Laparoscopic Surgery for Ovarian Torsion
Ovarian torsion is an acute surgical emergency condition where the ovary twists around its own ligament, causing partial or complete obstruction of blood flow to the ovary.
Ovarian torsion is an acute surgical emergency condition where the ovary twists around its own ligament, causing partial or complete obstruction of blood flow to the ovary. Presentation can be from mild to severe excruciating pain and vomiting. Over time it can lead to permanent damage to the ovary if not treated promptly.
Dr. Sunil Eshwar is a highly experienced gynaecologist with extensive expertise in performing laparoscopic surgery for ovarian torsion in Bangalore. With a patient-centered approach, Dr. Sunil Eshwar ensures that each patient receives personalized care tailored to their specific needs. He is skilled in performing minimally invasive laparoscopic surgery, which reduces recovery time and minimizes scarring. Dr. Sunil Eshwar provides comprehensive post-treatment care to ensure a smooth recovery.
Diagnosis
Ovarian torsion is often diagnosed based on a combination of clinical suspicion, physical examination, and imaging findings. In cases where torsion is strongly suspected but imaging is inconclusive, many clinicians will proceed with laparoscopy due to the urgency of the condition.
Early diagnosis and prompt intervention are essential for ovarian torsion to preserve ovarian function and prevent necrosis. If ovarian torsion is suspected, immediate medical attention is crucial, and surgical intervention may be required to detorse the ovary and prevent permanent damage.
Clinical history pertaining to symptoms of severe pain abdomen and associated vomiting and a high degree of suspiscion can lead to the diagnosis.
Physical examination include checking the vital parameters which can detect a increase in pulse rate due to pain and vomiting and a fever due to infection.
Local examination will reveal signs of acute abdomen with tenderness and guarding and rigidity. In severe cases ascitic fluid can be present depending on the cause.
Diagnosing ovarian torsion can be challenging because its symptoms often overlap with other abdominal and pelvic conditions.
1. Diagnostic tests: These tests can detect the presence of a twisted ovary, the location of the torsion, and the degree of blood flow
2. Blood tests: A complete blood count (CBC) , CRP and a pregnancy test is done in some cases to help rule out other causes of pelvic pain.
3. Transvaginal Ultrasound: This is the primary imaging modality used to assess for
ovarian torsion. A transvaginal ultrasound with color Doppler can help visualize the ovaries and
assess blood flow. Key findings suggestive of torsion include:
Enlarged ovary: Often due to edema or the
presence of an ovarian cyst.
4. Doppler Ultrasound can show decreased or absent blood flow to the affected ovary,
though normal blood flow does not necessarily rule out torsion.
Free fluid: Fluid in the pelvis can be a
secondary sign of torsion.
Indication
Laparoscopic surgery is the gold standard definitive treatment for this condition. The keyhole surgery involves untwisting of the twisted ovary so that the blood flow is restored. In some cases, the ovary may need to be removed if it is severely damaged. Early diagnosis and prompt treatment are essential for the preservation and saving of ovarian function and fertility.
- Torsion is suspected when ovaries are stimulated in an induced cycle for IUI or IVF.
- In ceratin cases of huge ovarain cysts >5 to 7 cm torsion is a likely sequelae .
- Certain cysts of ovary like dermoid and endomerioma are also prone for torsion.
Preparation: After a anesthetic clearance , the patient is given general anesthesia, and the abdomen is cleaned and draped. A small 1cm keyhole incision is made near the navel, and a video laparoscope (a thin, lighted instrument with a camera) is inserted through it.
This laparoscope allows the surgeon to see the ovaries and surrounding tissues on a high-definition monitor. Additional small incisions may be made for other specialized instruments.
Surgical removal: Using the instruments, the surgeon carefully examines and then detorsion is done to salvage the ovary. If other cysts like dermoid was the cause of torsion then such cysts are removed laparaoscopically.
a procedure that involves securing the ovary to nearby tissues or the pelvic wall to prevent future twisting.
This procedure is often recommended for patients with recurrent ovarian torsion or those with risk factors, such as an elongated ovarian ligament, that predispose them to torsion.
Closure: Once the procedure is complete, the small incisions are closed with sutures or surgical glue. The patient is taken to the recovery room to wake up from anesthesia.
Overall, laparoscopic ovarian surgery is a safe and effective option with less scarring and faster recovery than traditional open surgery. It is important to follow postoperative instructions carefully to ensure optimal healing and recovery.
Laparoscopic ovarian surgery, also known as minimally invasive surgery, is considered advantageous over traditional open surgery due to the following reasons:
Small incisions are used, resulting in less trauma to the body and less scarring.
Reduced blood loss during the surgery.
Faster recovery time and shorter hospital stay.
Reduced risk of infection due to smaller incisions.
Minimal pain after surgery, which may require less pain medication.
Reduced risk of adhesions (scar tissue).
Relief of symptoms
Preservation of ovarian function
Anesthesia complications- surgery under general anesthesia can have its own complications
Bleeding – injury to vessels in vicinity. It is rare.
Infection - a small incision does not make you immune to infection.
Technical difficulty: Laparoscopic ovarian surgery requires considerable technical skill and expertise, which can induce complications if not carried out by a professional.
Limited Device Availability
Increased Operative Time
Limited Accessibility
Surgical expertise
Cost
Laparoscopic ovarain or uterine or tubal surgery is usually done by a gynaecologist with specialized training and experience in laparoscopic surgery. It becomes prudent to choose a qualified and experienced surgeon who can ensure a successful outcome with minimal complications.
If you're looking for expert doctor for ovarian torsion treatment in Bangalore, Dr. Sunil Eshwar is here to help. With a commitment to excellence in gynaecological care, Dr. Sunil Eshwar offers compassionate and effective treatment solutions.
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