There are a variety of diseases and conditions of the surgical intervention for which minimal access surgery is recommended. Many times patient need mutiple surgery at the same time at same session. In addition to the decision to undergo any kind of multiple surgery, patients are often faced with a choice of traditional or minimally invasive surgical techniques. In order to participate fully in the decision-making process, patients need information about the following issues:
- How is traditional “open” surgery performed for multiple pathology.
- What is “minimally invasive multiorgan surgery”?
- A description of the minimally invasive surgery techniques available
- The benefits and risks of mutiple minimally invasive surgery at the same time
- The types of operations and diseases for which minimally invasive surgery is appropriate
- Individual patient factors that must be considered
- Questions to discuss with the surgeon and his experience of performing multiple surgery
The result of this surgery was following:
- Mean operating time was 90 minute
- Hospital stay was one day 24 hour
- Number of Ports were four
- One colpotomy was just additional wound to remove the myoma
- Pain of the patient was same as cholecystectomy alone
- The cost of surgery was very less compare to the cost of all these three surgery seperately
There is a significant amount of discomfort associated with these multiple incisions that can prolong the time spent in the hospital after surgery and can limit how quickly a patient can resume normal daily activities. Because traditional techniques have long been used and taught to generations of general surgeons and gynecologists, they are widely available and are considered the standard treatment to which newer techniques must be compared.
Because the incisions are much smaller than those used in traditional mutiorgan surgery, there is usually less discomfort following minimally invasive surgery. This has been shown to result in a shorter hospital stay, less need for prescription pain medications, an earlier return to normal activities and less visible scarring. While some experts have suggested a long-term benefit to minimally invasive surgery, it is generally accepted that the primary benefits are seen in the initial recovery from surgery.
Conclusion:
In properly selected women, combined myomectomy, cholecystectomy and ovarian cystectomy are safe, feasible and cost-effective procedures and can be considered by both gynaecologist and general surgeon. However if hysterectomy is complicated, gall bladder can be left for removal later on.