The removal of the fallopian tubes: laparoscopy. The features of the
The uterine, or fallopian, tubes that connect the ovaries to the uterus, in a woman’s body play an important role in the implementation of reproductive function. In case of certain serious violations may require their removal, which is increasingly used in laparoscopy that allows you to make major surgery less traumatic.
Indications for surgery
There are several types of pathological disorders, the consequence of which is the removal of one or both fallopian tubes. Among them:
- Ectopic pregnancy when a fertilized egg stops in the lumen of the tube, disrupting its permeability. This situation is a reason for emergency surgery, which in recent years is increasingly carried out by the method of laparoscopy. In case of small violations may be cut out only the embryo, but usually, in order to avoid relapse, practiced complete removal of the affected fallopian tube.
- Hydrosalpinx. This disease is characterized by accumulation inside the tubes of liquid, causes serious pathology in the form of inflammation of the lining pipe shells, which violates their permeability, creating obstacles to pregnancy. To delay the operation dangerous because of settling of fluid by the bacteria. Their active reproduction quickly degrade the condition of the patient, resulting in new more dangerous outbreaks of the inflammation of the affected tube and adhesive process.
- The obstruction of the fallopian tubes becomes the basis for the appointment of a laparoscopy with a view to their removal if the adhesive process has a broad distribution.
- Sterilization is most often relates to protection against a subsequent pregnancy, although it can be prescribed for medical reasons.
The advantages of laparoscopy
Analyzing patient feedback and expert advice, it can be concluded that laparoscopic surgery compared to traditional abdominal surgery ensures faster recovery. From hospital patients discharged no later than five days whereas after abdominal surgery, duration of hospital stay can reach fifteen days.
An important factor for women becomes an aesthetic component, which is expressed in a small, almost invisible scars that leave a puncture after laparoscopic surgery.
Preparatory stage for the removal of tubes
Before surgery the patient must undergo a series of examinations and pass the necessary tests, such as:
- fluoroscopy, if during the year before the patient was examined by a lung condition (if necessary, can be assigned x-ray);
- blood tests — biochemical, General, for detection of HIV, hepatitis, syphilis;
- specified RH factor, and if there is no mark in map and blood group, but also examines its clotting;
- Ultrasound. This type of survey does not allow to determine the permeability, but provides an overall picture of the subject of the operation pipe;
- Smear to rule out infectious diseases, as well as to study the vaginal flora.
In the interview process doctor will need to explain in details to the patient, what drugs she would have to accept. All recommendations must be performed rigorously. The evening before laparoscopy, intended to remove the affected fallopian tubes where broken terrain allowed the last meal, put an enema, shaved crotch. Morning again cleanse the intestines with an enema, and drink and food are excluded.
The algorithm to perform laparoscopy
Technique of laparoscopy, assigned if diagnosed obstruction in the cavity of the fallopian tubes for a variety of reasons, involves first, the introduction of drugs to provide General anesthesia.
An incision is made in the navel area intended for introduction into the operated region of carbon dioxide. This is done in order to expand the zone, which will host manipulation tools, providing a good overview.
The surgeon in the right places makes three small incision to 20 mm in length, through one of which after this, a special probe with a video camera broadcasting the whole process of removing the tubes with magnification on the monitor. Another two holes are used for special instruments, through which the surgeon performs the entire sequence of actions to cut off part of the pipe, which was discovered obstruction, extraction, and stitching the remaining tissue by ligatures. It remains to remove all the tools and put after this the seams.
The advantages of laparoscopy
Experts say sparing laparoscopic technology operations, designed to eliminate the obstruction a lot of advantages. Continuous monitoring carried out by the surgeon manipulation due to the increased display on an external monitor minimizes the risk of injury to surrounding tissues.
Recovery after laparoscopy takes less time than conventional surgery, since the incisions are small in size. Due to this fact on the body remain inconspicuous scars. During the first day possible pain, in this case, the patient is prescribed painkillers.
The consequences of amputation of the fallopian tubes
Even in such difficult situations, when a disruption of normal permeability in the direction of the fallopian tube and by all indications it is advisable to remove it completely, laparoscopy almost does not cause particularly severe complications. Only sometimes marked by internal bleeding after unsuccessfully stitches.
Sometimes the decision is made to restore patency in the detection of early stage of ectopic pregnancy by laparoscopic methods involving the dissection of the fallopian tube and removing only the embryo. Such cases do not always have a positive outcome, increasing the risk that a subsequent pregnancy will be ectopic again.
The doctor definitely puts a woman aware of the fact that after a complete amputation of the fallopian tubes they can not get pregnant.
If the obstruction that led to the operation, demanded the removal of only one of the fallopian tubes, the chances of conception is probable, although, of course, greatly reduced. The doctor, examining the patient’s health, condition and patency of the remaining fallopian tube develops an individual plan with the appointment of specific procedures that are designed to lead to the desired pregnancy.
Complete removal of the tubes does not exclude the possibility of getting pregnant through IVF.
Plastic fallopian tubes
Medical practice shows that even the blockage of both fallopian tubes does not prove the inability to have a child, because after surgery can be assigned and effectively carried out plastic microsurgery that restores patency. There are several methods of its implementation depending on the complexity of prior surgical intervention.
After alignment of the deformed tissue tubes on them later is not formed of rough scars. Perhaps even the formation of a functioning fallopian rings. After cosmetic reconstruction to restore patency could not in all situations, but the percentage is quite high. This means that for many women there remains the possibility of becoming a mother naturally.