What can you find out with a laparoscopy of the uterus. Removal of the uterus by laparoscopic method: postoperative period, consequences, reviews. Removal of uterine fibroids by laparoscopic method: reviews. Sex life after laparoscopy

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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. This type of access is advisable 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 tests, in the case when conservative treatment did not help. This includes the removal of various neoplasms, both malignant and benign in nature (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 of negative consequences after radical treatment if a woman:

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 to. A gynecological examination is performed using mirrors.

In addition to laboratory tests, you need to undergo 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 conducts 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. An exception is emergency surgery when it comes to life or death. The best time is the period after the 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;
the purchase of special compression stockings or tights that will prevent blood clots (it is better to do this 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:

The navel area is for the Veress needle. Gas will flow through it.
The next mini incision is made to insert the trocar with the camera.
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. The diagnostic procedure will take 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 medical 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. Proper nutrition and exclusion of physical activity are also important.

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. It:

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, the individual characteristics of the patient. First you need to consult with a gynecologist who will examine the patient, prescribe tests and some instrumental types of 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 childbearing function, but also lengthen the years of life for patients who have been diagnosed with 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 undergo a complete diagnosis, which will exclude all contraindications.

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» What is laparoscopy?

What is laparoscopy?

Laparoscopy is one of the modern and least traumatic methods of surgery, when an operation on the internal organs - in this case, the ovaries - is performed through small incisions, up to 1.5 cm. By laparoscopic intervention, ovary removal, removal of the uterus, operations for ectopic pregnancy, cystosis, tumors and other gynecological operations are performed.

The first day after surgery by laparoscopy

In gynecological practice, laparoscopy is the most convenient method of surgical intervention. The operation lasts from 40 minutes to 2 hours, depending on the complexity of the amount of work. After laparoscopy of the ovaries, uterus, the patient is in the hospital for some time under the supervision of doctors. Unlike a conventional operation with a large incision, laparoscopy reduces the risk of blood loss, shortens the recovery period after the operation, and the patient's condition after a competently and professionally performed intervention allows her to get up and walk after 2-3 hours, drink water and eat food on the same day, when operation was performed.

Discharge after laparoscopy

Usually the discharge takes 2-3 days. She has no special restrictions on the regime during her stay in the hospital. it is possible to return to work after 5-7 days after the operation, provided that the woman does not work in conditions of increased physical exertion. It is not forbidden to work in an office environment even on the 4th day after the operation. Bed rest is not a prerequisite for a woman who has undergone laparoscopy, but still any operation is stressful for the body and the cause of a decrease in immunity, so you do not need to use the time spent on sick leave for general cleaning, digging the garden and other energy-intensive work. You also need to avoid sunbathing and prolonged exposure to the sun, hypothermia, overwork. All this will negatively affect the state of health and can lead to complications.

Rehabilitation after laparoscopic intervention

Recovery after laparoscopy of an ovarian cyst will require increased attention to your health. It is necessary to follow the recommendations of the attending physician, follow the appointments and restrictions imposed.

Rehabilitation after laparoscopy is sometimes accompanied by prophylactic antibiotics. They are prescribed to prevent possible complications and infection of the body, weakened after the operation. Together with antibiotics, you need to take dry flora preparations for the normal functioning of the digestive system. It is possible to prescribe vitamins and additional microelements, for example, iron, iodine. Other drugs during this period can be taken only as directed or with the permission of a doctor. If you need to constantly take medications for allergies, to normalize blood pressure, to stabilize glucose levels, then this is also agreed with the doctor.

Sex life can be conducted in 2-3 weeks. The resumption of sexual activity is best agreed with the gynecologist after the examination.
If the purpose of ovarian laparoscopy was to treat infertility, then starting from the next menstrual cycle, you can not protect yourself. In this case, the intake of antibiotics and other potent and active agents should be completed.
If the operation was aimed at removing the cyst, then it is necessary to prevent pregnancy for at least two menstrual cycles.
If the reason for the operation was an ectopic pregnancy, then a new pregnancy can be planned in 6-9 months in consultation with the doctor.
When removing by laparoscopy of myomatous cysts, contraception should be used for at least a year.

What can I eat after laparoscopy surgery?

Nutrition after laparoscopy should be varied and light. Dairy products, fresh, boiled, steamed and stewed vegetables, fresh and baked fruits, boiled or steamed meat and fish are very suitable. It should be borne in mind that with hormonal rehabilitation therapy after laparoscopy, you can get fat because of the constant desire to eat. Therefore, you need to set a schedule for yourself with five to six meals a day and stick to it during the entire course of taking hormones. Three meals a day is not enough, and the patient constantly feels hungry. The diet after laparoscopy of an ovarian cyst includes protein foods (meat, fish, poultry, dairy products, eggs), carbohydrates (cereals, fruits, vegetables) and fats (vegetable oils and a small amount of butter in porridge or on a sandwich made of gray or black of bread). If the diet contains hard cheeses, eggs and pork, then an additional amount of fat is not required.

At all times of taking antibiotics and in the next month after laparoscopy, you can not drink alcoholic beverages. If the patient is planning a pregnancy after surgery, she should refrain from alcohol altogether.

Additional medical measures after surgery

Treatment after laparoscopy is carried out on an outpatient basis. The patient visits the attending gynecologist. The postoperative rehabilitation period generally takes up to 2 months. During this time, the patient returns to a normal lifestyle and completes courses of hormonal, vitamin and other types of therapy.

When to See a Doctor

In the first days after the operation, there may be slight pain at the incision sites and inside the abdominal cavity. Usually this pain is caused by the healing process. It must be reported to the doctor on duty in the department. By the time of discharge from the hospital, the patient should not have any pain and discomfort. If they are all preserved or suddenly appeared, they cannot be soaked. Sometimes women, trying to return home, do not talk about pain and other troubles to the doctor in the hospital, they are discharged, and after a short time they get back to the hospital by ambulance with inflammation, infection, adhesions and other serious complications.

Pain should not be

urination,
bowel movements,
Coitus after a sustained period of sexual rest,
cough,
sneezing,
Sudden change in body position.

If pain occurs, they should be reported to the doctor immediately.

It is especially important for a woman to take care of her health if she wants to live a long and happy life, as well as give it to her children. When the first alarming symptoms appear, indicating malfunctions in the body, you should immediately contact a specialist. At best, you can get away with only a course of vitamins, and at worst, chronic inflammatory processes can lead to disruptions in the endocrine system, hormonal disorders, and surgery to remove the uterus. The last procedure will be discussed in the article. We will tell you what pathologies can lead to amputation of the reproductive organ, how the removal takes place.

What is the uterus and what is its function?

The uterus is the reproductive organ in the female body that is responsible for procreation. In its structure, the organ resembles a small bag, which is covered with elastic muscles. As a rule, the main function of the uterus is the bearing of the fetus from conception to birth. Just like other organs, the pear-shaped hollow body is fed by blood vessels. Despite popular belief, the organ is not responsible for the production of hormones, such as the ovaries, thyroid gland and pituitary gland, but is important for those who want to bear a healthy baby.

Note. The uterus is a capricious organ that can easily shift if the body is subjected to excessive stress. It is for this reason that a woman is not recommended to lift weights of more than 2 kg in one hand. And they also distinguish pathologies (defects) of this organ, for example, omission, prolapse or doubling.

Why can the uterus be amputated?

It should be noted that the operation to remove the uterus is prescribed only by the surgeon and strictly after a full examination.

Main reasons for removal:

Benign / malignant fibroids. In this case, the organ can be amputated only for medical reasons. The number of fibroids on muscle tissue, their size and diameter are also taken into account. Also, a woman, upon detection of fibroids, must pass tests for histology. There are cases when fibroids are benign, that they can be removed without damaging the reproductive organ. This helps women under 50 bear children without harm to their health. By the way, in women after 50 years, uterine fibroids can lead to the development of cancer.
Oncology of the female genital organs. If metastases have spread to the ovaries, cervix, then amputation of the organ is often prescribed.
Omission or prolapse of a hollow body. There are 4 degrees of pathology. If a woman has been diagnosed with grade 3 or 4 prolapse, the uterus may be removed.
Rupture of an organ during childbirth or pregnancy.
Profuse bleeding, especially during the postpartum period.

Laparoscopy of the uterus: what is it

Removal of the uterus by laparoscopic method avoids the formation of large scars on the woman's abdomen. This is one of the most effective procedures, thanks to which the risks of both bleeding during amputation and the occurrence of complications in the postoperative period are reduced.

In medicine, laparoscopy is not only the removal of organs with minimal risks, but also a universal diagnostic method. For the procedure, manipulators, or instruments, are used that allow you to assess the condition of the internal organs through the smallest cut. If surgery is required during the diagnosis, the surgeon makes several punctures through the abdominal cavity.

The main feature of the procedure is the use of special tools. They are equipped with microscopic cameras and illumination, which allows the specialist to perform complex operations without opening the abdominal cavity. Removal of the uterus by laparoscopic method does not injure muscle tissue, which prevents the formation of hernias, adhesions and ruptures. In this case, the procedure is not performed without anesthesia, because the woman can feel how her stomach is inflated and the incisions are made, even if they are minimal.

How is the removal of the uterus using laparoscopy

Removal of the uterus by laparoscopic method takes place in several stages.

Preparing the patient for amputation. As a rule, a woman is prescribed a special diet and a solution for a complete bowel cleansing in a few days. On the day of the operation, the patient is given an enema twice a day, and an ultrasound scan is performed and the readiness for the operation is confirmed.
Anesthesia and the beginning of the operation. Amputation is performed either under local anesthesia or general. After the woman's body is ready for the procedure, the surgeon carefully makes several incisions where cameras, lighting devices, and amputation instruments are inserted. Immediately after anesthesia, gas is injected into the abdominal cavity, which expands the walls of the abdomen. This allows you to conduct a preliminary diagnosis of the pelvic organs and start the operation.
Uterus removal. The surgeon and his assistants monitor the progress of the operation through the monitor, which displays images from one of the cameras inserted into the abdominal cavity.
Abdominal cleansing. After amputation, it is necessary to check whether all vessels are clamped and whether there is any bleeding. During completion, the remnants of blood are removed, all instruments are removed from the cavity. It should be noted that all sutures after removal of the uterus are cosmetic, neat.

Cost of laparoscopy

Now the removal of the uterus by laparoscopic method is one of the most popular surgical procedures. All due to minimal risks, barely visible sutures and careful removal without damaging adjacent abdominal tissues. Let's look at the cost of laparoscopic surgery to remove the uterus, both in Russia and in other countries of the CIS and Europe.

Russia. The average cost of the procedure with all related tests is from 90,000 to 120,000 rubles. The reputation of the clinics must also be taken into account. For example, if there is only one clinic in the region where high-quality uterine laparoscopy is performed, then the cost can vary from 90,000 to 150,000 rubles. At the same time, for non-residents, the provision of a bed during the rehabilitation period may amount to an additional 30,000-60,000 rubles.
Germany. On average, the total price tag can reach 8,000-10,000 euros. The price includes flights, accommodation, and a full examination by the best specialists, as well as rehabilitation and follow-up in the postoperative period. For residents of the CIS countries, the amount can reach 800,000 rubles.
Israel. Despite the fact that some of the most competent and qualified specialists in the world are concentrated in Israel, the cost of the procedure can reach only 400,000 rubles.

Why such a cost? Because the laparoscopic method is a virtually bloodless operation that requires the use of the best skills and specialized instruments. At the same time, the time of the procedure does not affect the cost. Laparoscopy of the uterus can take place within 15 minutes, or for several hours.

Postoperative period

The laparoscopic method is unique in that a woman recovers in just 3-7 days. Immediately after the procedure, the woman is brought to her senses to check all reflexes. If the condition is satisfactory, then she is transferred to the general ward. As a rule, for recovery, the patient is prescribed a special diet consisting of liquid and non-rough food. This is necessary in order to injure the walls of the abdominal cavity as little as possible.

If a woman does not follow a diet, then feces and gases can form in the intestines, which, when expanded, will put pressure on the internal organs and cause pain. That is why the patient should monitor nutrition and consume as much fiber as possible in order to improve intestinal motility.

The postoperative period after removal of the uterus by laparoscopic method provides for additional diagnostics. In the first six months, a woman should be seen by a specialist at least twice to avoid complications and discharge.

Why does pain appear after amputation of the uterus

The risk of complications after removal of the organ is minimal, but the first alarming symptom for a woman may be pain. First of all, the patient should pay attention to the localization of pain and its nature, and immediately contact a specialist for diagnosis.

The main cause of pain is soft tissue damage. Despite the fact that laparoscopy is performed without opening the abdominal cavity and removing internal organs, the procedure still consists in amputating the uterus. Tissue damage occurs in any case. Even the most qualified surgeon cannot avoid this, because the uterus has a complex muscular structure. The first pain may appear after a few hours, when the effect of anesthesia and painkillers finally wears off. By nature, it is weakly expressed, aching and long.

Another reason for the appearance of unpleasant pain is nitrous oxide or carbon dioxide, which is used during the procedure to expand the boundaries of the abdomen.

Pain after removal of the uterus can occur from excessive exercise or non-compliance with the diet. As mentioned above, if a woman in the postoperative period abuses salty, spicy and smoked foods, drinks alcohol and carbonated drinks, intestinal motility will be disturbed, which may cause constipation, which will put pressure on injured tissues.

What to do if there is a selection after removal

If there is a discharge after the removal of the uterus by the laparoscopic method, then in no case should you panic. In the postoperative period, discharge is a completely natural phenomenon, especially if they do not have a purulent odor, they consist of a translucent liquid. This is an indicator that the process of repairing damaged tissues is taking place. Let's look at normal discharges and those that should cause anxiety in the patient.

Norm. In the process of rehabilitation after removal of the uterus by the laparoscopic method, the discharge should be light and transparent. Blood stains can be observed. If there are no complications, then discharge appears within 3-4 weeks after amputation. At the same time, their number is gradually reduced to zero.
Pathology. Blood clots, pus, an unpleasant odor and heavy bleeding are the first signal that complications have appeared. You may have an infection that may also cause irritation or itching. It should be noted that thrush often occurs in the postoperative period.

How to speed up the recovery process

A woman should lead a correct lifestyle after removal of the uterus. The consequences for the body can be the most unpredictable if the patient does not follow all the established rules:

Psychological trauma

In this paragraph, we will talk about the last tip above. Indeed, life continues after the removal of the uterus, so a woman who agrees to an amputation must understand that in the future she will need to deal with a certain psychological barrier. Let's consider them all:

The laparoscopic method gives women a new life. This procedure does not cause adhesions, such as abdominal amputation surgery, which involves opening the abdominal cavity and removing the intestines. After this procedure, women rarely experience psychological difficulties. After all, in appearance you can’t say at all that any major surgical interventions were performed. This step in medicine prevents the development of cancer and allows women to live a full life. The main thing is not to ignore the alarming symptoms, which can sometimes save the lives of us and our loved ones!

Laparoscopy is the most sparing method of surgical intervention in gynecology, which does not require incisions in the abdominal cavity. Its main advantage is the minimum number of unpleasant consequences and complications. This method is used to treat and diagnose many gynecological diseases.

Laparoscopy of the uterus is one of the modern minimally invasive methods of surgical intervention, during which it will be necessary to make only a few punctures in the abdominal region.

The laparoscopic method of the operation does not leave marks and scars on the skin of the abdomen, and also minimizes the risk of developing thromboembolism and pneumonia.

Laparoscopy of the uterus is used to treat and diagnose various diseases. With its help, you can identify endometriosis, fibroids, cysts and identify the cause of infertility. Full recovery after such an operation will take no more than two weeks.

This method is less harmful to the body and has virtually no complications.

There are two types of laparoscopy:

diagnostic - it is used to confirm or refute the diagnosis.
operational - used to treat the female genital organs.

If the disease is in the initial stage, this method helps to completely remove the neoplasm. Even at an advanced stage, laparoscopy allows you to save the uterus and remove only the tumor in it. This method helps to maintain the menstrual cycle, and also gives a woman the opportunity to become a mother.

Features of laparoscopy of the uterus

This technique has gained great popularity in gynecology, and all because:

It does not require an incision to be made.
Prevents the development of adhesions in the tissues due to low injury risk.
Helps to examine the abdominal cavity in detail.
It is possible to increase several times.
Short rehabilitation period.
Leaves no marks or scars.

When is laparoscopy performed?

As noted above, laparoscopy has different goals, someone needs it to accurately diagnose the disease, and someone to treat it. It may also be given after surgery to monitor the healing process. But the most common goals for laparoscopy are:

When is laparoscopy performed?

Preparation for the operation begins with the clarification of the patient's menstrual cycle. This question is very important, because the effect of the procedure depends on it. If you carry it out during menstruation, you can bring an infection, because the female body at this time is most susceptible to various kinds of infections.

According to 2 gynecologists, laparoscopy is best done immediately after menstruation, or in the middle of the cycle. If this method is required for the treatment of infertility, then it is better to do it after ovulation, so you can see what happens to the egg.

A method such as laparoscopy is used to treat ovarian and uterine cysts. To do this, three punctures are made in the abdominal cavity without dissecting the abdominal muscles. The main advantages of this method are:

Minimal risk of developing adhesions.
A small likelihood of a hernia after surgery, which usually appears due to the insolvency of the dissected muscles.
The absence of serious incisions, which makes it possible to recover quickly.
Reducing the risk of intestinal hypotension, as well as the development of other diseases of nearby organs.

This method allows you to return to normal life much faster and forget about the disease.

What are the possible complications?

After laparoscopy of the ovary, most often, severe pain is disturbed not only in the place where the operation was performed, but also in the region of the right side and shoulder. The reason for this is the accumulation of carbon dioxide residues in the liver, which acts on the nerve as an irritant. There may also be muscle pain and swelling of the extremities.

In the first days after the procedure, gas may accumulate in the upper fat layer. It is not life-threatening and goes away within a few days.

They can also appear, but after laparoscopy this happens very rarely.

Possible complications such as:

Damage to the internal organs, which can occur both during the penetration of the instrument, and in the process of filling the abdominal cavity with carbon dioxide.
Damage to blood vessels during the puncture process. This can lead to severe bleeding and blood transfusion.
Infection that can penetrate the wound. It is to prevent such consequences that after the operation it is required to drink a course of antibiotics.

In any case, after the operation, an individual course of rehabilitation is selected for the woman and her nutrition is regulated (refusal of fatty, sweet, flour, spicy, etc.).

When is laparoscopy not performed?

Laparoscopy cannot be performed if:

severe obesity;
existing chronic diseases, as well as the risk of stroke or heart attack;
pathology of blood clotting;
recent, up to six months, abdominal surgery;
suspicion of a malignant tumor;
accumulation of blood in the abdominal cavity;
fistulas and purulent lesions of the abdominal cavity.

How long does the operation take?

No doctor can give an exact answer to the question about the duration of this method. Everything here is individual and depends on many factors. On average, the operation takes from half an hour to 3 hours. During this time, the surgeon performs a number of activities:

Introduction of anesthesia.
Performing punctures, usually 3 or 4.
Filling the abdominal cavity with carbon dioxide. This is necessary to protect the internal organs from injury and create space for the surgeon to work.
The introduction of a laparoscope is a small tube with a mini-camera. This helps the doctor to monitor what is happening inside the process.
Additional tools can be used as needed. For example, laparoscopy of the ovary will still require scissors, forceps and a coagulator.
Withdrawal of the laparoscope and removal of gas.
Suturing.

Important! On average, after 2 hours the patient will be able to move independently. This moment is mandatory, it helps to prevent the development of adhesions.

How is laparoscopy performed to remove the uterus?

Laparoscopy to remove the uterus is an excellent alternative to hysterectomy, which is performed in the case of a malignant tumor. To begin with, a woman must undergo a full course of examination. Only after this can a laparoscopy be performed to remove the uterus. The survey consists of:

Based on the patient's condition, other types of examinations may be prescribed.

Laparoscopy to remove the uterus

Usually, laparoscopy of the uterus is performed with an existing myoma, which grows very quickly and is accompanied by pain. In this case, the doctor, on the basis of the examination, decides whether to remove the neoplasm itself or the uterus itself. If you have to resort to the second option, then the procedure is as follows:

Four punctures are made and trocars with a special chamber are inserted. This allows you to see and control what is happening inside. This device also has a light installation.
After the examination, the surgeon alloys (that is, puts ligatures on them to prevent bleeding) of the vessels, cuts off the uterus from the walls of the vagina.
The uterus is then removed through the vagina and the incisions are sutured.

Important! Such an operation also makes it possible to remove lymph nodes.

If a large amount of blood has accumulated during laparoscopy, then it is also removed.
The surgeon examines the abdominal cavity.
Sutures are applied to the puncture sites.

An integral part of the laparoscopic method is anesthesia. This issue is decided individually by the doctor and anesthesiologist. At the same time, the patient's condition is assessed, the results of the examination are viewed, and, on the basis of this, the issue of anesthesia is decided. Most often, endotracheal anesthesia is prescribed, it excludes headache after surgery. After the procedure, the woman wakes up after 15 minutes.

Laparoscopy to remove an ovarian cyst for endometriosis

Endometriosis is a disease in which the cells of the walls of the uterus grow outside of it (on the fallopian tubes, peritoneum, appendages, etc.), including on cysts. This disease requires mandatory removal of the neoplasm, as it very quickly becomes large. In this case, laparoscopy is the most optimal and safest option, thanks to which you can completely recover from this disease.

Before starting the operation, it is necessary to determine the anesthesia. This is decided by the anesthesiologist and anesthesia is different for each case. Thereafter:

The patient is given sleeping pills and a sedative.
A puncture is made in the abdominal cavity and carbon dioxide is injected inside.
Then two more punctures are carried out and a laparoscope with a video camera is inserted.
The surgeon examines the abdominal cavity and clarifies the diagnosis. After that, the question of the method of surgical intervention is decided. If the tumor is malignant, then more radical methods will have to be resorted to.
Next, the cyst is husked, and part of the ovary is removed with it.
After that, the doctor once again examines the abdominal cavity and pulls out the devices.
The operation is completed, stitches are applied to the puncture sites.

Recovery process

For several days after the procedure, a woman may experience pain in the abdominal region. This is normal and goes away after a couple of days. If during the recovery period severely tormented by nausea, then it is better to consult a doctor..

The first days after laparoscopy, you need to drink water, and preferably do it in a supine position. Already on the second day, you can start eating light snacks so as not to heavily burden the stomach. It can be broths, cottage cheese, oatmeal. Usually sick leave is given for a month, but physical labor is prohibited for two months.

Two weeks after the operation, the patient already feels normal, but it is not worth overloading the abdominal muscles. Sometimes women develop adhesions, this happens due to a genetic predisposition or endometriosis. Disturbing discharge is a normal process, which means that the ovaries produce hormones.

Various kinds of inflammation occur very rarely, since antibiotics are indicated after the operation. All medicines recommended by the doctor should be taken in the prescribed manner, otherwise it will lead to adverse effects (inflammation, infection, etc.).

Any disease of the female genital organs requires a complete examination and treatment. If pathologies requiring surgical intervention are identified, then it is best to resort to laparoscopy. Thanks to it, you can perform the operation without severe damage to the abdominal region.

Video: what is laparoscopy?

Video: the second day after the operation. GHA. Laparoscopy

Video: diagnostic laparoscopy

Video: laparoscopic surgery

One of the most popular minimally invasive operations is the removal (extirpation) of the uterus by laparoscopic method. But not all patients realize that with the help of laparoscopy it is possible not only to examine, but also to remove the uterus.

Laparoscopic extirpation (removal) of the uterus is a method of surgical intervention that allows manipulation through several small (5-10 mm) incisions. This method can be used to perform the following procedures:

conservative myomectomy (the myomatous node is removed, preserving the uterus);
supravaginal ectomy (remove the body without laparoscopy of the cervix);
extirpation (laparoscopy of the uterus and appendages).

Abdominal abdominal surgery, of course, is inferior to laparoscopic manipulations in such matters:

Safety. High quality endoscopic equipment allows surgeons to perform complex manipulations without the risk of injury to important adjacent structures of the operated field.
Fewer complications during and after laparoscopy. During the intervention, healthy tissues are minimally damaged, and the likelihood of secondary infection and the appearance of reactive-inflammatory complications is minimized.
After laparoscopy, patients experience much less pain. This is due to the lack of a large wound surface. In addition, pain is much less, since muscle structures are preserved during such an intervention.
Facilitated postoperative care. Single skin sutures remain at the injection sites of endoscopic equipment; therefore, after surgery, patients do not require special care and are discharged from the hospital much faster than with abdominal operations.
More attractive total cost. Despite the fact that laparoscopic intervention may initially cost more than abdominal surgery, but due to the short period of hospitalization and further recovery, the overall cost of such a procedure is significantly reduced.

Laparoscopic extirpation of the uterus with appendages can significantly reduce the rehabilitation period. The patient can be discharged from the medical facility within 7-10 days.

Indications for the procedure

Laparoscopic surgery to remove the uterus is primarily prescribed if a malignant tumor (cancer) of the uterus is diagnosed. Laparoscopy performed for cervical cancer prevents the spread of atypical cells to adjacent organs. In addition, the removal of the uterus and ovaries is indicated in such cases:

uterine fibroids;
necrosis of the myomatous node;
prolonged and profuse uterine bleeding;
internal endometriosis 3-4 degree;
transgender operations;
chronic pain in the small pelvis, which is not stopped by traditional methods of treatment.

Laparoscopy for endometriosis is indicated if there is no positive dynamics from the applied conservative therapy and therapeutic curettage. Cervical erosion or other uterine disease is not an indication for extirpation, especially in women of childbearing age.

Medical contraindications

Laparoscopic extirpation (removal) of the uterus is contraindicated in such cases:

acute blood loss against the background of hemodynamic instability;
the risk of tumor rupture into the peritoneum during its resection;
the size of the uterus, as at 16 weeks of gestation (with large fibroids);
prolapse when the uterus prolapses (vaginal access is recommended);
abdominal ascites (fluid more than 1 liter);
cystomas of the appendages;
the general serious condition of the patient;
decompensated chronic diseases.

Infectious processes in the acute stage during laparoscopy to remove the uterus are considered a relative contraindication. Laparoscopy in this case is postponed for a while until the patient recovers completely.

Preparation for the procedure

At the stage of preparation for laparoscopy, a reduced hemoglobin concentration, provoked by heavy menstruation, is treated. And if a woman's uterus has an impressive size, then she is prescribed hormone therapy with drugs that are analogues of GnRH. The therapeutic course, as a rule, is 3-6 months.
Within 7-14 days before the scheduled laparoscopy, a woman should pass tests:

cervical smear;
clinical analysis of urine and blood;
blood biochemistry;
coagulogram;
blood test for RW;
electrocardiogram;
fluorography.

24 hours before the scheduled laparoscopy, a woman should switch to food that is easily digested. In the evening of the previous day, the intestines are cleansed, and the lower abdomen and pubis are also depilated. Enema bowel cleansing is also repeated in the morning. 12 hours before laparoscopy, you must refuse food, and 6 hours - from water.

The course of laparoscopic surgery

Laparoscopic surgery is performed under general anesthesia. After a small (3-4 mm) incision in the anterior abdominal cavity, special optical equipment and endoscopic surgical instruments are inserted into it. In addition, the abdominal cavity is filled with a certain amount of carbon dioxide.

After the laparoscope is inserted into the abdominal cavity, an audit of the organs subject to surgical intervention is carried out. Then the surgeon cuts off the uterus, bandages the main vessels that supply it with blood, and if there are medical indications, removes the uterine cervix and appendages. Then the amputated organs are removed from the peritoneum by making an incision in the lower abdomen.

In especially severe cases, there is a need to remove not only the body, cervix and appendages, but also the upper part of the vagina, as well as the nearest lymph nodes and tissue fragments. So, gynecological organs are completely removed by laparoscopy only if there is a high probability of spreading metastases to adjacent organs of the small pelvis.

Life after surgical removal of the uterus

With laparoscopic removal (hysterectomy) of the uterus, recovery is usually faster than with abdominal surgery, but can also take up to 4 weeks. A woman can take an upright position and try to move around already 24 hours after the operation, but first she must put on a bandage and compression stockings. You will have to wear a bandage on your stomach and therapeutic hosiery on your legs for 2 weeks.

The postoperative period requires daily treatment of sutures with antiseptic agents. While the patient is in the surgical department, she is being dressed by nurses, and after discharge, the woman will have to do such procedures on her own daily until the stitches are removed.

Rehabilitation after laparoscopy imposes the following restrictions on the patient:

Upon returning home, it is forbidden to take a shower or bath for 14 days until the stitches are removed. Water procedures can be carried out only partially.
It is expected that the woman will have more rest and temporarily give up intensive sports.
The resumption of sexual activity is permissible no earlier than 1-1.5 months after laparoscopic hysterectomy.
The maximum allowable load that a woman can lift should not exceed 3 kg.
You should also not visit pools, swim in the sea, rivers, lakes within one and a half months after laparoscopic intervention.

Recovery after laparoscopy also requires a careful review of eating habits, and a woman must take all hormonal drugs prescribed by her doctor in a timely manner. In addition, patients who have survived the removal of reproductive organs need to consult a psychologist.

Possible Complications

Laparoscopy of the uterus is a relatively sparing manipulation, but complications are not excluded with it:

damage to large vessels, which are found out with severe bleeding.
subcutaneous emphysema (accumulation of air in the subcutaneous tissue);
mechanical damage to internal organs;
the formation of hematomas at the puncture sites;
the development of inflammation against the background of the addition of a secondary infection.

Slight bloody vaginal discharge after hysterectomy is normal and usually goes away on its own in 2-3 weeks. If the appendages were also removed, then in the near future after the operation, a woman may experience symptoms that usually occur during menopause (hot flashes, hyperhidrosis, sleep problems, emotional instability).

If you refrain from hormonal therapy, which will imitate the work of the female gonads, then after some time pathologies of the cardiovascular system may occur, inflammation of the bladder, dryness and itching of the vagina will often begin to disturb.

When the reproductive organs are removed, a woman certainly loses her reproductive abilities, but this is an extreme measure, which in many cases saves her life. The laparoscopic method of extirpation not only allows this procedure to be performed with less damage to health, but also aesthetically gives women much less inconvenience.