Laparoscopic tubal ligation: preparation, performance, recovery
Gynecological diseases are not always being treated using hysteroscopy or laparotomy incisions. Pathology of the fallopian tubes and ovaries (called the appendages of the uterus) is an indication for the use of laparoscopy. This method is used not only under such conditions as obstruction of the fallopian tubes. Laparoscopy cysts possible to valesiana or removal. Removal of adhesions is also carried out using the described methodology. Laparoscopic removal of tubes is applicable to situations such as adnexitis, including purulent character. How is the laparoscopy of fallopian tubes, are there indications and contraindications?
The method of the study
Translated from Latin, laparo means abdomen, belly, and scopia – watch, inspection. In other words, a laparoscopy of fallopian tubes – imaging technique that allows to assess the condition of the uterine appendages.
Before laparoscopy, and before any other operation of the plan, there are a number of studies. This withdraws blood serum for General and biochemical analysis. It is important to exclude severe anaemia or to treat her in identifying the reduction of red blood cells or hemoglobin.
Evaluate the parameters of blood clotting, RH (for transfusion in case of massive bleeding). Preparation for surgery includes tests for markers of HIV, viral hepatitis and syphilis. To exclude nonspecific inflammation of the genital tract pass vaginal smears for cytological examination. Also required assays, eliminating diseases, sexually transmitted.
The somatic status was assessed using ultrasound examination of abdominal cavity organs, electrocardiography, x-ray. According to testimony, can hold esophagogastroduodenoscopy and colonoscopy to exclude of ulcers of the gastrointestinal tract.
How are you preparing for surgery?
Preparing for a laparoscopy of fallopian tubes includes not only examination. Before the operation, we need a complete cleansing of the bowel. What do doctors recommend?
You should eat normally, but the last three days before surgery you need to eat only foods that contain the least amount of so-called toxins. What are the products that can be in this situation should recommend that the attending physician or a consulting gastroenterologist. Food must be fractional. And 12 hours before the intended surgery (especially removal) of the fallopian tubes must be made of the last meal. At the same time, it is necessary to do enemas for 2 each day (3 days before surgery).
If laparoscopy of the fallopian tubes is carried out on the inflammatory diseases of the appendages, it is extremely important becomes the task of the identification of foci of chronic infection.
To do this, examine the urine, discharge from the urethra and smear with the mucosa of the nose and throat.
Another common question: what day of cycle do laparoscopy? This is usually 6 days after the last menstrual period. But many patients are possible options depending on the underlying disease.
In the pathology of the fallopian tubes laparoscopy is the gold standard for both diagnosis and treatment. What disease are the indication for carrying out the described methods?
To begin to understand that a possible operation on a scheduled and emergency basis. If elective surgery cannot complete the necessary training (minimum of research and analysis) to avoid possible complications. The most frequent indication for minimally invasive intervention is the treatment of tubal infertility. Less women turn to sterilization with the creation of tubal obstruction.
There are also the following clinical situations in which laparoscopy is indicated:
- Ovarian neoplasms.
- Tumor-like diseases of the uterus.
- Myomatous lesions of the uterus.
- Adenomyosis (endometrial lesion tissue of the uterus).
- Pain syndrome of lower back or stomach in the absence of other obvious causes.
Spectrum of diseases for emergency surgical operations is quite wide. Most often laparoscopic intervention is performed when ectopic pregnancy, rupture of ovarian cysts, inflammatory diseases of the uterine appendages. Surgery is indicated also in the case of unknown origin of pain in the abdomen (the syndrome of «acute abdomen»).
The most frequent types of transactions
A condition in which there is obstruction of the tubes, called tubal infertility. About a third or even half of the cases the pathology of the uterus – the reason for the inability to get pregnant. This is a very important problem at the moment.
Laparoscopy is indicated for obstruction of one or both fallopian tubes. It is necessary in order to determine the cause and eliminate it. In what situations can carry out this operation? It must be patient with regular menstruation in the absence of tuberculosis of the fallopian tube, marked sclerosis or adhesions (grade 3-4).
To check patency of tubes used promoalenas. Is the introduction of a contrast agent into the tube cavity through the cervix using special probe. How to check if there’s any blockage in any of the divisions of the body? To check injected through the probe into the cavity of the contrast substance. This is usually methylene blue. Further, by means of a laparoscopy possible the actual evaluation of the patency of the tubes. Normal contrast agent to be used in the abdominal cavity through the mouth of the body. If contrast has passed, there is no full blockage. Otherwise, the obstruction and correct it using laparoscopic surgery, which is curative.
To resolve the problem, often it is necessary to conduct salpingoophoritis. This uses laparoscopy adhesions of the fallopian tubes. Adhesive the formulations can be between the tube and the adjacent ovary, bowel loops, omentum and can also connect appendages and to fix them to the uterus or of the pelvic wall. What is the procedure? Adhesions can be dissected by using the electrode, but only after adequate and thorough coagulation. If the pipe is soldered to the intestine, then use a pair of scissors.
The patency of the fallopian tubes after laparoscopy (salpingoophoritis) is recovered in most cases. To prevent secondary bacterial flora prescribe a course of antibiotics for 7-10 days along with medications that normalize the intestinal microflora. The recovery process also includes early activation and application of physiotherapeutic methods of influence in order to accelerate recovery and prevent the recurrence of adhesions. The doctor may allow you to get out of bed and walk around the ward a few hours after surgery. After a laparoscopy the fallopian tubes postoperative period usually occurs quietly. However, some time will have to be in the hospital. Hospital after laparoscopy have been issued in the clinic. How many days it will be given, depends on the decision of the physician in specific clinical situations (if there are any complications, unwanted effects). Rehabilitation after laparoscopy short-lived.
The removal of the fallopian tube is about a tubal pregnancy or if persistent course of salpingitis or oophoritis. How is laparoscopy? The technique of operation differs little from the scan. Much attention is paid to the possible accumulation of fluid in the abdominal cavity. It is removed by suction. Sometimes leave the drainages. So prevent unwanted consequences of surgery (adhesions). Also watch out for any discharge after laparoscopy of the genital tract.
Usually patients are rapidly study and after a brief period of observation are sent home. How to go to the hospital, is solved in each case individually. Sometimes missing two days. All depends on the condition of the patient after the intervention. Pain after laparoscopy is usually short. They are cropped non-steroidal anti-inflammatory drugs.
Recovery after a laparoscopy of fallopian tubes does not require much effort. The main thing – to follow the doctor’s recommendations. Diet after laparoscopy does not require restrictions. It should be high.