Where is the best surgery or laparoscopy? What gynecological diseases are treated with laparoscopy - preparation, operation and recovery. How is laparoscopic surgery performed?

The endoscopic direction in surgery is developing with great strides. If earlier with the help of this technique only diagnostic procedures were possible to confirm or exclude any organic or functional diseases, today the era of minimally invasive methods of treatment is coming.

Laparoscopy is performed using specialized instruments

Laparoscopy is a surgical operation aimed at diagnostic search or treatment of surgical pathology of the abdominal cavity and small pelvis in women. It is carried out today more often, but it can not always fully replace laparotomic interventions. What is laparoscopy, in what cases is this method necessary and informative - this will be discussed in the article.

Disadvantages of laparoscopic interventions

The disadvantages of the operation relate only to unreasonable appointment. This refers to situations where it is more appropriate to use laparotomic intervention, and instead, laparoscopic manipulations are performed. For example, purulent inflammation of the gallbladder, which was complicated by peritonitis.

Among the disadvantages of laparoscopic interventions is the fact that the range of motion performed by the endoscopist surgeon is very limited.

The required force during laparotomic operations is calculated intuitively, by touch. It's not easy to learn this.

The visualization itself also has some features. This technical problem is faced not only by young specialists, but also by experienced endoscopists. The surface and depth in the abdominal cavity are distorted through endoscopes.

Young specialists may not calculate the force with which it is necessary to act on tissues. Sometimes this leads to rough, violent movements, which, in turn, is a risk factor for the development of adhesive disease. This is another disadvantage. In addition, not every hospital has the ability to organize this type of care, especially in the periphery.

The essence and benefits of the intervention

Laparoscopy as a diagnostic method is valued because it allows you to visualize the pathology of the abdominal cavity or small pelvis. It involves the use of an optical technique – a laparoscope. How is laparoscopy performed?

An optical device is inserted into the abdominal cavity after a series of punctures have been made through the abdominal wall.

Their number may vary depending on the purpose of the operation itself. Hence, another advantage of the method is low trauma.

There are the following types of laparoscopy:

diagnostic;
medical;
medical and diagnostic.

Based on the name, it is easy to guess what this or that type of intervention is intended for. During laparoscopy, one variety can smoothly flow into another.

If we compare laparotomic surgery with laparoscopy, then the pros and cons are obvious.

The first advantage is the time during which the procedure itself is done to the patient, as well as the time of disability. Usually, patients do not stay in the hospital for more than five to six days with uncomplicated surgery.
The second advantage is atraumaticity, which is provided by small incisions. This is necessary for the introduction of optical technology. Unlike laparotomic incisions, healing is much faster.

Laparoscopy and laparotomy

The third advantage is that there is no disfiguring large postoperative scar. After all, the presence of cosmetic defects can be very worrying for patients, especially women.

What is laparoscopy in relation to internal organs? Unlike large-scale laparotomies, in this case there is no rough effect on the fiber, intestinal loops. Therefore, the risk of developing adhesions and adhesive disease is minimized. But they are possible. It depends on the skill of the endoscopist surgeon during the intervention, as well as on how adequately and competently the postoperative period is carried out.

The use of video systems significantly improves this method of research or treatment. It allows you to enlarge the picture dozens of times, as well as adjust the clarity of the image and the brightness and contrast of colors.

When is laparoscopy indicated and contraindicated?

There are quite clear indications and contraindications for laparoscopy. After all, this is not the most harmless intervention. If you think about it: laparoscopy - what is it in relation to the human body.

Despite the fact that this procedure is usually carried out for diagnostic purposes, it is an invasive intervention, an operation in essence.

This means that preparation and anesthesiology allowance are needed. To do such a manipulation without reason is to expose yourself to unnecessary risk.

Among the indications for laparoscopy, emergency and planned are divided. In what situations is laparoscopic intervention urgently needed?

The clinic of the "acute abdomen", which makes one suspect appendicitis, when there is no possibility for an unambiguous exclusion of gynecological or urological pathology.

Patients with "acute abdomen" need urgent surgical care

Thrombosis of mesenteric (mesenteric) vessels.
Atypical clinic of acute inflammation of the gallbladder or cholecystopancreatitis.
Differential diagnosis for suspected pancreatitis, intestinal obstruction.
Possible clinical symptoms of a cancerous tumor.

Thus, the indications for laparoscopy are delineated. It is worth considering the conditions when this intervention is not recommended or even strictly prohibited.

There are absolute and relative contraindications for laparoscopy. Such acute conditions are considered absolute, such as:

myocardial infarction;
terminal stages of insufficiency of the function of the heart, liver, kidneys and other vital organs.

More specific are situations with fecal fistulas, multiple scars after operations on the anterior abdominal wall.

Relative contraindications can be considered:

high blood pressure in hypertension;
uncontrolled attacks of bronchial asthma;
acute pneumonia;
the presence of angina pectoris and other serious lesions of the heart and coronary vessels.

Why take risks if you can stabilize the condition, and then calmly conduct a diagnosis?

Preparation and methodology

Laparoscopy is performed on an empty stomach

The preparatory stage for laparoscopy is no less important than the procedure itself. The most important thing is bowel cleansing. What is provided for this?

It should be noted that on the day of the study, you can not eat.

The next step is premedication. It is necessary to eliminate the sympathetic effect on the cardiovascular system. Anesthesiological assistance can be performed both locally and with the help of general anesthesia. Everything will depend on the specific clinical situation, the diagnostic task, as well as on the desire of the patient. But you need to understand that surgeons themselves give preference to local anesthesia.

How is laparoscopy done? The first step is to search for the necessary points for the puncture of the anterior abdominal wall. Calc points are used for average patients with normosthenic physique. They are found 30 mm above the umbilical line and below it. From the median line depart 5 mm to the side. The search for other points for a puncture is necessary already during pregnancy, a dense physique.

Then, for normal clear visualization, inflation of the abdominal cavity is provided. For this purpose, chemically inert gases are used. Gas-free laparoscopy is possible. Everything will depend on the specific diagnostic or clinical task.

The laparoscope contains an optical system and a camera

Examination with the help of endoscopic technique is carried out first panoramic (in other words, overview). That is, the quadrants of the abdomen are indicated, and the actual examination is carried out, starting from the lower right (hepatopancreatobiliary) zone in a clockwise direction. There is also a second option. This is a targeted inspection of a particular area.

When diagnosing, doctors often have to resort to surgical intervention. Then a wider range of surgical instruments is used, as well as additional punctures or mini-incisions of the anterior abdominal wall.

The opinions of doctors and patients regarding laparoscopy usually do not differ. This intervention, due to its advantages, is used more often and is becoming the "gold" standard in the diagnosis and treatment of a large number of diseases.

Laparoscopic surgery- a study of the pelvic organs, which allows for the diagnosis, treatment of gynecological diseases with the help of special endoscopic instruments.

Types of laparoscopy

Laparoscopy can be conditionally divided into two types:

Diagnostic- the operation is performed to detect a disease or pathology, confirm or refute the diagnosis;
Operational- intended only for the treatment of the disease, the removal of foci of inflammation.

Quite often, there are cases when, during a diagnostic laparoscopy, doctors decide on an emergency surgical operation. This is due to the detection of serious pathologies, a protracted disease or acute rapidly developing inflammation. It also happens that surgical laparoscopic treatment, on the contrary, is canceled due to a serious disease of the pelvic organs, in which it is necessary to make a large incision on the anterior abdominal wall.

Advantages of the operation

Unlike other surgical interventions, the operation by laparoscopy of the pelvic organs has a number of advantages. The main advantage of this operation is the ability to accurately determine the presence of infection, inflammation and pathology in general. Through laparoscopy, the actual shape and size of organs can be seen. Blood loss during its implementation is minimal.

The postoperative period is not long and requires the patient to stay in the hospital for only a couple of days. After laparoscopy, the woman practically does not feel pain. Cosmetic defects, unfortunately, remain. The seams are small, inconspicuous and do not cause discomfort. Adhesions after surgery in most cases does not occur.

If the laparoscopy was successful and the woman is healthy, you can start planning a child in the near future.

Indications

If a serious illness or serious infection is suspected in the reproductive organs of a woman, the doctor most often prescribes laparoscopy, both for the diagnosis of the pelvic organs and for the purpose of treatment.

Planned diagnostics through the abdominal wall is indicated in such cases:

. Conducting a biopsy;
Pathological form of pregnancy, when the development of the embryo occurs outside the uterine cavity;
The formation of tumors of unknown origin in the ovarian region;
Pathologies of the development of the uterus and its structure of a congenital nature;
Anomalies in the development of the internal genital organs of a woman;
Fallopian tube obstruction;
Infertility. Establishing its causes;
Prolapse of the genitals;
Chronic pain in the lower abdomen and other pains of unclear etiology;
Malignant processes in the pelvic organs, determining their stages of development and making a decision on surgical intervention to eliminate them;
ECO. Preparation for the procedure;
Inflammatory processes, monitoring the effectiveness of their treatment.

Urgent laparoscopy is prescribed for such indications:

Perforation of the uterine wall after curettage (abortion);
Progressive ectopic pregnancy or its violation by the type of tubal abortion;
Tumor of the ovary, torsion of the cyst legs;
Rupture of ovarian tissue, open bleeding into the abdominal cavity;
Necrosis of the myomatous node;
An increase in painful symptoms within 12 hours or the absence of effective dynamics for two days in the treatment of acute inflammatory processes in the uterine appendages.

Contraindications

Despite all the advantages and effectiveness of treatment, laparoscopy has its contraindications. In no case should an operation be performed by this method if a woman has such diseases and disorders:

Hemorrhagic diathesis with severe bleeding;
Blood clotting disorders. Poor coagulation;
Purulent peritonitis;
Obesity;
Diseases of the cardiovascular system;
Hernia of the anterior abdominal wall;
Pregnancy;

It's important to know! The operation is allowed only in the first and at the beginning of the second trimester of pregnancy, in the third trimester - it is strictly prohibited!

Liver and kidney failure;
Malignant cysts, tumors of the uterus, appendages;
Coma, state of shock;
Multiple spikes in a state of disrepair;
The abdominal operation of the pelvic organs, which was carried out quite recently - abdominal myomectomy, laparotomy and others.

Preparing for the operation

Before starting the operation with this method, a woman must pass the necessary tests and pass all the examinations that the gynecologist prescribed for her. Most often it is:

smear from the vagina;
general analysis of blood and urine;
fluorography;
cardiogram;
biochemical analysis of blood and coagulability;
ultrasound examination of the pelvic organs;
blood test for sexually transmitted infections;
consultation of the therapist and his conclusion about the general state of health of the patient.

However, preparation for laparoscopy consists not only in passing tests, but also in the behavior of the woman herself. So, a few days before the scheduled date of the operation, the patient should exclude all negative situations, not be subjected to stress and nervousness. It is not recommended to eat foods that cause bloating and severe flatulence - beans, cabbage, peas, corn and others. Avoid alcohol, soda, and caffeine-rich drinks for at least a week before surgery.

Laparoscopy is performed on an empty stomach, so eating and drinking before the operation is prohibited. Also, a woman is prescribed a cleansing enema.

Upon arrival at the hospital, the patient begins to prepare for the upcoming operation. Even in the ward, drugs are administered that improve the introduction to anesthesia and its course.

In the operating room, a dropper and monitor electrodes are installed, through which constant monitoring of blood saturation with hemoglobin and cardiac activity passes. Next, intravenous anesthesia and the introduction of relaxants are carried out, which completely relax all the muscles. Such total relaxation makes it possible to introduce an endotracheal tube into the trachea, through which an overview of the abdominal cavity is improved. Then the tube is connected to the anesthesia machine and the operation itself begins.

Carrying out laparoscopy

The operation is performed using a laparoscope - a thin tube, at the end of which there is a small light bulb and a video camera. Thanks to the video camera, everything that will happen in the abdominal cavity is reflected on the monitor screen at a sixfold magnification.

Initially, the doctor makes three small incisions in the abdominal wall. One of them is located under the navel, the other - in the groin. Based on the diagnosis, the location of the incisions may vary. Further, for better visibility of the internal organs and creation of volume, a special gas is injected into the abdominal cavity.

A laparoscope is inserted into one of the holes, and manipulative instruments are inserted into the others, with the help of which the doctor will perform the operation. At the end of the procedure, the manipulators remove and release the gas. The skin at the incision site is sutured.

Postoperative period

Based on the general well-being of the woman, after 4-6 days she is discharged from the hospital. It is allowed to return to the previous life, including sexual life, at least after two weeks. However, you need to remember about regular monitoring by a doctor to prevent possible complications:

internal blood loss;
violations of the integrity of organs and their vessels;
the formation of blood clots;
residual gas in subcutaneous fat;
disorders of the cardiovascular system.

The operation, which takes place by laparoscopy, helps to identify malignant neoplasms at an early stage of development. It has a minimum rehabilitation period and practically does not leave cosmetic defects.

What is this operation - laparoscopy in gynecology? This is a minimally invasive surgical intervention in which a layer-by-layer incision is made in the anterior wall of the peritoneum. It is carried out using special endoscopic (optical) equipment in order to study the organs located in the abdominal cavity. Thanks to its introduction into practice, the possibilities of specialists in the urological, gynecological and general surgical areas are significantly expanded. Much experience has been accumulated so far showing a much easier and shorter recovery after laparoscopy compared to the traditional laparotomy approach.

What is laparoscopy in gynecology? More on that below.

Use of the method in the field of gynecology

Laparoscopy in the gynecological field has become very important. It is used both for the diagnosis of various pathological conditions, and for surgical therapy. According to various reports, in many gynecological departments, approximately 90% of the operations performed are performed through this access. For example, laparoscopy of uterine fibroids.

When is the operation performed?

There are such types of diagnostic laparoscopy as emergency and planned.

For routine diagnostics, there are the following indications:

Tumor-like formations of unknown origin in the ovarian region.
The need for differential diagnosis of the resulting tumor of the internal genital organs and intestines.
A biopsy procedure that is performed for polycystic ovary syndrome or other tumors. Indications for laparoscopy in gynecology are very extensive.
With the possibility of an ectopic unbroken pregnancy.
A study of the patency of the uterine tubes, which is performed to determine the cause of infertility (if it is impossible to diagnose using more gentle methods).
Clarification of the presence and characteristics of abnormal signs in the development of internal genital organs.
Establishing the stage of the process of a malignant nature, thanks to which the question of the possibility and extent of surgical intervention is decided.
Differential study of chronic pelvic pain in endometriosis with other pain of unknown etiology.
Monitoring in the dynamics of the effectiveness of therapy for inflammation processes in the pelvic organs.
The requirement for control in order to maintain the integrity of the uterine wall during hysteroresectoscopic operations.

What is laparoscopy in gynecology?

When is the emergency?

Such emergency diagnosis is carried out in the situations described below:

If perforation of the uterine wall with a curette is expected during the procedure of diagnostic curettage or instrumental abortion.
If there is suspicion of torsion of the cyst leg, myomatous subserous node or ovarian tumor; ovarian apoplexy or cyst rupture; tubal pregnancy of a progressive nature or ectopic pregnancy with violations in the form of tubal abortion; necrosis of the myomatous node; pyosalpinx, tubo-ovarian inflammatory formation, especially with destruction of the uterine tube and the occurrence of pelvioperitonitis. In these cases, it is carried out very often.
If within 12 hours the symptoms intensify or for two days there is no positive dynamics in the treatment of an acute inflammatory process in the uterine appendages.
Pain in the acute form in the lower abdomen, of unknown origin, as well as the need for differential diagnosis with perforation of the ileum diverticulum, with acute appendicitis and necrosis of the fat suspension, with terminal ileitis.

Transition to medical

After the diagnosis is clarified, often diagnostic laparoscopy develops into a therapeutic one, when laparoscopic removal of the uterine tube, ovary is performed, when the uterus is perforated, sutures are applied to it, with necrosis of the myomatous node - emergency myomectomy, dissection of abdominal adhesions, resumption of patency of the fallopian tubes, etc. P.

Elective surgeries, in addition to some of those listed above, are tubal ligation and plastic surgery, therapy for polycystic ovaries and endometriosis, elective myomectomy, hysterectomy, and a number of others.

However, not everyone knows what laparoscopy in gynecology is.

The operation is performed under general anesthesia, in connection with which, during the preparation of the patient, the anesthesiologist and the operating gynecologist, and, if necessary, also other specialists are examined, which depends on the simultaneous presence of other pathologies or doubtful questions regarding the diagnosis of the underlying disease (urologist, surgeon, therapist, etc.). ).

In addition, additional instrumental and laboratory studies are assigned. Before laparoscopy, the same mandatory tests are performed as before other surgical interventions, that is, general urine and blood tests, a biochemical study of the blood composition, which includes the content of electrolytes, glucose, prothrombin, etc., a coagulogram, identification of the patient's blood group and Rhesus -factor, tests for hepatitis, syphilis and HIV.

A fluorographic examination of the chest is also carried out, if necessary, repeated ultrasound of the pelvic organs, electrocardiography. Before the operation in the evening it is forbidden to eat, and on the day of the operation in the morning - both food and liquid. In addition, a cleansing enema is done in the evening and in the morning.

When performing laparoscopy for emergency indications, the number of examinations is limited only by general blood and urine tests, coagulogram, electrocardiogram, determination of the Rh factor and blood type. Other analyzes are carried out only if necessary. The method of laparoscopy in gynecology is now used more and more often.

Two hours before an emergency operation, it is forbidden to drink liquids and eat food, a cleansing enema is performed, if possible, the stomach is also washed with a probe to prevent regurgitation of its contents into the respiratory tract during induction anesthesia, as well as vomiting.

Contraindications for laparoscopy

The operation is not performed when:

diseases of the respiratory and cardiovascular systems;
hemorrhagic shock;
ovarian cancer;
stroke
myocardial infarction;
poor clotting;
fallopian tube cancer;
liver and kidney failure;
coagulopathy, not amenable to correction.

Laparoscopy is directly related to the woman's menstrual cycle. During menstruation, tissue bleeding is very high. That is why a planned operation is usually carried out at any time after five to seven days from the start of the last menstruation. When performing laparoscopy of uterine fibroids on an emergency basis, the presence of menstruation does not act as a contraindication, but is taken into account by the anesthesiologist and surgeon.

Features of direct preparation for surgery

With laparoscopy, general anesthesia can be performed intravenously, but endotracheal anesthesia is most often used, it can be combined with intravenous anesthesia. Subsequent preparation for the operation is carried out in several stages:

an hour before the transfer of the patient to the operating room, in the ward, premedication is carried out on the recommendation of the anesthesiologist, that is, the necessary drugs are introduced that help prevent certain complications during the introduction of the patient into anesthesia and improve its course;
a woman is placed in the operating room with a dropper for intravenous administration of necessary medications, as well as monitor electrodes to constantly monitor the functioning of the heart and blood hemoglobin saturation during anesthesia and the operation itself;
carrying out anesthesia of an intravenous type with further introduction of relaxants into the vein, contributing to the absolute relaxation of all the muscles of the patient, which allows you to insert an endotracheal tube into the trachea and increases the possibility of viewing the peritoneum during the operation;
an endotracheal tube is inserted and attached to the anesthesia machine, whereby artificial ventilation of the lungs is performed, as well as inhalation anesthetics that maintain anesthesia, and this can be carried out in combination with intravenous anesthesia or without them.

This completes the preparation for the operation of laparoscopy of the ovarian cyst.

Methodology

Directly, the methodology for its implementation includes:

the imposition of pneumoperitoneum, when gas is injected into the abdominal cavity, and due to this it is possible to increase the volume by creating a free space in the abdomen, which provides a view and allows easy manipulation of instruments, reducing the risk of damage to organs located nearby;
the introduction of tubes into the abdominal cavity - hollow tubes that are intended for passing endoscopic instruments through them.

Now it is clear what kind of operation it is - laparoscopy in gynecology.

What complications are possible?

When performing diagnostic laparoscopy, there are very few complications. The most dangerous among them can occur with the introduction of carbon dioxide and trocars. These include:

severe bleeding due to injury to a large vessel in the anterior wall of the peritoneum, inferior vena cava, aorta or mesenteric vessels, internal iliac vein or artery;
gas embolism caused by the penetration of gas into a damaged vessel;
damage to the outer lining of the intestine, that is, deserosis or intestinal perforation;
pneumothorax;
emphysema, widespread under the skin, characterized by compression of organs or displacement of the mediastinum.

The period after surgery and some negative consequences

The immediate and long-term negative consequences after laparoscopy are adhesions that can cause intestinal dysfunction, infertility, and intestinal obstruction. Their formation can be the result of manipulations that caused injury if the surgeon is not experienced enough or if there is a pathology in the abdomen. However, most often it depends on the specifics of each female body.

Another significant complication after surgery is slow bleeding from damaged small vessels into the abdominal cavity or due to a small rupture of the liver capsule, which may appear during a panoramic revision of the peritoneum. A similar complication occurs when the damage went unnoticed and the doctor did not eliminate them during the operation, but this is very rare.

Other consequences that are not dangerous are hematomas and a small amount of gas in the tissues under the skin in the area where self-absorbable trocars are inserted, as well as purulent inflammation in the wound area (very rarely) and the appearance of a postoperative hernia.

Complications after laparoscopy in gynecology, we examined.

Recovery period

Recovery after laparoscopy is usually quick and without complications. Already in the first hours, you can make active movements in bed, and walk - after a few hours, which depends on the patient's well-being. This prevents intestinal paresis. Usually, after seven hours or the next day, the woman is discharged.

In the first few hours after laparoscopy, some soreness in the lumbar region and abdomen remains, which does not require the use of painkillers. On the day of surgery, in the evening, or the next, subfebrile temperature, as well as sanious discharge from the genital tract, may be observed. Subsequently - mucous membranes without blood impurities. They may stay for one or two weeks.

Quite often there are situations when a person needs surgery. A few decades ago, doctors used laparotomy. In the process of its implementation, the patient is introduced into the deepest sleep with the help of general anesthesia, after which the abdominal wall, muscles and tissues are dissected. Next, the necessary manipulations are performed and the tissues are sutured in layers. This method of intervention has many disadvantages and consequences. That is why the development of medicine does not stand still.

Recently, almost every medical institution has all the conditions for a more gentle surgical intervention.

Laparoscopy

This is a method of surgical intervention or diagnostics, after which a person can quickly return to the usual rhythm of life and get a minimum of complications from the manipulation.

Laparoscopy in gynecology

The use of this manipulation has gained quite a lot of popularity. If the doctor is not able to make an accurate diagnosis for the patient, then this type of procedure will help in this. Laparoscopy in gynecology is used in the treatment or removal of tumors, for the treatment of infertility in women. Also, this method will help to eliminate and remove foci of endometriosis as accurately as possible.

Other applications

In addition to the diagnosis and treatment of gynecological pathologies, the intestines, stomach and other organs can be performed. Quite often, using this method, one or another organ or part of it is removed.

Indications for intervention

Laparoscopy is a correction method that has indications for carrying out, like any other surgical intervention:

Severe internal bleeding.
Rupture of any organ.
Female infertility with no known cause.
Tumors of the ovaries, uterus or other abdominal organs.
The need for ligation or removal of the fallopian tubes.
The presence of an adhesive process that brings severe discomfort to a person.
Treatment of ectopic pregnancy.
With the development of endometriosis or other diseases of the organs.

In some cases, laparoscopy is not the best treatment option and a laparotomy is necessary.

Contraindications for intervention

Laparoscopy is never performed in the following cases:

In the presence of a severe stage of vascular or heart disease.
During a person's stay in a coma.
With poor blood clotting.
With colds or poor analyzes (with the exception of emergency cases that do not tolerate delay).

Before the operation

The patient is advised to undergo a small examination before the operation. All tests assigned to a person must comply with the standards that the hospital has. Planned laparoscopy before carrying out provides for the following examination:

The study of blood analysis of general and biochemical.
Determination of blood clotting.
Analysis of urine.
Fluorography and cardiogram examination.

If an emergency operation is performed, then the doctor is limited to a minimum list of tests, which include:

Blood test for group and coagulability.
Pressure measurement.

Patient preparation

Planned operations are usually scheduled for the afternoon. The day before the manipulation, the patient is advised to limit food intake in the evening. The patient is also given an enema, which is repeated in the morning before surgery.

On the day on which the manipulation is scheduled, the patient is forbidden to drink and eat.

Since laparoscopy is the most sparing method of surgical intervention, microinstruments are used during its implementation, and small incisions are made in the abdominal cavity.

To begin with, the patient is put into a state of sleep. The anesthesiologist calculates the required dose of the drug, taking into account the sex, weight, height and age of the patient. When the anesthesia has worked, the person is connected to the artificial respiration apparatus. This is necessary so that no unforeseen situations arise during the operation, since the abdominal organs are subjected to intervention.

Longer to the patient with the help of a special gas. This will help the doctor move the instruments freely in the abdominal cavity and not catch on its upper wall.

Operation progress

After the preparation of the patient is completed, the doctor makes several incisions in the abdominal cavity. If laparoscopy of the cyst is performed, then incisions are made in the lower abdomen. If surgery is needed in the intestines, gallbladder or stomach, then incisions are made at the location of the target.

In addition to small holes for instruments, the surgeon makes one incision, which is somewhat large. It is necessary for the introduction of a video camera. This incision is usually made above or below the navel.

After all the instruments are inserted into the abdominal wall and the video camera is connected correctly, the doctor sees a several times enlarged image on the big screen. Focusing on it, they perform the necessary manipulations in the human body.

The time period for laparoscopy can vary from 10 minutes to one hour.

Condition after surgery

Upon completion of the manipulations, the doctor removes the instruments and manipulators from and partially releases the air that raised the abdominal wall. After that, the patient is brought to his senses and the control devices are turned off.

The doctor checks the state of reflexes and reactions of a person, after which he transfers the patient to the postoperative department. All movements of the patient are carried out strictly on a special gurney with the help of medical personnel.

After a few hours, it is recommended to lift the upper body and try to sit down. You can get up no earlier than five hours after the end of the operation. It is recommended to take the first steps after the intervention with outside help, as there is a high risk of losing consciousness.

The patient is discharged within five days or a week after the operation, subject to good health and positive dynamics. Sutures from the performed incisions are removed on average two weeks after the intervention.

Recovery after surgery

If the tumor was treated, then after laparoscopy, the cyst or its fragment is sent for histological examination. Only after receiving the results, the patient can be prescribed follow-up treatment.

When or part of another organ is carried out, if necessary, to clarify the diagnosis.

If an operation was performed on the female organs, then the ovaries after laparoscopy should “rest” for some time. For this, the doctor prescribes the necessary hormonal drugs. Also, the patient is shown taking anti-inflammatory and antibacterial drugs.

Choice of clinic

Before preference is given to the institution in which laparoscopy will be performed, the cost of work and stay in the hospital must be taken into account and agreed with the attending physician. Analyze the operation and cost of maintenance in several places and make your choice.

If the surgery is an emergency, then most likely no one will ask for preferences and you will be treated at a public medical institution. In this case, laparoscopy has no cost. All manipulations are carried out free of charge in the presence of an insurance policy.

Consequences and complications of surgery

In most cases, laparoscopy has a positive effect on human health. However, sometimes complications can occur both during the manipulation and after it.

Perhaps the main complication is the formation of adhesions. This is an inevitable consequence of all surgical interventions. It is worth saying that during laparotomy, the development of the adhesive process occurs faster and is more pronounced.

Another complication that may occur during the operation is injury to neighboring organs by the inserted manipulators. As a result, it may begin. That is why at the end of the manipulation, the doctor examines the abdominal cavity and organs for damage.

After the operation, the patient may feel pain in the clavicle area. This is completely normal and does not last more than one week. Such discomfort is explained by the fact that the gas “walking” through the body is looking for a way out and affects nerve receptors and tissues.

Never be afraid of an upcoming laparoscopy. This is the most gentle way of surgical treatment. Do not get sick and be healthy!

It is very strange to see how many women still do not know that now most operations can be performed in a gentle way, without an incision, with a short recovery period and with a minimal likelihood of adhesions and relapses. Currently, most operations are performed by a (minimally invasive) laparoscopic approach.

In this section, we will be able to answer some questions:

So what is laparoscopy?

- this is an examination of the abdominal cavity through a hole in the abdominal wall using the optical system of the laparoscope. The operation is carried out under the control of an endovideo camera, the image from which is transmitted to a color monitor with a sixfold increase, using special instruments inserted inside through small holes - punctures with a diameter of about 5 mm.

The laparoscope is a metal tube with a diameter of 10 or 5 mm with a complex system of lenses and a light guide. The laparoscope is designed to transmit images from the cavities of the human body using lens or rod optics and having a rigid outer tube. The laparoscope is the first link in the image transmission chain. In the general case, the laparoscope consists of an outer and an inner tube, between which an optical fiber is laid to transmit light from the illuminator into the body cavity. The inner tube contains an optical system of miniature lenses and rods.

Endocamera designed to display a color image of the surgical field from various endoscopic devices - laparoscopes, cystourethroscopes, rectoscopes, hysteroscopes, flexible endoscopes, etc. during surgical operations and diagnostic manipulations.

A bit about the history of the development of laparoscopy

In our country, as well as throughout the world, the development of laparoscopy continues. Unfortunately, in the outback, such operations are still the exception, not the rule, although laparoscopy has existed in the world for more than 100 years.

The first experience of laparoscopy was described as early as 1910, and until the middle of the twentieth century, laparoscopy was diagnostic in nature, it developed, more and more sophisticated equipment was created, and safe lighting systems were developed.

Consultation of Doctor of Medical Sciences, Professor of Obstetrician-Gynecology
Preoperative examination in 1 day!
Expert ultrasound of the pelvic organs with dopplerometry
Conducting simultaneous operations by combined teams, if necessary (gynecologists, urologists, surgeons)
Postoperative management
Histological examination in the leading institutions of Russia
Consultation on the results and selection of preventive measures
Preconception preparation