Laparotomy is a surgical procedure involving an incision through the anterior abdominal wall and entry into the abdominal area. Laparotomy is a "traditional" procedure being performed for centuries. The incision may be horizontal, vertical or oblique and its length depends on the procedure type. A specialist surgeon needs to train for a number of years and tends to perform laparotomy as the primary method for various procedures.
Further optional training in the latest techniques, such as laparoscopic or robotic surgery, helps the surgeon gain a more complete and in-depth specialization. Only few highly sought after specialty programs at reference centers of top US university clinics offer such comprehensive surgical training in subspecialties of gynecologic surgery.
Today, the surgical method of choice for most gynecologic procedures is laparoscopic or robotic surgery. This is due to the fact that its comparative benefits over typical surgery are well-documented. It does not imply that an experienced surgical team favors consistently and exclusively a particular procedure over another. It means that the team possesses the appropriate specialization and experience to perform various procedures, even very serious ones, using the laparoscopic or robotic technique safely and effectively, with all the advantages and benefits of these modern and minimally invasive procedures.
It should be noted that laparotomy is still a reliable and trustworthy procedure for a trained surgeon to perform whenever deemed clinically necessary. For instance, acute internal bleeding is a clear indication for laparotomy. Laparotomy is also the procedure of choice for advanced (3rd or 4th stage) ovarian or endometrial malignancies etc. On the other hand, a history of laparotomies, the presence of sizeable fibroids or cysts, and “visibility” issues at the surgical field or “better debridement” are NOT actual medical indications favoring laparotomy over laparoscopy, especially when performed by a specialized surgical team which is highly experienced in a great number of complex procedures.
Laparoscopic surgery has gained popularity over the last decades as an alternative method for performing a multitude of procedures.
Hysteroscopy (from the Greek word “ύστερον”= uterus and endoscopy) is the detailed examination of the uterus (or endometrial cavity).
The first total laparoscopic radical hysterectomy, with complete lymph node dissection, was performed in Greece in 2004 by Dr. G. Hilaris and his team.