Laparoscopy – A Safe Surgical Option for High-Risk Patients

Laparoscopy can be a true blessing for patients with high-risk conditions such as anemia, obesity, or diabetes mellitus. These patients often have a compromised healing capacity, making traditional open surgery more risky.

One major advantage of laparoscopic surgery is the significant reduction in blood loss. This becomes especially important in cases of thrombocytopenia (low platelet count) where bleeding and clotting disorders pose serious challenges. Patients with conditions like ITP, hypersplenism, or liver disorders are often denied surgery due to fear of uncontrolled blood loss and abnormal clotting mechanisms.

However, with strict precautions, prophylactic support, and high-risk consent, laparoscopy can be safely attempted.

A Recent Case

We recently treated a patient who had persistently low platelet counts (50,000–60,000) for the last 10 years. She had been suffering from menorrhagia for many years and had tried multiple treatments, including medical management for the past year, without success.

After thorough counseling and explaining the risks to her family, we decided to perform a

laparoscopic hysterectomy.

• Prophylactic FFP and platelet transfusions were given.

• Surgery was completed successfully with expected but controlled blood loss.

• The patient recovered well and was discharged in a stable condition.

This case was kindly referred to us by Dr. Pranit Sungare Sir (Narwad).