Minimal Access and Laparoscopic ('Key Hole") Surgery

Dr. Onuma has a particular interest and expertise in laparoscopic and minimal access pelvic floor and urogynaecological surgery. He often combines laparoscopic (key hole) surgery with vaginal surgery using mimimal access techniques. He rarely resorts to open surgery which means that his patients have a faster recovery with less pain and increased mobility and function.

Operation Types

• Laparoscopically assisted vaginal hysterectomy
• Total laparoscopic hysterectomy
• Vaginal hysterectomy
• Laparoscopic vaginal vault suspension (± mesh)
• Laser Vaginal Rejuvenation
• Designer Laser Vaginoplasty
• Vaginal approach to prolapse repair incorporating mesh
• Laparoscopic paravaginal repairs

All of these procedures can be combined with minimal access incontinence surgery such as:

• TVT (Retropubic)
• TVT O (Transobturator)
• Monarch TVT (Transobturator)
• Laparoscopic Burch Colposuspension
• Paraurethral injections

Minimally Invasive Surgery

One of the greatest trends in the history of surgery is the advent of minimally invasive techniques for a wide spectrum of surgeries. Minimally invasive means performing surgery in many cases without large, open incisions and sometimes under sedation and local anesthesia. For patients, this can translate into much less postoperative discomfort, lower risk of infection, faster recovery and little scarring. The great benefits offered by minimally invasive options challenge the standard of care for many conditions and should always be considered. The physician at the Institute is a national expert in minimally invasive reconstructive pelvic surgery.

Laparoscopy

• At the Institute, laparoscopy is used in vaginal reconstruction and support of the bladder and the urethra. Laparoscopy means visual examination of the abdomen by means of a laparoscope. Laparoscopy (often called "belly button surgery", or endoscopy) is a surgical technique involving small incisions in the abdomen (usually three) through which major surgical procedures can be performed. One of the incisions is made in the belly button, the other two on either side of the abdomen.
  
• The laparoscope (which looks like a tiny telescope) is placed through the belly button incision and attached to a small video camera. The video image is shown on a TV monitor in the operating room. The surgeon using instruments passed through the other two incisions performs the surgery guided by the TV images.

Less Hospitalization - Many laparoscopic cases are done as outpatient (< 23 hours) or an overnight stay. Major operations using a traditional incision often require a hospital stay of several days.

Quicker Recovery Time - Since laparoscopic surgery does not require the abdomen to be opened with a large abdominal incision, you take less time to heal, require less pain medication and are able to resume normal activities in a shorter period of time.

Decreased Scar Formation - Since the abdominal incisions are small, less internal scarring or adhesions can form. Laparoscopy significantly reduces the scar formation (adhesions) and internal abdominal pain associated with these adhesions.