Techniques in laparoscopic gynaecological surgery

Laparoscopic surgery differs from conventional open surgery in several ways. Firstly the operator needs to be comfortable with a two dimensional image viewed either through the laparoscope or on the television monitor, although recent advances would suggest the 3D television technology will be widely available in the near future, once problems with operator discomfort and nausea have been overcome. Secondly, the lack of tactile sense and the use of long instruments far removed from the target organ, requires considerable manual dexterity and hand-eye co-ordination which not all surgeons possess. This type of surgery takes far longer than conventional surgery and in order to avoid back strain on the operator and assistants it is necessary to operate directly off a television monitor. Recent developments in three chip endoscopic cameras have given much better resolution on the television monitors, but the major contribution to the excellent optics that endoscopic surgeons enjoy in modern times is due to the development of the rod lens optical system and the fibre light cables used to provide illumination from an exterior high intensity light source. For this reason endoscopic surgeons will forever be indebted to Harold Hopkins, FRS, from Reading University who invented both the lens system and the fibre optic cables