australian Coalition for Endometriosis(ACE).

Fibroids

Fibroids are large benign lumps of the uterus which can cause heavy bleeding, infertility, pressure symptoms(frequent passage of urine/bowel issues) sometimes due to their sheer size(can grow up to a few kilograms in weight and can be the size of a football!!) and can also cause pain. Due to their often large size, again an open surgery is often used to remove them. This increases morbidity as explained above in the hysterectomy section.

How does laparoscopic surgery help fibroids?

Lotus Medics offer laparoscopic removal of large fibroids. This process is done by removing the fibroid from the uterus laparoscopically and putting it in a bag inside the abdomen- in this bag, the fibroid is then “minced up”(in-bag contained morcellation) using safe techniques which avoid the spread of the fibroid fragments and result in safe and minimally invasive removal of the specimen thus enhancing fertility, and reducing symptoms. These are the latest techniques using high-end equipment that allow patients early recovery and make surgery safer.