Laparoscopy in gynecology – what is it?
Operative laparoscopy in gynecology is a decent alternative to surgical treatment when it is a small scale or for diagnostic purposes. If you translate the name of the method literally, it means «to inspect the belly». Despite the fact that gynecological laparoscopy is a minimally invasive intervention in the body of a woman, her conduct is related to the tissue trauma, requires advance preparation and has the features of postoperative period and complications.
What is a gynaecological laparoscopy?
What is laparoscopy? The procedure allows the surgeon to visually assess the condition of the internal organs using a special device, the laparoscope. Thus in the abdominal cavity of women have used the flexible tubes equipped with lighting devices, visualization tools. If the inspection process specialist detects problems, some of them can be immediately eliminated, with the most gentle way. Therefore, there are two types of surgery: elective and emergency. Both can be curative or performed to diagnose.
Sometimes patients confuse these methods of surgical intervention, as laparoscopy and laparotomy. What are their differences? The first thing you need to note that laparoscopiceski method involves carrying out abdominal surgery. While abdominal wall women make a long incision unlike laparoscopic method in which the slits do not exceed 2 cm.
Thus, after laparotomy remains a pretty big scar, require a longer rehabilitation period (up to months). After second method on the body are only minor skin damage, which quickly tightened without causing subsequent psychological discomfort. In addition, laparotomy is used for carrying out therapeutic procedures, at the time, like laparoscopic method is intended primarily for diagnostic purposes.
Indications for the procedure
Why to perform laparoscopy in gynecology? Indications (diagnostic and therapeutic) may be too much. Among them:
- tumours in the ovaries;
- inflammation of the endometrium;
- pain syndrome chronic pelvic;
- the need for sterilization of women;
- polycystic ovaries and other disorders and diseases.
If we are talking about military intervention, the indications for laparoscopy in gynecology are:
- ectopic pregnancy;
- torsion of cysts;
- cyst rupture of the appendages when there is internal bleeding;
- the presence of purulent uterine or inflammatory processes.
One can not do a laparoscopy?
Contraindications for an exploratory lap may be absolute and relative. The former include:
- shock and coma;
- heart disease;
- low blood clotting;
- hypertension severe;
- acute infectious diseases;
- diaphragmatic hernia;
- asthma in acute period;
Relative contraindications of laparoscopy, the uterus can be attributed to conditions such as:
- the presence of numerous adhesions in the abdominal region;
- a large accumulation of blood;
- obesity is the last stage;
- a large number of tumors in the pelvis;
- cancer of the uterus cervix and ovaries.
Do I need to prepare to conduct a laparoscopy?
The degree of preparation for carrying out gynaecological laparoscopy depends on the urgency of the situation. If the intervention needs to be done quickly in order not to lose time limited to a minimum set of laboratory tests.
The planned training involves several aspects. The patient should pass urine and blood samples, to do a vaginal swab. You will need to be screened for HIV, syphilis, hepatitis, to provide information about RH factor and blood group. Conducting laparoscopy requires the reporting of fluoroscopy, ECG, ultrasound feminine, a certificate about the possibility of anesthesia.
Other aspects of preparation for surgical intervention are compliance with diet. Although a certain diet to comply with is not required, before the day of the laparoscopy is better to starve. This will reduce the load on the heart and blood vessels, and also reduce the likelihood of blood pressure increase during the operation. To reduce the amount of gases in the intestines can help supply that eliminates bread, beans, cabbage and other related products.
In the previous day to eat a woman may not later than 19 hours, drink – not later than 10 PM. Evening to do a cleansing enema (be sure and put immediately before surgery).
Before laparoscopy, the doctor will briefly introduce a woman to what was going on, then she will need to sign the consent for the operation. Also she will need to wear on your feet antivarikozny stockings to prevent clots.
How is the laparoscopy in gynecology?
How is laparoscopy? In General terms this happens as follows.
- The woman was anesthetized (endotracheally or intravenously). On the wall of the stomach making a hole and injected into the abdominal cavity some air. This technique gives the possibility to increase its volume and to avoid trauma to the internal organs.
- Made a few incisions (the number depends on the complexity laparoskopii).
- In one of the sections introduce the laparoscope and the other with a special device by which the doctor performs the necessary manipulations.
- At the end of surgery, the experts again examine the operating field (through the monitor).
- If after removal of oxygen, no bleeding, the instrument is removed and incisions sutured.
The duration of such an operation lasts no more than one hour if carried out diagnosis, and up to several hours, if laparoscopy in gynecology is the therapeutic goal.
Features of the postoperative period
After an exploratory lap gynecological patient is taken to recovery. A feature of this recovery period is the early physical activity. The woman should get up and move a few hours later. The purpose of this campaign – stimulation and normalization of blood flow in the pelvic organs.
To be discharged from the hospital the patient is approximately 2-5 hours after the laparoscopy. Everything will depend on her health and the complexity of the surgery.
What is recommended to do after the surgery? Will require compliance with some rules:
- about a week later to come in for removal of sutures;
- lead an active lifestyle (within reason);
- to abandon an intimate relationship for 30 days;
- to follow the work of the intestine;
- to provide adequate nutrition.
Do I need a diet after gynecologic laparoscopy?
In the hospital after the laparoscopy allows to drink after about 5 hours and the first meal (in liquid form) is allowed two hours later. On the first day of the postoperative period the emphasis is on products sour-milk origin or broths. Eat recommend fractional to remove stress from the digestive tract.
The second day after the operation involves the incorporation of pureed vegetables, meat, fish products. Fiber should be avoided in order not to provoke swelling. In the future, connect baked and boiled dishes, juices rich in vitamins. Until the end of the rehabilitation period under the ban are: alcohol, fatty, sweet, spicy, fizzy drinks.
Possible complications of laparoscopy
Since the implementation of this procedure in gynecology is a major intervention in a woman’s body after the operation there may be some consequences, for example:
- thrombosis of blood vessels;
- leakage of gas in subcutaneous fat;
- disorders of the respiratory or cardiac system;
- damage to intra-abdominal organs.
They are rare: some of them can pass without treatment, while others require medical approach.
Complications of laparoscopy depend on the degree of preparing women for surgery, and the competence and experience of the specialist. So in preparation for this gynecological method need to be more open to all the nuances.