How to make a laparoscopy free of the pole MLA?
Laparoscopic interventions are becoming more prevalent because of their advantages. This high-tech operation is easier than the standard abdominal intervention, has fewer complications and the recovery period it is much shorter. But such intervention has its indications and contraindications, and the final decision on the method of access if you need to remove the gallbladder takes the doctor.
Indications and contraindications to laparoscopic intervention
Today laparoscopic gallbladder free of charge under policy OMS (mandatory medical insurance) is subject to a physician’s/medical Commission, which is issued in case of confirmation of one of the following diagnoses:
Laparoscopic surgery may be included in the list of high-tech services provided at the expense of the Federal budget. The corresponding order of the health Ministry No. 1248н dated 31 December 2011. If a referral for a free laparoscopy problems hardly arise in regions often this operation is performed for a fee. If the doctor does not want to submit to free treatment, you can contact the territorial Department of the mandatory health insurance Fund – phones specified in the policy.
If laparoscopy is one of free interventions in a specific region, is to go to the Department of health of the city with the appropriate claim. In most cases, such a visit is enough to see that justice was restored. In some cases, helps find another specialist. Doctor other medical facility often relates differently to work, and easily prescribes the need to do laparoscopic surgery in history – is a strong basis for the provision of free care.
The progress of the operation
Any laparoscopy is performed under endotracheal anesthesia. Time of introduction it can be up to half an hour, after which the surgeon makes several punctures or cuts up to a length of 2.5 cm:
- in the epigastric region for tools;
- in the right upper quadrant;
- in the umbilical region for camcorder and extraction of the bladder.
Sometimes you have to do additional puncture/punctures, if access to the operated region is difficult, which is often observed when adhesive disease or marked obesity. After the installation of the trocars are introduced through them the necessary tools, and the surgeon examines the abdominal cavity in order to exclude possible pathological conditions, remaining undetected during the preliminary diagnosis.
Alternately allocated neck of the gall bladder, its duct, cross feeding artery is separated and removed from the body of the liver parenchyma. Bubble cut, and then carefully inspected his box – this prevents bleeding, and if it is present immediately to coagulate the wound surface. After removing all the bubble punctures/incisions are sewn, superimposed aseptic bandage.
Any surgery can be difficult, and laparoscopy is no exception. Because of the low morbidity it is possible to avoid long-term complications, for example, the development of adhesions. Nevertheless, the following negative aspects:
- bleeding from the bed of the remote bladder;
- damage to the ducts or internal organs;
- the flow of bile.
Such complications are mostly associated with the individual anatomical characteristics of the patient, presence of concomitant diseases. It is important to inform the doctor about all new symptoms in the postoperative period – this will not be allowed to develop more formidable States and to avoid a second operation.