Laparoscopy uterine fibroids larger sizes: preparation, surgery, recovery

 

Uterine fibroids is a dangerous disease, not just prevent conception and gestation, but also life-threatening, because at any moment there can be degeneration of the benign tumor cells into malignant. Laparoscopy uterine fibroids is a less traumatic method for diagnosis of disease or method of tumor removal without the traditional incision of the anterior abdominal wall. Laparoscopy uterine fibroids with surface nodes of small size has become the «gold standard» of providing elective surgical care.

If there is a choice between what type of intervention to choose, an operation to remove large fibroids – way or laparoscopy, the laparoscopic method may prove preferable. It leaves almost no scars, significantly reduces and simplifies the rehabilitation period, and, importantly, leaves the women of childbearing age to become pregnant and bear a child. In addition, the feedback from patients and compared those who moved lane operation, the recovery of the body after the laparoscopy takes place almost without pain.

Myomas located in the submucosal layer or within the muscle tissue of the uterus, as well as with surface nodes larger than the area of 6 cm2 or if there are too many small nodes, surgery is the only classic band way.

Contraindications for the removal of uterine fibroids through the laparoscope are absolute when laparoscopy is expressly forbidden, and the relative – the cases when a doctor may still decide to conduct laparoscopic, and not band interference.

Contraindications for laparoscopy in the removal of uterine fibroids

Absolute

Relative

  • cardiovascular and pulmonary pathologies that render impossible the formulation of the anesthesia;
  • too small the weight of the body;
  • pathology blood clotting;
  • hernia in the abdominal wall;
  • fibroids interstitial and/or submucous etiology.
  • a large number of adhesions in the abdominal cavity;
  • obesity;
  • ovarian cancer or cervical;
  • fibroids, larger than «12 weeks»;
  • the presence of effusion or fluid in the abdominal cavity.

The timeframe of the operation will be postponed if less than 1 month before the appointed date was a hypertensive crisis, exacerbation of asthma attacks or the patient suffered an infectious disease.

Preparing for surgery

Laparoscopy in myoma nodes in the womb is a routine operation that is performed in a hospital or private clinic where you have the opportunity, within 2-5 days after the removal of fibroids, to watch the recovery of the patient in stationary conditions. Before this operation the necessary preoperative preparation, which facilitates its implementation for the surgeon-gynecologist, and also promotes easy portability patient.

First, the monthly menstrual cycle in which laparoscopy is performed, must be protected from conception not hormonal means, and by using condoms.

Second, before the appointed day of the laparoscopic removal of myoma node on the uterus it is necessary to collect or get:

  • Tests, the term «shelf life» which is not more than 10-14 days:
    • General blood analysis (erythrocyte sedimentation rate) and urinalysis;
    • biochemical analysis of blood (the required parameters to be indicated by the gynecologist);
    • help from the therapist and coagulation (possible);
    • a swab from the vagina;
    • Ultrasound or MRI of the uterus and appendages (desirable).
  • Studies that have to be made no later than 1 month prior to laparoscopy – a blood test for syphilis and electrocardiogram.
  • The tests are valid for 3 months – blood tests for HIV, hepatitis b and hepatitis C.
  • Fluorography of the lungs with the lapse of time max 1 year.
  • The original analysis of blood group and RH factor.

From the documents and personal things need to bring:

  • Passport.
  • Compression stockings (degree of compression necessary to check with the therapist).

  • Compression bandage features which will prompt the gynecologist.
  • Personal hygiene, bottom and nightwear.

Please note that all test results must be «original». If admission to the hospital will be presented photocopies or the results printed on a home printer, the operation will be canceled.

However, passing tests, and protection from conception is only half of the preoperative preparation. Before laparoscopy uterine fibroids should withstand the following algorithm:

  • a day before laparoscopy, 14:30 – light lunch: nenavistyu broth or liquid porridge with milk, a glass of kefir;
  • 15:00 – take a shower and thoroughly wash the feet, groin, armpits;
  • 16:00-17:00 – admission to the hospital;
  • in the evening a consultation with the anesthesiologist and, if necessary, drug sedation at night, a high cleansing enema before bedtime;
  • evening diet – any meal, including light snacks that are prohibited, you can drink unsweetened juice, water, weak tea;
  • on the day of the laparoscopy, after waking up – lying to wear compression stockings, to shave off hair in the area of operations (the lower part of the abdomen, pubis, inguinal folds), in no case do not eat or drink!

If the patient wishes to do in the clinic on the day of the laparoscopy myoma node, the above algorithm is preserved, but the performance evening a cleansing enema may be replaced by taking a special laxative, for instance, the Fortrans. However, doctors recommend hospitalization in a private clinic the day before surgery the evening. In this case, training the body is better, so the operation is easier, and intraoperative complications occur rarely, and, therefore, rehabilitation after removal of fibroids is faster.

Recovery period after removal of fibroids

The duration of laparoscopy to remove fibroids with the laparoscope depends on the complexity of the operation, the level of skill of the doctor and equipment of a hospital with modern tools. On average, these operations lasted from 40 minutes to 2-3 hours and is done on day 15-25 of the cycle (if 28 day cycle is usual).

Since laparoscopy is less traumatic than usual surgery, a few hours after removal of fibroids is not only permitted, but mandatory shows the physical movement – walking-gradually increasing time and distance traveled. In addition to reducing the time of rehabilitation, walking and special complexes of physical therapy will also help the patient to come to normal. Physical activity will prevent the formation of adhesions and to promote rapid removal of residual gas, which was introduced during the operation and during its conduct had spread into the muscles and connective tissue.

There are no special diet restrictions, but need to eat small portions and fractional (5-6 times a day). And here round the clock to wear compression stockings worn before the surgery, you will need one or two weeks. This period is individual, and the decision to withdraw the stocking will take a doctor. The need for and duration of wearing the compression bandage will also prompt the surgeon.

The timing of discharge from hospital will depend on the recovery rates of the body – the absence or presence of primary complications. Sick leave is given at least 7 days, but the indications can be extended.

Stitches after laparoscopy fibroids removed in 7-9 days. Active exercise is allowed after 3, and our sex life after 4 weeks from the day of laparoscopic surgery.

As for pregnancy, the timing of its planning after laparoscopic myomectomy depends on the size and number of remote sites – no earlier than 6-12 months. At this time, may be prescribed birth control or contraceptives, or it will be necessary to prevent «mechanical» way because early pregnancy and the increase of the uterus may lead to its rupture.

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