Laparoscopy – what is it for operation, how do the pros and cons
The direction of the endoscopic surgery is developing at a fast pace. If using this technique was possible only diagnostic procedure for confirming or excluding any organic or functional diseases, today the era of mini-invasive methods of treatment.
Called a laparoscopic surgical operation directed to a diagnostic finding or treatment of surgical pathology of abdominal cavity and small pelvis in women. It is performed most often today, but to replace the laparotomy intervention can not always. What is laparoscopy, in which cases it is necessary and informative, this method – will be discussed in the article.
Laparoscopy as a diagnostic method is valued because it allows you to visualize the pathology of the abdomen or pelvis. It involves the use of optical equipment–laparoscope. How is laparoscopy?
The optical device is introduced into the abdominal cavity after a number of punctures through the abdominal wall.
Their number can vary depending on what the purpose of the operation itself. Hence another advantage of the method is low invasiveness.
The following types of laparoscopy:
- medical diagnostic.
As the name suggests, it is easy to assume what it is intended for a particular kind of intervention. During laparoscopy one variety can be smoothly flow into the other.
If you compare open surgery with laparoscopic surgery, then the obvious pros and cons.
- The first advantage is the time during which the patient is procedure itself as well as the time of incapacity. Usually five or six days in uncomplicated surgery, patients not in hospital.
- The second advantage is atraumatic, which is provided by small cuts. It is necessary for the introduction of optical technology. Unlike laparotomy incisions healing occurs much faster.
- The third benefit is the large disfiguring postoperative scar is formed. Indeed, the presence of cosmetic defects can be very worried patients, especially women.
What is laparoscopy in relation to internal organs? Unlike large-scale laparotomy in this case no gross effects on tissue, bowel loops. Therefore, minimizing the risk of adhesions and adhesive disease. But they are possible. It depends on the skill of the surgeon-endoscopist during the procedure, and how to adequately and competently performed the postoperative period.
The use of video greatly enhances this technique of research or treatment. It allows you to enlarge the picture dozens of times, and adjust image sharpness and brightness, contrast, colors.
When indicated and contraindicated for laparoscopy?
To conduct laparoscopy there are quite clear indications and contraindications. It’s not the most innocuous intervention. If you think about it: laparoscopy – what is it in relation to the human body.
Despite the fact that usually this procedure is performed for diagnostic purposes, it is invasive, surgery in fact.
Hence, the necessary preparation and anesthesia. To do such manipulation without reason, it means to expose themselves to unnecessary risk.
Among the indications for laparoscopy share emergency and planned. Under what circumstances laparoscopic intervention is needed urgently?
- Clinic of acute abdomen, forcing to suspect appendicitis, it is not possible to uniquely exclude gynecological or urological pathology.
- Thrombosis of the mesenteric (mesenteric) vessels.
- Atypical clinical picture of acute inflammation of the gallbladder or cholecystopancreatitis.
- The differential diagnosis in cases of suspected pancreatitis, intestinal obstruction.
- Possible clinical symptoms of cancer.
Thus, for laparoscopy the indications outlined. It is necessary to consider the state when this intervention is not recommended or even strictly prohibited.
For laparoscopy distinguish absolute and relative contraindications. Absolute are acute conditions, such as:
- myocardial infarction;
- end-stage failure of functions of heart, liver, kidneys and other vital organs.
More specific situations are fecal fistulas, multiple scars after surgery on the anterior abdominal wall.
Relative contraindications can be considered:
- high blood pressure numbers hypertension;
- uncontrollable fits of bronchial asthma;
- acute pneumonia;
- the presence of angina and other serious lesions of the heart and coronary vessels.
Why risk if you can stabilize, and then quietly to make a diagnosis?
Preparation and methodology
Preparatory stage of laparoscopy is no less important than the procedure itself. The most necessary thing is colon cleansing. What is envisioned for this?
It should be noted that on the day of the study to eat is impossible.
The day before the intervention, the patient is recommended to drink a laxative drug Macrogol. Dosage is calculated individually based on the weight of the patient. The entire dose is divided into 2-3 reception, drink within 3 hours.
The next step is to premedication. He needed to eliminate the sympathetic influence on the cardiovascular system. Anesthesia can be done locally, and with the help of General anesthesia. All will depend on the specific clinical situation, diagnostic problem, and the patient’s wishes. But you need to understand that the preference of the doctors themselves surgeons give local anesthesia.
How to do laparoscopy? The first step is to find the necessary points for puncture of the anterior abdominal wall. For average patients with normosthenic physique use point Tracing. Find them at 30 mm above the navel line and below it. From the midline deviated 5 mm to the side. Search for other points to puncture necessary during pregnancy, tight physique.
Then normal clear visualization provided for inflating the abdominal cavity. Used for this purpose chemically inert gases. It is possible to conduct bezguzova laparoscopy. All will depend on the particular diagnostic or clinical problems.
The examination using the endoscopic technique is performed first. (in other words, the review). That is indicated by the quadrants of the abdomen, and conducted the actual survey, starting from the bottom right (hepato-pancreato-biliary) zone clockwise. There is a second option. We are talking about the sighting survey a particular area.
During diagnosis, doctors often have to resort to surgical intervention. Then used a wider variety of surgical instruments, and additional punctures or mini-incisions of the anterior abdominal wall.
The opinions of doctors and patients with regards to the laparoscopy usually do not disagree. This intervention by virtue of their advantages is used more often and is becoming the gold standard in the diagnosis and treatment of a large number of diseases.