Laparoscopy ectopic pregnancy: preparation, surgery, recovery
Ectopic pregnancy occurs in 2-5% of all births and is characterized by the attachment of a fertilized egg outside the uterus. This situation can cause a miscarriage, internal bleeding and even life threatening conditions. Methods of treatment of this disease, mostly surgical, for example, laparoscopy ectopic pregnancy. Laparoscopic surgery allows you to remove incorrectly attached the egg without serious consequences to the patient, which is the reason for the increasing popularity of this procedure. Laparoscopy with the development of ectopic pregnancy possible after full clinical examination of women and the conduct of additional studies.
Types of ectopic pregnancy
The normal process of fertilization occurs in the ampullar part of the fallopian tube located at some distance from the uterus. Then the fertilized egg moves into the uterus, where it attaches to the «prepared» inside of the shell. However, in some cases, the attachment is not in the uterus, and in other parts of the female reproductive system. This situation can cause damage and the beginning of massive bleeding from the damaged wall of the body.
Different types of the disease may have various manifestations, however, there are a number of common symptoms associated with ectopic pregnancy:
- Menstrual cycle;
- Discharge of blood from the vagina that can be mistaken for bleeding;
- Long period, lasting more than 3 days;
- General weakness is a woman, pale skin and visible mucous membranes, dizziness;
- Reduction in blood pressure.
Laparoscopic treatment for ectopic pregnancy
Laparoscopic surgery for ectopic pregnancy – the best method of surgical treatment of this disease. The essence of the operation is to delete the incorrectly implanted ovum. While there are several types of operations with different scope of intervention:
- Lobotomy, which consists in the dissection of the wall of the fallopian tube before it will extract the fertilized egg. It is important to say that after this surgery the fallopian tube preserves its functions. I.e., the least invasive type of surgery.
- Tubectomy, which consists in the complete removal of the fallopian tubes, what is necessary in the case of serious damage to the body wall and the impossibility of carrying out lobotomie.
- In ovarian pregnancy is necessary to conduct oophorectomy associated with the complete removal of one ovary.
- Hysterotomy and hysterectomy held in cases too deep for the attachment of a fertilized egg or in severe cervical ectopic pregnancy.
The operation is performed through a small puncture of the anterior wall of the abdomen, where the laparoscope is introduced, which is a flexible probe with a camera and a light source at the end and also other instruments required for the surgical intervention.
Laparoscopy ectopic pregnancy is carried out most frequently, as compared to conventional laparotomy, this method of surgical intervention has the following advantages:
- Shorter duration of surgery and postoperative recovery;
- Reduction of terms of hospitalization in a hospital:
- The reduction in the risk of development of adhesions in the abdominal cavity and in the pelvis.
Because of this, laparoscopic surgery is shown in the case of treatment of ectopic pregnancy in any location.
Preparations for the operation
Preparations for the laparoscopic surgery may vary depending on the clinical situation: before the appearance of pronounced clinical symptoms, or after their manifestation, in connection with the development of complications.
Correct preparation for a laparoscopy, to prevent the development of complications and to facilitate subsequent rehabilitation.
In that case, if the complications had not yet developed, it is possible to conduct a full preoperative preparation. In the evening the day before and the day of a laparoscopy is recommended to refuse eating, as this will prevent the ingress of stomach contents into the trachea and bronchi, which can lead to the development of aspiration pneumonia. For prevention of thromboembolic complications in the lower limbs to wear special compression stockings or elastic bandaging is used. An important step before any surgical intervention – a conversation of the surgeon and the anesthesiologist with the patient to explain to him the process of operation and characteristics of rehabilitation.
If a woman has ruptured the fallopian tubes or the case of tubal abortion, the operation is performed on an emergency basis with the minimum necessary preparatory measures. Any postponement of the procedure may lead to severe complications, even death.
A laparoscopy of fallopian tubes
After adequate anesthesia through General anesthesia or spinal puncture, the surgeon will properly handle the surgical field with antiseptic solutions. Through a small incision in the skin injected a special needle, through which the abdominal cavity is fed carbon dioxide to increase its volume and thereby facilitate surgical manipulation. The laparoscope and instruments are inserted through additional incisions in the abdominal wall, the size of the incisions are very small – from 1.5 to 3 cm.
The laparoscope allows the doctor to view the condition of the abdomen and pelvis, as well as to identify the degree of damage to the fallopian tubes, ovaries or the uterus. Depending on the seen picture, the surgeon decides on the volume of transactions – whether it is a regular dissection of the body wall with its preservation or complete removal of the fallopian tubes or even uterus. In each case the decision is made individually.
After surgery, the incisions are sewn with a layer by layer, and in the pelvic cavity leave several drainages. During the first days after the laparoscopy the patient establish a close supervision of the attending physicians.
How to prevent the recurrence of ectopic pregnancy?
Ectopic pregnancy may occur again, especially against the background of surgical intervention in the pelvic cavity. To prevent this it is necessary to observe a number of recommendations:
- To use enzymes that prevent the formation of adhesions between sheets of peritoneum and parts of internal organs. These include Longido, Lidaza, etc.
- Within six months after the surgical intervention need to follow strict contraception to prevent pregnancy.
- Active use of physiotherapy and vitamin therapy helps to accelerate the recovery process.
Detailed recommendations for the rehabilitation and prevention of ectopic pregnancy can be obtained from your doctor.
Early rehabilitation after surgery is the best way to prevent negative consequences.
Laparoscopy ectopic pregnancy is the gold standard surgical treatment. Low invasiveness, high effectiveness and low risk of side effects lead to wide application of this method. It is important to follow all recommendations of your doctor on the preparation for the procedure, as well as the period of rehabilitation, because that is how you can reduce the chances of possible complications of the operation.