Laparoscopic tubal ligation: operation, characteristics, complications
Surgical techniques used in gynecology widely due to the anatomy of women. It is desirable to reduce injury to internal organs and skin to a minimum, especially for patients of reproductive age, as abdominal surgery and formed them after the seams have a negative impact on pregnancy.
One of the most popular therapeutic and diagnostic procedures is becoming a laparoscopy with its own characteristics and contraindications.
Laparoscopic surgery as the preferred method of therapy of gynecological pathologies
Laparoscopy is a minimally traumatic method of investigation of the audited body and its handling. The essence of the procedure is to create in the abdominal wall several punctures (center and sides), through which are special positioners, equipped with cameras, lighting and miniature surgical tools.
Thanks to such features during the operation is under constant visual control of the ongoing process with minimal dissection of tissue. The result is fast recovery of patients, and complications are minimized.
After the introduction into the abdominal cavity of the instrument the abdominal wall is lifted by inflating air inside. In a professional environment this procedure is called superimposition of pneumoperitoneum. To eliminate the discomfort in most cases General anesthesia is used.
Laparoscopy does not apply in the following situations:
- if diagnosed with pulmonary and cardiovascular disease, characterized by severe;
- when the body is too exhausted;
- hypertension and bronchial asthma;
- if impaired blood clotting;
- in the presence of a hernia of the diaphragm, the anterior abdominal wall.
On the eve of the scheduled surgery, the patient had a viral respiratory infection, the intervention of lay low for one month.
Recovery and possible complications
As already noted, recovery from laparoscopy is fast enough. Already on the operating table to the woman returns to consciousness, is checking her state of medical personnel. Also after this traumatic interventions, it is desirable not to postpone getting out of bed. Therefore, for emptying of bladder and locomotor activity is required for activation of blood circulation need to find their own feet after just a couple hours after the surgery.
Good nutrition is also introduced earlier than in the abdominal variant of surgical treatment. The first day is shown sparing diet, consisting of liquid low-fat food, yogurt. Food on the usual menu is allowed at the end of the postoperative period.
Extract after laparoscopy is already possible on the third day. If you have made a large amount of work, period of hospital stay is increased to 5 days. Throughout this period, the sutures daily treated with antiseptics.
Complications after laparoscopy unlikely, but still there is a risk of the following consequences.
- Wounds of the internal organs carelessly entered tarakanami (with sufficient experience of the doctor, the probability is almost zero).
- Damage of blood vessels with subsequent bleeding.
- Subcutaneous emphysema due to injection into the abdominal cavity of gas.
Often, especially in gynecology is carried out laparoscopy of the fallopian tubes within the treatment of infertility or other disorders.
The specificity of surgery of the fallopian tubes
The uterine, or fallopian, tubes through which the uterus connects with the ovaries are the organ of a small pelvis, directly involved in the process of conception. The need for laparoscopy pipes can occur in a variety of situations, ranging from inflammation of the appendages, adhesions and ending with sterility, sterilization to eliminate unwanted pregnancy.
Infertility in this case is positioned separately because laparoscopy helps to simultaneously clarify the clinical picture and, if possible, fix the problem, that is, a diagnostic procedure combined with therapeutic.
Indications for the procedure
There are the following main pathology under which a laparoscopy the fallopian tubes.
- Peritubarnyh adhesions. Can occur after inflammation of the appendages, infection by chlamydia, previously performed abdominal surgery. Adhesions is one of the main causes of infertility. Laparoscopy in such a situation allows to coagulate the undesirable formation using an electric Curling iron and then cut them with scissors, eliminating the problem.
- Ectopic pregnancy. Minimally invasive laparoscopic surgery of the fallopian tubes is tubal pregnancy, which is characterized by the location of the ovum in the lumen of the tube. Surgical intervention is urgent because of possible rupture of the pipe. During the operation, the pipe can be removed completely or only extract the embryo, making a corresponding cut. The first option in most situations becomes the preferred option as due to severe damage to the pipe following the risk of ectopic pregnancy is extremely high.
- Impaired patency of the fallopian tubes. Usually laparoscopic method is used, if it is diagnosed a blockage in the tube near the ovary and there is no pronounced adhesive process. To get pregnant in case of positive outcome of the operation is possible already after a couple of months in 30% of cases.
- Hydrosalpinx. We are talking about the accumulation of fluid in the cavity of the pipe and the development of obstruction simultaneously with bacterial infection. In such a situation in the course of a laparoscopy and remove the pipe, which will not be functional because of the constant recurrence of the inflammatory process.
- Sterilization. Laparoscopy can be a surgical method of preventing unwanted pregnancy. During the operation, the fallopian tube and cauterize the cross current, so the process may not be reversible. Carry out such intervention, if a woman reached 35 years of age and has at least two children.
Laparoscopy or abdominal surgery?
The advantages of laparoscopy the fallopian tubes compared to traditional abdominal surgery obvious. After this procedure, the stitches are healing nicely after just a couple of weeks, while the aesthetic appearance is acceptable due to the minimal visibility of scars, the size of which is a maximum of half an inch.
The image of the area being treated during the operation is displayed on the monitor in a 10-fold increase, therefore, possible to accurately perform the planned activities without damaging the surrounding tissue.
Preparation and technique of the procedure
Laparoscopy, like any other surgery, requires a careful preliminary survey, especially when it comes to the fallopian tubes. Usually the preparation for the operation includes the following list of activities.
- Fluoroscopy of the lungs, or chest x-ray.
- Clinical analyses of urine and blood biochemistry.
- Assessment of hemostasis.
- Analysis for detection of HIV, syphilis and hepatitis.
- Determination of blood group and RH factor.
- Ultrasound of the pelvic organs.
- Smear to determine vaginal flora.
Before the operation the preparation is to cleanse the bowel with a special enema. The last meal must be made no later than 6 PM. If you have recently taken aspirin or oral contraceptives, it is necessary to put a doctor in popularity in advance for the timely cessation of treatment. Laparoscopic tubal ligation is performed under General anesthesia, making a three inch incision and deepening them through a blunt probe. After the introduction of the instruments and injection of carbon dioxide into the abdominal cavity through scheduled events, extracted tracery and sutured.
Prognosis after laparoscopy
Forecast pregnancy after the surgery depends on the nature of obstruction of the fallopian tubes. So, if the spikes are placed directly inside the pipe, the effectiveness of surgery is limited to a maximum of 10%. When adhesions surround the pipe, the chances of recovery of fertility of up to 60%.
If you follow the recommendations of the experts, to get pregnant after laparoscopy one or both of the fallopian tubes, it is desirable for the following months, and without delay (upon successful completion of the operation). According to statistics, the maximum chance to conceive a baby has in the first 2 — 3 months, and after six months they begin to approach zero because of the high likelihood of developing in the tubes of a new adhesive process.
During the first six months after surgery you need to carefully track all the changes in well-being, not to miss the pregnancy. Doctors recommend periodically to check its presence by means of tests, as possible after a laparoscopy partial obstruction of the fallopian tubes can cause an ectopic pregnancy which required emergency surgery. If the laparoscopy is performed as a diagnostic procedure, its results are assigned to help remove the infertility medication treatment with hormonal therapy and homeopathic remedies.