Laparoscopy - Causes, Symptoms and Treatment .MF .
Laparoscopy (from the Greek λαπάρα -. Groin, belly and Greek σκοπέο -. Look) - a modern surgical technique in which operations on internal organs is carried out through a small (typically 0.5-1.5 cm) hole inwhile large incisions required in traditional surgery.Laparoscopy is usually performed in the abdominal or pelvic cavity.
main tool in laparoscopic surgery - a laparoscope: telescopic tube comprising a lens system and usually is attached to the camcorder.It also attached a tube fiber optic cable, illuminated by "cold" light source (halogen or xenon lamp).The abdomen is usually filled with carbon dioxide to create an operative space.In fact, the abdomen is inflated like a balloon, the wall of the abdominal cavity rises above the internal organs like a dome.
Laparoscopy is usually performed under general anesthesia.Purge potential space in the abdominal cavity and intestines offset used harmless gas.Next, an endoscope is inserted through a small incision and through it introduced a va
• Fabrics can be sprayed or laser cut without bleeding using the resolution of the device for the cauterization of a wire loop.
• Lots of damaged tissue can be destroyed using a cautery device in the form of a wire loop or laser.
• From any body can take tissue for a biopsy using a biopsy forceps to pinch off a tiny piece of body tissue.
patient may seem that the gas pressure causes discomfort within 1-2 days, but the gas will soon be absorbed by the body.
When vidiolaparoskopii to laparoscopy mounted video camera, and the inside of the abdominal cavity is displayed on a video monitor.This allows the surgeon to carry out the operation, looking at the screen - a much more comfortable way than to look through a small eyepiece for a long time.This method also allows you to record the video.
General indications for laparoscopy.
When planning treatment
2. Suspicion for the presence of tumors of the uterus or the uterus.
3. Chronic pelvic pain with no effect on the treatment.
Laparoscopy in extreme situations
1. Suspected tubal pregnancy.
2. Suspicion of ovarian apoplexy.
3. Suspected uterine perforation.
4. Suspicion of torsion legs ovarian tumor.
5. Suspicion of rupture of an ovarian cyst or piosalpinks.
6. Acute inflammation of the uterus in the absence of the effect of the complex conservative therapy for 12-48 hours.
7. Loss Navy.
Contraindications to diagnostic and therapeutic laparoscopy.
Laparoscopy is contraindicated in diseases that may at any stage of the study to burden the general condition of the patient and be dangerous for her life:
- diseases of the circulatory and respiratory systems in the stage of decompensation;
- hemophilia and severe hemorrhagic diathesis;
- acute and chronic renal failure.
listed contraindications are common contraindications for laparoscopy.
The clinic female infertility patients, who could meet such contraindications, as a rule, do not occur, ie. A. Patients suffering from severe chronic extragenital diseases, is not recommended to continue the examination and treatment for infertility at the first, outpatient.
In connection with specific tasks solved with the help of endoscopy contraindications to laparoscopy are:
1. Inadequately conducted examination and treatment of the couple at the time of the alleged endoscopic examination (see indications for laparoscopy.).
2. Existing or transferred in less than 6 weeks ago, acute and chronic infections and colds.
3. subacute or chronic inflammation of the uterus (a contraindication for laparoscopic operational phase).
4. Deviations in terms of clinical, biochemical and special methods of investigation (blood count, urinalysis, biochemical blood analysis, hemostasiogram, ECG).
5. III-IV degree of vaginal purity.
Pros and cons of laparoscopy
in modern gynecology laparoscopy is perhaps the most advanced method of diagnosis and treatment of diseases.Among its positive aspects need to include the absence of postoperative scarring and postoperative pain that is caused by the small size of the incision much.Also, the patient is not usually necessary to comply with strict bed rest, and the normal state of health and capacity for work is restored very quickly.Thus laparoscopy after hospitalization period does not exceed 2 - 3 days.
During this operation, there is very small blood loss, trauma is extremely low body tissues.When this tissue not in contact with the surgeon's gloves, gauze, and other means, inevitable at a number of other operations.As a result, the possibility of formation of so-called adhesions that can cause a variety of complications is reduced as much as possible.In addition, the undoubted advantage of laparoscopy is the ability to simultaneously diagnose and resolve specific pathologies.However, as mentioned above, organs such as the uterus, fallopian tubes, ovaries, despite surgery, remain in their normal state and function the same as before the transaction.
Cons laparoscopy, as a rule, are reduced to the use of general anesthesia, which is inevitable in any surgery.The impact of anesthesia on the body in many ways individually, but it is worth remembering that the various contraindications to it still being investigated in the course of preoperative preparation.On this basis, the expert concludes that, as far as general anesthesia is safe for the patient.In cases when other contraindications to laparoscopy does not exist, the operation can be performed under local anesthesia.
What tests need to take before laparoscopy?
The doctor has no right to take you on a laparoscopy without results the following tests:
- blood chemistry;
- coagulation (blood clotting);
- blood + Rh factor;
- tested for HIV, syphilis, hepatitis B and C;
- general smear;
Pathology of the cardiovascular, respiratory, gastrointestinal, endocrine disruption is necessary consultation with other professionals to develop the tactics of the patient in the pre- and postoperative periods, as well as to assess the presence of contraindications to laparoscopy.
Remember that all the tests are valid no more than 2 weeks!In some clinics made to the patient was examined, where it will be operated as normal in different laboratories and different doctor more convenient to focus on the results of his laboratory.
What day cycle to do a laparoscopy?
Generally, laparoscopy can be performed on any day of the cycle, not only during menstruation.This is due to the fact that during menstruation is increased bleeding risk of increased bleeding during surgery.
Is obesity and diabetes contraindication to laparoscopy?
Obesity is a relative contraindication to laparoscopy.
With sufficient skill of the surgeon in obesity grade 2-3 laparoscopy may well be technically feasible.
In patients with diabetes, laparoscopy is the operation of choice, healing skin wounds in diabetic patients takes much longer, and the probability of septic complications is significantly higher.When laparoscopy is minimal trauma and the wound is much smaller than the other operations.
as an anesthetic during laparoscopy?
Laparoscopy is performed under general anesthesia, the patient sleeps, she feels nothing.Laparoscopy is used only endotracheal anesthesia: during surgery through a tube light of the patient breathe through a special breathing apparatus.Using other
anesthetics impossible laparoscopy, since during operation in the abdominal cavity is entered gas, which "pushes" on the aperture bottom, which leads to the fact that light can not breathe independently.Once the operation is completed, tube is removed, the patient "wakes up" the anesthesiologist, anesthesia ends.
How long does a laparoscopy?
This depends on the pathology, due to which the operation is performed and the practitioner.If this division of adhesions or endometriosis coagulation medium complexity, the laparoscopy lasts an average of 40 minutes.
If the patient has multiple uterine fibroids, and it is necessary to remove all fibroids, the duration of the operation can be 1.5-2 hours.
When can I get out of bed and eat after laparoscopy?
As a rule, you can get up after laparoscopy in the evening on the day of surgery.
The next day, we recommend fairly active lifestyle, the patient should go and eat fractionally to recover faster.Diskofort after operation preferably is related to the fact that little gas remains in the abdominal cavity and then gradually absorbed.The gas, which remains, can cause pain in the muscles of the neck, press the shins., You need traffic and normal operation of the intestine to accelerate the absorption process.
When the sutures are removed after laparoscopy?
stitches are removed 7-9 days after surgery.
When can I start having sex after a laparoscopy?
sexual life is permitted one month after laparoscopy.Physical activity is necessary to limit the first 2-3 weeks after surgery.
When can I start trying to get pregnant after a laparoscopy?How fast you can start trying to get pregnant after laparoscopy:
If laparoscopy performed about adhesions in the pelvis, which is the cause of infertility, then you can start trying to get pregnant within a month after the first menstruation.
If laparoscopy performed for endometriosis, and in the postoperative period require additional treatment, it is necessary to wait until the end of treatment, and only then plan a pregnancy.
after conservative myomectomy pregnancy is prohibited within 6-8 months, depending on the size of myoma node, which was removed during laparoscopy.This period of time will not prevent reception of contraceptive drugs, because pregnancy is very dangerous and threatens to rupture of the uterus during this period.Therefore patients recommended strict protection from pregnancy after laparoscopy.
When can I go to work after a laparoscopy?
By the standards of sick leave on average after laparoscopy is given for 7 days.Usually, at this point the patient may have to work quietly, if their work is not related to heavy physical labor.After a simple operation the patient is ready for use within 3-4 days.