Laparoscopy in gynecology

author: gynecologist Snytko I.М.

Laparoscopy is a modern surgical method for diagnosis and treatment of various gynecological diseases, which is performed by penetrating the abdomen of a special device - the laparoscope. Laparoscope - tube, equipped with a camera, which displays the image on the screen.

Thus, the surgeon can see what happens in the abdominal cavity and small pelvis, without performing large traumatic incisions. This contributes to a quick recovery, an early discharge and a good cosmetic result (small scars). In addition to the laparoscope, backlighting and various surgical instruments are involved in this procedure.

The advantages of laparoscopy

In addition to the fact that after this method of surgical treatment there is no long scar, and there is a possibility to leave the hospital walls faster, it allows performing small manipulations under a large increase. Multiple increase in the operative zone reduces the risk of surgical complications, and with such a pathology as a commissural disease - it allows to achieve the best results.

Indications for operation

The operation is prescribed by a gynecologist, having previously revealed the patient's indications for the operation. Laparoscopy can be prescribed: with prolonged infertility, if previously all possible methods of diagnosis have been carried out and the cause has not been identified; with spasms in the small pelvis, interfering with fertilization; with a constant aching pain in the cavity of the small pelvis with an unknown cause; endometriosis; ectopic pregnancy; before in vitro fertilization; rupture of ovarian cysts and various emergency situations in which it is necessary to examine the cavity of the small pelvis in a woman.

Contraindications

Contraindications may be severe uncompensated concomitant diseases, respiratory failure, bronchial asthma. Most contraindications are associated with increased pressure in the abdominal cavity (due to pneumoperitoneum), resulting in difficulty breathing. Pneumoperitoneum - air in the abdominal cavity, which is injected artificially to raise the anterior abdominal wall and improve visualization conditions during the operation. It is also recommended to postpone the operation for a month if you have recently had an acute respiratory disease.

List of research methods before laparoscopy

Laparoscopic operations can be carried out both in planned and in urgent order. In these two cases, the list of preparatory stages has cardinal differences. In emergency laparoscopy, several methods of instrumental or laboratory diagnosis are often performed. They are appointed by the on-duty surgeon of the hospital. The blood group, the Rhesus factor, the general blood test are compulsorily determined. If the operation is done on schedule, the woman in the inpatient department of the hospital comes with a ready set of tests: a gynecological smear on the flora, a general and biochemical blood test, ultrasound of the pelvic organs, results of fluorography and a cardiogram. Before the operation, the written consent of the woman for the forthcoming surgical treatment is mandatory.

Preoperative preparation

In order to avoid situations that can reduce the accuracy of laparoscopic diagnosis and reduce the likelihood of operational and anesthesia complications, a number of preparatory procedures are performed before planned operations. On the eve of the evening and morning on the day of the operation, a cleansing enema is required. To all women and men after 40 years, people with obesity are prescribed elastic bandage of the lower extremities.