Laparoscopic surgery of the prostate: indications, preparation, complications
BPH is a benign tumor with minimal risk of degeneration into malignant, but refers to her treatment must be very responsible. Gradual expansion of medical education leads to ever-progressive difficulty urinating, and decreased sexual function. Medical tactics such as laparoscopy BPH, is the best way to get rid of the tumor. This non-invasive method of intervention is well tolerated by most patients, has few contraindications and is considered the gold standard treatment of this pathology.
The indications and the main constraints for laparoscopy
The indication for such treatment is adenoma – even if detected early, conservative therapy is not always successful, and the disease progresses. This method can completely remove the tumor even of large size and do not damage the surrounding tissue, in particular, to preserve the patient’s ability to self-controlled urination. The progression of the disease leads to increased residual urine volume, hematuria and formation of calculi in the urinary bladder causes urinary retention. Often joins renal failure.
Any surgical intervention, resulting in planned, carefully prepared. A week before the operation is canceled, all drugs that affect blood clotting. In the presence of indications or prerequisites for development of infection during the recovery period may be appointed antibacterial therapy. It is a standard examination of the patient, which includes:
- clinical and biochemical blood tests;
- Ultrasound of the prostate;
- fluorography of the chest.
Depending on the condition of the patient and presence of comorbidities may require a more serious examination, with involvement of specialists of different profile.
The course laparoskopiya, its benefits
The technique of laparoscopic surgery is simple, but therein lie the advantages of such an operation. After an accurate preliminary diagnosis, the surgeon determines the places of the anterior abdominal wall – they are required for the introduction of instruments. After immersion of the patient into a deep medicated sleep are punctures or incisions of the abdominal wall, which serve for the introduction of the trocars. Using special tools, carried out the removal and extraction of the tumor. Before you begin to operate in the abdominal cavity is pumped carbon dioxide that increase the space for manipulation and reduces the risk of damage to internal organs. The whole operation takes no longer than 2.5 hours, and its implementation requires the introduction of 3 to 5 trocars.
Due to the fact that laparoscopy prostate is a minimally traumatic operation, easy to identify the following advantages for the patient:
- almost never required a blood transfusion that is often required for abdominal operations;
- dramatically reduced the Cath Suite, the company to the bladder;
- pain syndrome in the postoperative period is expressed in the minimum degree that rarely requires prolonged use of narcotic analgesics;
- walking after surgery is allowed in the first day;
- quick healing of surgical wounds.
Very accurate excision of the tumor formation and prostate tissues allows with high probability to prevent the relapse of the disease.
Rehabilitation period and possible complications
After successful surgery, the patient remains in the hospital under supervision of doctors within 3-5 days. During this time the confidence in the absence of complications from the intervention, subsides pain. To move independently permitted on the day of the operation, and the next day – it is a necessary measure to accelerate removal from the body residues of carbon dioxide introduced into the abdominal cavity during the operation.
Despite the need for some physical activity in the postoperative period, it must be reasonable and agreed with the doctor. As a rule, in the early days encouraged a leisurely walk. Higher physical activity are resolved not earlier than in a month after discharge from hospital.
May experience dyspepsia, pursuing a person for several days. For prompt rectification’ll need to keep drinking regime – drink at least 2 liters of still water a day. Restrictions on diet is not seen. Easily digestible food is recommended in the first day with a gradual transition to the usual patient table. For the early recovery of a chair is usually recommended prune juice or dried fruit. Medicines with this purpose are assigned very rarely.
To prevent infection for a few days is assigned to antibiotic therapy, with severe swelling shown chelators, can be used Espumizan. Among the possible complications of laparoscopy adenomas need to name a few:
- wound infection;
- damage to internal organs;
- erectile dysfunction;
- urinary incontinence;
With the advancement of technology, high resolution surgical video equipment and active introduction of robotic systems risks of such complications is rapidly reduced.