Laparoscopy where punctures are made. Types, advantages and disadvantages of laparoscopy

Laparoscopy is one of the most gentle ways surgical intervention. During this operation, doctors make only three to four small incisions, no more than one and a half centimeters in length. The thinnest telescope with a video camera is inserted into one of the incisions, which transmits the image to a large screen and allows you to see everything that happens inside the body. Other point punctures are necessary for the introduction of manipulators - tools for carrying out the operation itself.

Benefits of laparoscopy.

The laparoscopy method has been used for over 70 years. During this time, doctors around the world have improved this method surgical intervention, making it as safe as possible.
The main advantages of laparoscopy compared to abdominal surgery are:

• low injury rate
• fast recovery period,
• shorter duration of surgery
• the ability to see clearly on the monitor internal organs patient,
• pain after surgery disappears after 2-3 days, and not after 2-3 weeks,
• a short period of hospitalization,
• absence of scars and scars,
• reduction in blood loss
• during gynecological operations, the possibility of subsequent pregnancy.

Despite the obvious advantages of laparoscopic intervention, you should prepare for it as carefully as before the abdominal operation!

duration of laparoscopy.

How long does the operation take? The answer to this question depends on various factors. For example, laparoscopy of an ovarian cyst may include not only exfoliation of the cyst itself, but also the removal of foci of endometriosis, inflamed ovarian tissues. Also, if necessary, the doctor separates the adhesions, checks the patency of the fallopian tubes and removes the myomatous nodes.
On average, laparoscopic interventions last from 30 minutes to 3 hours. To understand what this time includes, you should consider all phases of the operation.

Stages of the operation.

1. Introduction of general anesthesia.
2. Making cuts. The number of holes in the skin depends on the complexity of the operation. Usually 3, maximum 4 cuts are enough.
3. Pneumoperitoneum. The abdominal cavity is filled with carbon dioxide using a special needle. This procedure is needed to tighten the internal organs, protecting them from injury and creating space for the surgeon to work.
4. Introduction of a laparoscope - an illuminated tube with a miniature webcam. This allows the doctor to consider in detail the presence of pathologies and decide how long the operation itself will take.
5. Insertion of necessary instruments into other incisions. The doctor chooses manipulators depending on the operated organ. One of the most common operations in gynecology, laparoscopy of an ovarian cyst is most often performed using a laser, scissors, forceps and a coagulator.
6. Extraction of manipulators, removal of carbon dioxide. Small sutures.

The postoperative period can take from 1 to 7 days. On average, 2-4 hours after surgery, the patient can already move independently.

Moving around is not only allowed, but strongly recommended, in order to avoid the development adhesive process, thrombophlebitis, as well as to restore normal blood circulation!

Preparation for the operation.

How long laparoscopy lasts depends not only on the diagnosis, but also on how carefully the preparation was made. It is best to start the preparatory period a week before surgery. You should follow a diet that excludes fresh fruits, vegetables, black bread, legumes and other foods that promote gas formation. It is not recommended to consume an excessive amount of liquid, which can lead to swelling of the tissues and thus complicate the course of the operation.

Help your body tolerate anesthesia more easily by quitting smoking and losing weight!

On the day for which laparoscopy is scheduled, doctors advise to completely abandon the liquid and any food. It is also necessary to clean the intestines; for this, the patient is given an enema in the hospital.
As before any intervention, it is imperative to go through a series of laboratory research, including tests, ultrasound, coagulogram, fluorography, cardiogram and other necessary examinations.

What can and can not be done after the intervention?

How long will it last recovery period due to the correct implementation of the doctor's advice.
General recommendations:

• begin to move a little a few hours after the operation, gradually increasing the distance traveled;
• food can be taken after 6-8 hours, the consistency should be liquid or puree, you should not eat and drink too much, the number of servings is minimal;
• it is not necessary to bring down the natural temperature of 37 degrees after the intervention and anesthesia;
• exclude alcohol;
• process the seams, and after 10-15 days, you can start using ointments that absorb scars;
• after gynecological operations, it is necessary to refrain from sexual contact for a month;
• avoid high physical activity and weight lifting.

How long is the recovery period?

The uniqueness of laparoscopic surgery is that the patient can theoretically go home on the first day after the operation. But doctors recommend staying in the hospital for a few days in order to observe the patient's condition.
bloating, pain, nausea and dizziness are easily eliminated by the hospital staff with the help of medications.
On average, complete healing and restoration of the body occurs within a month. The patient himself can make the healing process more comfortable, following a sparing regimen and the recommendations of doctors.

Possible complications.

Complications after laparoscopy are much less common than after abdominal surgery and do not exceed 2%. The feeling of pain also passes much faster and may accompany the patient for the first 3-5 days.

Pain for more than 5 days may be a sign of complications that have begun! You must report your condition to your doctor!

Complications may include:

• thrombus formation,
• disruptions in the work of the heart - vascular system and lungs
• nausea, vomiting due to anesthesia,
• infection,
• bleeding,
• damage to internal organs,
• the ingress of carbon dioxide into the subcutaneous fat,
• suppuration in the area of ​​the seams.

The process of surgical intervention, the time of its implementation and postoperative period directly depend on the professionalism of the doctor. An experienced doctor will reduce the possibility of complications to zero.

Any operation is a shock for the whole organism. Often physical stress accompanied by psychological Therefore, doctors recommend preparing for the intervention comprehensively. It is desirable to lead healthy lifestyle life in the preoperative period, sleep at least 8 hours a day, eliminate stressful situations.

If you cannot calm the excitement associated with the operation, take a tincture of valerian or motherwort.

The anesthesiologist may, at your request, prescribe you additional sedatives, such as diazepam. The most important thing is a favorable mood and faith in the successful outcome of the upcoming operation!

I have not been able to get pregnant for about five years. bypassed a large number of clinics, doctors, given a lot of money over the years. Doctors could not find the cause of infertility. In the end, they decided to send me to diagnostic laparoscopy.

Laparoscopy - modern method surgery, in which operations on the internal organs are performed through small (usually 0.5-1.5 cm) holes, while traditional surgery requires large incisions. Laparoscopy is usually performed on organs inside the abdominal or pelvic cavities.

I did laparoscopy for free (under the MHI policy) in the city hospital. Before that, I had never been given anesthesia, so it was scary: I was afraid not to wake up. Before the laparoscopy, I was given a list of tests that needed to be done before the operation:

General blood test, coaculogram;

Blood for HIV, hepatitis;

General urine analysis;

Blood type and Rh factor;

smear for flora, smear for oncocytology;

Information about vaccinations;

Therapist's consultation;

Certificate of absence of contact with infectious patients;

Ultrasound of the pelvic organs.

And then came the day "X". Laparoscopy was performed on the 12th day of the cycle. The day before the operation, he was admitted to the hospital. In the evening, before the operation, they allowed light dinner, after 18.00 nothing can be eaten. Before going to bed, they did an unpleasant procedure - an enema. In the morning, before the operation, too.

In the morning, when I woke up, I asked the nurse to bandage my legs with an elastic bandage, although the hospital did not insist on this. After reading about veins on the Internet, I decided to play it safe.

I'm waiting in the call ward. It becomes scary. The anesthesiologist comes into the ward and asks questions about weight, height; asks if there is an allergy; measures blood pressure and talks about the essence of anesthesia. If you are going to a laparoscopy, be sure to bring adult diapers with you to the hospital. I was not warned that they would be needed. Lucky: the neighbor in the ward had extra diapers, and she shared them with me.

They took me to the emergency room and told me to undress completely. They only allowed us to take off our socks, because it was cold in the room. I lay down on the couch, put my legs the way they put them, while in the gynecological chair. per finger right hand they attached some kind of device (as I understood that it showed my pulse), and they began to look for a vein on my left arm. I didn't understand how I fell asleep. It happened instantly. And so I wake up, I hear the instruments in the intensive care unit beeping, I try to open my eyes, but I can’t. I feel like I have a tube in my mouth that prevents me from breathing. I wanted to remove it, but it turns out that my hands were tied. Here I begin to feel that I am suffocating, I begin to turn my head. The doctor tells me: "Don't shake your head." I think: “Well, that’s it, I’m definitely going to suffocate now.” It turns out that the doctors were waiting for my lungs to fully function. When they hung up the phone, I felt an unreal relief. The anesthesiologist asks me how I feel, I say in a slow voice that it’s normal, but I can’t open my eyes. Here they take me to the nurse's room, put me on the couch, the nurse gives an injection with an antibiotic, and I fall asleep.

I wake up in two hours. I had a very bad stomach ache, and a roommate called a nurse who gave me an anesthetic injection. I fell asleep again. I had a laparoscopy with hysteroscopy and a fallopian tubes check for about 1.5 hours. Started at 11:00 am and normal condition I arrived around 5:00 pm. Since laparoscopy is diagnostic, they made 2 punctures: above the navel and on the right.

I was allowed to get up only the next morning, and, accordingly, it was possible to eat only the next day after the operation. After anesthesia, I was still stormy for two days.

During the operation, the stomach is inflated with gas in order to better see the organs. The abdomen was distended. For about a week I went with gas, it put a lot of pressure on my shoulders. You need to move more so that this gas leaves the body faster.

As a result, during laparoscopy, they found external endometriosis on the utero-sacral ligaments, cauterized its foci and removed adhesions. At the same time they checked the pipes: they are passable. The doctor who operated on me first advised me to try to get pregnant on my own for 2-3 months, without using medicines If it does not work out, then consult a doctor for the appointment of hormonal drugs.

I spent only 6 days in the hospital. After laparoscopy, I was injected with antibiotics for 5 days and did magnetotherapy 4 times for the formation of adhesions. On the 5th day after the operation, the stitches were removed and I went home.

I have been on sick leave for a month since the operation. It was hard to recover, there was some kind of lethargy, I forgot everything. The doctor said it would pass. Indeed, it has passed.

Stomach punctures, while in the hospital, I was afraid to look. I saw them later at home. Not so scary, it turns out. After the seams are removed, these places need to be treated with brilliant green. A crust will appear at the puncture sites, which will then fall off.

As you can see from the photo, after 3 months the seams were already visible. They say that after laparoscopy, new adhesions appear again, so I would like to get pregnant as soon as possible. 3 months have passed since laparoscopy, the result is zero so far. You will probably need to take hormones though.

In general, to whom laparoscopy is prescribed, I advise this procedure, since today it is the most informative way to identify and eliminate the causes of women's diseases.

Collapse

If you need to make a diagnosis or low-traumatic treatment, laparoscopy of the uterus is performed in gynecology. The choice of procedure depends on the type of disease and the severity of its course. In order for everything to go without consequences, the operation must be carried out by an experienced specialist using serviceable equipment. Is it possible to do laparoscopy during menstruation and how it is performed, you will find out below.

What is uterine laparoscopy?

Laparoscopy of the uterus is a safe and gentle technique, which allows not only to diagnose the organ, but also to perform successful operations. At the same time, the surgeon makes the required number of punctures in the peritoneum. expedient this species access for neoplasms that are present in the area of ​​​​the organ, with anomalies in its development.

With the help of laparoscopy, endometriosis can be diagnosed, microcysts can be detected and a definite answer can be given to why a woman is infertile.

After this method the woman comes to her senses in 1-2 weeks.

In what cases is the operation performed?

The operation may be prescribed for:

• myomas;
• fibroma;
• cysts;
• cancer;
• regular bleeding from the uterus of an unexplained nature;
• omission of the uterus and its prolapse;
• endometriosis;
• congenital defects;
• ineffective hormone therapy;
• unknown nature of infertility;
• adhesions;
• pregnancy outside the uterus.

If a woman has any of the above pathologies, it is not a fact that the doctor will stop at laparoscopy. Everything is purely individual, the age of the patient, the present symptoms, etc. are taken into account.

Kinds

Laparoscopy is diagnostic, operational and control.

Diagnostic

Its purpose is to confirm or refute the established diagnosis. They resort to such diagnostics in a hopeless situation, when other methods could not provide answers to questions of interest. There are cases when this type smoothly turns into an operational one.

Operational

It is done after receiving all the analyzes, in the case when conservative treatment did not help. This includes the removal of various neoplasms, both malignant and benign (fibromas, myomas, cysts, tumors, etc.) and the removal of the organ itself.

Control

It is done to check the previous surgical intervention.

Contraindications for surgery

Before laparoscopy, the doctor must exclude all contraindications. These include:

• the presence of a hernia;
• poor blood clotting;
• exhaustion of the body;
• serious pathology of the lungs;
• the presence of diseases that are associated with the heart and blood vessels.

If you do not take into account the above, then complications may appear after the operation.

There is also a risk negative consequences after radical treatment if a woman has:

• there is obesity;
• adhesions are present;
• diseases of an infectious nature;
• more than 1 liter of fluid inclusions in the peritoneum.

In order for everything to go without excesses, you first need to carry out preparatory procedures or treatment (if necessary).

How to prepare for the procedure?

If the laparoscopy is planned, then the preparation will take a week, sometimes more. During an emergency operation, a woman is prepared in a few minutes, sometimes it takes up to half an hour. The countdown is in seconds, because we are talking about human life.

If there is no need for emergency surgery, the doctor gives the patient a referral for tests:

• general (urine and blood);
• checking blood glucose;
• exclusion of STIs, HIV, hepatitis and syphilis;
• biochemical;
• clarification of the Rh factor, blood group;
• a swab is taken from the vagina.

Beforehand, the doctor should familiarize himself with the anamnesis and find out what the woman has allergic reactions. Held gynecological examination using mirrors.

In addition to laboratory tests, you need to pass instrumental diagnostics. This is an electrocardiogram, a study using ultrasound, a fluorographic study. All this is necessary for the selection of the anesthetic drug and the type of anesthesia.

Sometimes a woman is referred to a psychotherapist who psychological preparation. Conversations with the doctor help to recover and calm down emotionally.

Is it possible to do laparoscopy during menstruation? During menstruation, surgery is usually not performed. The exception is emergency surgical intervention when it comes to life or death. best time- period after critical days, in the first phase of the cycle.

If we talk about direct preparation the day before the operation, then this includes:

• refusal of food in the evening;
• using an enema before bed;
• conversation with an anesthesiologist and choice of anesthesia;
• acquisition of special compression stockings or tights that will prevent blood clots (this is best done in advance).

Procedure technique

Laparoscopic surgery to remove the uterus or neoplasms in its cavity passes through minor punctures in the peritoneum. Trocars are installed in them, which will hold the endovideo camera and other instruments that will be used during laparoscopy.

Previously, the entire area is treated with an antiseptic. After punctures and the introduction of instrumental equipment, the peritoneal cavity is inflated with a special harmless gas. It does not cause allergies and dissolves quickly. This is necessary for:

• enlargement of the abdominal space;
• visualization improvements;
• freedom of action.

There can be 2, 3 or 4 punctures. It all depends on the purpose of the laparoscopy. Their purpose is the following:

1. The navel area is for the Veress needle. Gas will flow through it.
2. The next mini incision is made to insert the trocar with the camera.
3. If laparoscopic removal of the uterus or any formations is done, then a third (if necessary, fourth) puncture is performed. The 3rd will be in the area above the pubis. A laser, scissors and other instruments are inserted there.

On the monitor screen there will be an image of what is happening inside. In this case, the picture is enlarged several times. Laparoscopy lasts from 45 minutes to two hours. It all depends on the severity of the intervention. Diagnostic procedure takes the least time, no more than half an hour.

During the operation, the woman does not feel any discomfort or pain, since the anesthesia is general, and the patient is in a drug-induced sleep.

Recovery period

After the operation, the woman needs a little time to recover. Since the violation of the integrity of the tissues is insignificant, the healing process is fast. You can get out of bed after 7-8 hours. They are discharged home in three to five days. It all depends on the condition of the woman.

At first, painkillers are prescribed to eliminate pain. Antibiotics may be prescribed to prevent infections. Important proper nutrition and exclusion of physical activity.

Sometimes a woman needs 10 days to get everything back to normal, some will have to wait 20-30 days.

To reduce the recovery period, you should listen to the recommendations of a specialist, exclude visits to baths, saunas, baths. You can not play sports, have sex and lift heavy objects.

Possible consequences and complications

Usually, after such a technique, complications appear the least, but they can also be. This:

• soreness;
• bleeding (external and internal);
• difficult emptying of the urethra.

Such consequences do not need to be treated, everything will pass by itself. Sometimes a woman may have a fever, weakness, increasing pain and discharge from the genitals. This indicates the development of an infection. To prevent this from happening, the patient should not neglect taking antiseptic drugs and antibiotics. With laparoscopy of an ovarian cyst or removal of the uterus, symptoms may be present for a longer time.

Is pregnancy possible after this operation?

It is possible to get pregnant after laparoscopy, but it is not advisable to rush. Planning a pregnancy is recommended after 3-6 months. Sometimes you have to wait 8-10 months. It all depends on the diagnosis individual characteristics female patients. First you need to consult with a gynecologist who will examine the patient, prescribe tests and some instrumental types. diagnostic examination. Only after receiving the results can something clearly be said about further actions.

If the uterus was removed using this method, pregnancy is impossible.

Cost of laparoscopy

The cost of a particular operation may vary. In each case, everything is individual.

Conclusion and Conclusion

Laparoscopy of the uterus is distinguished by its sparing technique. Recovery is quick and not very painful. Operations performed on the body of an organ can not only restore the childbearing function, but also lengthen the years of life for patients who have been found to have malignant tumors. Now the question of whether it is possible to remove the uterus by laparoscopy has a clear answer.

In this way, it is possible to determine why a woman cannot become pregnant and immediately eliminate the present defect. But before resorting to laparoscopy, you need to go through complete diagnostics, which eliminates all contraindications.

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Laparoscopy is a low-traumatic operation performed for therapeutic and diagnostic purposes. Its essence lies in the fact that the doctor can perform an operation on the internal organs abdominal cavity through small punctures, avoiding abdominal incisions. Special tubes are inserted into the peritoneum through small holes, and with the help of them the doctor controls the instruments, lights and cameras. In gynecology, laparoscopy (endoscopy in gynecology) has importance, because it can be used both for the purpose of diagnosing pathologies and for the purpose of treatment. How is laparoscopy performed?

Laparoscopic surgery is performed under general anesthesia.

A small passage is pierced in the wall of the patient's abdomen, through which air is pumped into the peritoneum. This manipulation helps doctors avoid injuries to organs located nearby, as the stomach increases in volume.

After that, several small micro-incisions are made for the introduction of the laparoscope. The laparoscope is special device tube-like. On the one hand, it has an eyepiece, and on the other, a video camera with a lens. The second incision is necessary for the insertion of the manipulator. After that, the procedure begins. How long does the operation take? Its duration may be different, it depends more on the severity of the disease and the purpose of the procedure. If the task of laparoscopy is diagnostics, then no more than 60 minutes. Treatment can last up to several hours.

When is the choice: laparoscopy or abdominal surgery? Compared with conventional abdominal surgery, laparoscopy is able to provide better visual control with the help of optical magnification several times of the examined organs, the abdominal cavity, and the retroperitoneal space.

During the course of the operation, doctors monitor their own movements and what happens to the patient's organs on a special screen. The surgeon performs the necessary actions, focusing on him.

A video inspection of the area where the operation was performed is mandatory after the procedure is completed. The surgeon must make sure that there is no bleeding, remove the blood or fluid that has accumulated during the operation. Then gas or oxygen is removed. Only after that the instruments are removed, and the cuts in skin stitches are applied.

Drainage at the end of the operation is necessary in without fail. It is placed after laparoscopy in order to remove blood residues, the contents of wounds and abscesses from the peritoneum to the outside. This helps prevent the possibility of peritonitis.

Types of laparoscopy

In gynecology, a distinction is made between elective and emergency laparoscopy. And also carried out diagnostic laparoscopy or medical. When prescribing a planned operation, the surgeon must carefully study the results of the tests, read the information about chronic diseases, if they are. Important age and indications for laparoscopy, preparation.

Currently, diagnostic laparoscopy (in other words, endoscopic surgery in gynecology - diagnosis through natural holes or punctures 0.5 cm) is often used by surgeons. One of the main advantages of this method is considered to be low tissue trauma, a minimum of complications and a rather quick return of the patient to the normal rhythm of life.

Diagnostic laparoscopy allows the doctor, with the help of a tube with a video camera inserted into the abdominal cavity, to have a good opportunity to examine in detail the organs of the patient's abdominal cavity. This allows you to assess the situation and understand the cause of the disease, ways to eliminate it. Or make sure the woman is healthy.

It often happens when diagnostic laparoscopy, according to the indications that emerged during the procedure, is reclassified as a medical one. This happens if the surgeon during the operation sees that there is an opportunity to help the patient right now. At the same time, laparoscopy, now aimed at treatment, leads to recovery, complete or partial.

As a rule, interventions by this method are done according to the prescription of the attending gynecologist. Before a laparoscopy is performed, tests are preliminarily given and an examination is performed.

Emergency execution is assigned in certain cases. Laparoscopy, indications for urgent conduction:

• Rupture of the ovary (apoplexy);
• , ovary;
• flowing in acute form infectious and purulent diseases;
• With a ruptured cyst;
• Necrosis of the myomatous node;
• If the pregnancy is ectopic and progresses;
• Puncture of the uterine wall during a medical abortion;
• If diagnosis is needed in acute pain syndrome lower abdomen with unclear etiology.

Emergency laparoscopy in gynecology is necessary in a situation where surgical intervention needs to be performed urgently. Its purpose can be both therapeutic and diagnostic.

Indications for laparoscopy

Gynecological diseases lead to the need for an operation.

Indications for laparoscopy:

• Infertility
• Obstruction of the fallopian tubes (for example, when diagnosing infertility - if it was not possible to find out by other methods), excision of adhesions in the small pelvis
• Endometriosis (If combined with other ailments of unclear etiology)
• Ovarian cyst (laparoscopic cystectomy)
• Myoma node
• Violations menstrual cycle
• Inflammatory processes in the pelvic area
• Suspicion of ectopic pregnancy
• Tumor in the ovarian region of unknown nature
• Polycystic
• To clarify the development and nature of anomalies of the internal genital organs of a woman
• To control the treatment, aimed at suppressing inflammation in the pelvis.
• To clarify the stages of development of a pathological and malignant nature (when there is a question about surgical treatment and its volume)
• To control the integrity of the uterine wall during hysteroresectoscopy

Quite often, diagnostic laparoscopy during surgery is retrained as a medical one.

Statistics show that the number of complications associated with infertility due to obstruction of the fallopian tubes is approaching 40% relative to all others. Therefore, laparoscopy of the fallopian tubes is a fairly common procedure in the gynecological profile. Obstruction can be caused by inflammatory processes, the consequences of past interventions, when adhesions form, infections.

Laparoscopy of the fallopian tubes can be performed both with diagnostic and with therapeutic purpose. At the same time, diagnostics during the operation can become a stage of therapeutic intervention in the process, for example, laparoscopy of adhesions.

It turns out that laparoscopy of the fallopian tubes becomes an excellent alternative to conventional abdominal surgery: it is less traumatic, the rehabilitation period is short, and it allows the doctor to perform all the necessary manipulations.

Despite the fact that surgical intervention using laparoscopy is less traumatic, there are several contraindications to its implementation.

They are divided into absolute and relative.

The first group includes:

• Respiratory ailments (decompensation diseases, exacerbation of asthma);
• Cardiovascular diseases, including cerebral vessels, diaphragmatic hernia or infirmity esophageal opening, that is, those ailments that may prevent the woman from giving the correct body position on the operating table for the work of surgeons;
• Poor blood clotting;
• severe exhaustion;
• Shock of any kind and coma. state of shock may occur if there is a break fallopian tube or cysts. Then laparoscopic operations are replaced by abdominal ones;
• Hypertension in severe degree;
• Acute viral infections;
• Acute renal or hepatic failure.

The second group includes (relative):

• Cancers of the ovaries, cervix or any other localization;
• Obesity (3, 4 degree);
• Pathological formations in the small pelvis of a significant volume;
• Adhesions in the abdominal cavity that have arisen after previous operations;
• Hemorrhage in the peritoneum;
• Inflammation of the peritoneum (peritonitis);
• Allergy;
• Pregnancy more than 16 weeks;
• Fibroids larger than 12 weeks.

Contraindications to laparoscopy will also be situations if the patient has a lot of adhesions in the small pelvis, if tuberculosis is detected in the organs reproductive system, with endometriosis in advanced severe form, as well as if the hydrosalpinx is large.

Since there are indications and contraindications for laparoscopy in gynecology, it is necessary to undergo an examination before the procedure.

The doctor determines whether it is possible to carry out laparoscopy of the abdominal cavity in each individual case after examining all the tests, getting acquainted with the results of the ultrasound. It happens that the positive effect of treatment with laparoscopy is quite difficult, then a laparotomy is prescribed (an operation with an incision in the abdominal wall).

How to prepare for laparoscopy should be explained in detail by the attending physician. In addition to the gynecologist-surgeon and the anesthetist, the patient must undergo consultations of related specialists. All comorbidities are identified. Since the operation is performed under general anesthesia, the preparation of the patient for laparoscopy should take place at a serious level. Before the operation, a woman should visit:

• therapist
• Neurologist
• Nephrologist
• Dentist and other doctors, to detect possible chronic foci of infection.

It is mandatory to pass tests:

• Blood and urine for general analysis;
• Biochemistry of blood;
• On the level of glucose and sugar;
• Blood type;
• For syphilis and HIV;
• For hepatitis;
• Coagulogram (blood clotting test);
• Smear on flora.

Before the operation, the patient also receives referrals for fluorography, cardiograms, ultrasound of the pelvic organs.

If a laparoscopy of the uterus or other organ is performed urgently, then the number of studies and analyzes is limited to general ones, because in this situation not only the woman's health, but also her life can be in danger.

The minimum is blood type and Rhesus, general analyzes blood and urine, determination of coagulability, cardiogram, measure pressure. The rest are performed when absolutely necessary.

Before an emergency operation, food and water intake is prohibited for two hours. They put a cleansing enema, wash the stomach in order to prevent vomiting and the release of stomach contents into Airways under the influence of anesthesia.

During the planned preparation for the operation, a strict diet is prescribed before laparoscopy: do not eat anything in the evening, and do not drink anything in the morning either. A cleansing enema is prescribed both in the evening and in the morning.

On what day of the cycle do laparoscopy? Usually this is the date of the planned operation is appointed after the fifth - seventh day from the onset of menstruation. During the period of menstruation, they try not to carry out laparoscopy, since the bleeding of tissues increases. However, this is not a contraindication, but is taken into account by the operating surgeon and anesthesiologist.

Is laparoscopy a danger or a benefit?

Many patients are afraid of laparoscopy, removal of cysts and fibroids. Are their fears justified? How dangerous is this procedure? How is the rehabilitation going?

There are risks, of course. After all, laparoscopy is a full-fledged operation and it is performed under general anesthesia. However, such a surgical intervention is considered much less dangerous compared to, for example, abdominal surgery. This information is correct based on the fact that when it is carried out, the risk of complications is reduced to a minimum. The main rule is to obey the doctor and follow all the recommendations during preparation and after.

Advantages and disadvantages of the laparoscopy procedure

This method of operation has both advantages and disadvantages. Let's take a look at them.

The advantages include:

• Small cuts in abdominal wall instead of wide;
• After the operation, there is practically no pain;
• Scars do not remain due to the lack of an incision;
• The need for hospitalization is minimal;
• Pretty soon after the operation, you can get up and walk;
• Sometimes you can go home on the same day in a maximum of 2-3 days. At abdominal operations this period will be 14–21 days;
• The rehabilitation period passes quickly and you can return to normal life;
• Postoperative hernias are rare. So, after simple operations, this complication is common;
• The surgeon gets a more convenient view of the organs due to the multiple magnification of the optics;
• Blood loss is much lower;
• Tissues are less injured;
• It is possible to clarify the diagnosis, and hence the change in treatment tactics;
• It is possible to identify comorbidities;
• It is permissible to perform two operations without unnecessary skin incisions and insertion into abdominal region additional tools. For example, ovarian resection and simultaneous plastic surgery;
• The adhesive process, which can lead to infertility, and other serious pathological ailments, is minimal, since during laparoscopy there is no need to use gloves with talc, gauze wipes, and there are fewer manipulations with the intestines;
• There are practically no divergences of seams;
• The use of laparoscopy for diagnosis allowed physicians to negate exploratory operations (cavitary diagnostic operations used when it is impossible to make a diagnosis);
• With the use of this sparing method, even laparoscopic hysterectomy (amputation of the uterus) is easier for the body to tolerate.

In the treatment of women's diseases, the use of laparoscopic technology is especially important, since there are many operations that require only a ten-minute intervention to heal an organ. And at the same time, making a large incision of 15 centimeters is impractical.

How much does laparoscopy cost depends on the clinic.

However, we can say that usually free insurance is enough to cover the cost of the operation.

The disadvantages of this method of diagnosis and treatment include:

• The high cost of equipment, the rapid deterioration of instruments, disposable consumables, the uniqueness of the laparoscopy method requires special training - hence the high cost of the procedure;
• General anesthesia;
• Some laparoscopic operations take longer than usual, because the control of the equipment reduces the freedom of manipulation;
• There are a number postoperative complications associated with laparoscopy. They are rare, yet they exist. About 1% of patients suffer from subcutaneous emphysema (accumulation of air in the tissues), malfunction of the heart and respiratory systems due to gas in the abdominal cavity, burns of trocar wounds during coagulation.

What you need to know about complications

After such a type of surgical intervention as laparoscopy, complications in gynecology are extremely rare, provided that the preparation for laparoscopy has been completed correctly. The laparoscopic operation itself in gynecology is more easily tolerated by the body, therefore, severe consequences occur in exceptional cases.

If an experienced surgeon operates, then there should be no complications.

After laparoscopic intervention, the following consequences may occur:

• Complications of laparoscopy - this is when, during the implementation of surgical procedures, the internal organs were accidentally damaged. The reason may be poor visualization of the progress of the operation;
• Bleeding in the abdomen;
• Violation of the integrity of one or more vessels when piercing the abdominal wall;
• Gas embolism (blockage of the vessel with air bubbles) as a result of gas entering the damaged vessel;
• subcutaneous emphysema;
• Damage to the outer lining of the intestine.

How is the postoperative period

Upon completion of the laparoscopy, the operated woman wakes up immediately after anesthesia, on the operating table. Doctors have to make sure that her condition is normal and that her reflexes are working properly. The patient is then transferred to the recovery room.

It is recommended to start moving lying down after an hour. And literally after 5 hours (according to well-being), a woman begins to get out of bed in order to activate blood circulation, to prevent intestinal paresis (lack of peristalsis). Recommend independent trips to the toilet, food. You need to move carefully, smoothly and slowly, avoiding sudden movements. You can’t eat on the first day, only drink non-carbonated water.

The seams are looked after with the help of antiseptics. There are small scars on the abdomen from punctures. The stitches will be removed about a week after the operation. And the discharge will be carried out depending on how large the volume of intervention was - in 2-5-7 days. After laparoscopic extirpation of the uterus, sometimes a little later.

Pain in the abdomen and lower back after surgery is relative. It disappears approximately 3 days after the intervention. Often you can do without painkillers. But if necessary, you need to tell your doctor about it. Evening or morning next day possible discharge with ichor, and then without it. The temperature can rise up to 37 o. Allocations can last up to 1.5–2 weeks.

At the beginning of the recovery period after the laparoscopy, discomfort and heaviness in the lower abdomen, as well as nausea, are possible. These symptoms are the result of carbon dioxide introduced into the abdominal cavity. As soon as the gas is completely released, all unpleasant feelings will stop.

Most women who have undergone laparoscopy leave positive feedback about the procedure. Quick recovery and good health are always joyful and satisfying. Some managed to completely get rid of the disease, which had long tormented and disturbed, others partially.

If you strictly follow all the recommendations of the doctor, then the operation will be successful and the recovery period will be short - laparoscopy is the least traumatic operation.

Anna Mironova

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The diagnostic type of laparoscopy is prescribed in the case when it is difficult to make an accurate diagnosis for diseases in the pelvic or abdominal cavity. This is the most popular modern procedure for examining the abdominal cavity.

How is laparoscopy performed?

Video: how laparoscopy works and what is "tube obstruction"

Indications for laparoscopy

Contraindications for laparoscopy

Absolute

relative

What complications are possible after the procedure?

Complications with this procedure are rare.

What can they be?

Preparing for the operation

Before a planned operation, the patient must undergo a certain number of different examinations. As a rule, they are carried out directly in the hospital, or the patient enters the department already with complete map all necessary analyzes. In the second case, the number of days required to spend in the hospital is reduced.

An approximate list of examinations and analyzes:

• Coalugram;
• Biochemistry of blood (total protein, urea, bilirubin, sugar);
• General analysis of urine and blood;
• Blood type;
• HIV test;
• Analysis for syphilis;
• Analysis for hepatitis B and C;
• Fluorography;
• A smear from the vagina on the flora;
• The conclusion of the therapist;
• Ultrasound of the pelvis.

With existing pathologies from any body system, the patient should consult a specialist to assess the presence of contraindications and develop management tactics before and after surgery.

Mandatory actions and instructions before the operation:

Operation and postoperative period

Laparoscopy is not performed:

• During menstruation (given the risk of increased blood loss during surgery);
• Against the backdrop of sharp inflammatory processes in the body (herpes, acute respiratory infections, etc.);
• Other (described above) contraindications.

The optimal time for the operation is 15 to 25 days of the menstrual cycle (with a 28-day cycle), or the first phase of the cycle. The day of the operation depends on the diagnosis.

Do's and don'ts after laparoscopy

Duration of laparoscopy

• The timing of the operation depends on the pathology;
• Forty minutes - with coagulation of foci of endometriosis or separation of adhesions;
• One and a half to two hours - when removing myomatous nodes.

Removal of sutures, nutrition and sex life after laparoscopy

It is allowed to get up after the operation in the evening of the same day. active image life should begin the next day. Required:

Pregnancy after laparoscopy

When you can start getting pregnant after surgery is a question that worries many. It depends on the operation itself, on the diagnosis and on the characteristics of the postoperative period.

When can you go to work?

Based on the standards, after the operation, a sick leave is issued for seven days. Most patients by this time are already quite capable of working. The exception is work associated with heavy physical labor.

Advantages and disadvantages of laparoscopy

Pros:

Flaws:

• The effect of drugs on the body.

Mode after surgery

Real reviews and results

Lydia:

She found out about her endometriosis in 2008, in the same year she was operated on. 🙂 Today I am healthy, pah-pah-pah, so as not to jinx it. I myself was finishing my studies in gynecology, and then suddenly I myself turned out to be a patient. :) On ultrasound, they found a cyst and sent me for surgery. I arrived at the hospital, chatted with the anesthesiologist, the tests were all ready. After lunch, I went to the operating room. It’s uncomfortable, I’ll say, to lie naked on the table when there are strangers around you. :) In general, I don’t remember anything after anesthesia, but I woke up already in the ward. My stomach ached wildly, weakness, three holes in my belly under the patches. :) Pain from the anesthetic tube added to the pain in my stomach. Dispersed in a day, another day went home. Then another six months was treated with hormones. Today I am a happy wife and mother. :)

Oksana:

I had a laparoscopy due to an ectopic. 🙁 The test constantly showed two bands, and the ultrasound doctors could not find anything. Type, hormonal disbalance you, girl, do not compost our brains. At this time, the child was developing right in the tube. I went to another city, to normal doctors. Thank God, the pipe did not burst while driving. The doctors there looked and said that the period was already 6 weeks. What can I say ... I cried. The tube was removed, the adhesions of the second tube were cut ... She quickly moved away after the operation. On the fifth day, she went to work. All that was left was a scar on his stomach. And in the soul. I still can’t get pregnant, but I still believe in a miracle.

Alyona:

Doctors put me an ovarian cyst and said - no options, only surgery. I had to lie down. I did not pay for the operation, they did everything in the direction. At night - an enema, in the morning an enema, in the afternoon - an operation. I don’t remember anything, I woke up in the ward. So that there were no adhesions, I circled around the hospital for two days. :) They injected me with some hemostatic drugs, I refused analgesics, and was discharged a day later. Now there are almost no traces of holes. Pregnancy, however, so far too. But it would still have to be done. If you need it, then you need it. For the sake of them, after all, cubs. 🙂

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