LAPAROSCOPY

 

 

Laparoscopy is one of the endoscopic techniques that enables a direct insight into the patient’s body cavities and organs using a specialized equipment. Thanks to the constant technological development, this method has not only become the diagnostic technique, but also an operative one.

 

 

Procedure description – an overview

 

 

This procedure is performed under general anesthesia. The doctor makes a small incision (about 5-10 mm) in the umbilical region, through which the camera equipped with a trajectory to insufflation  is introduced into the patient’s body. Then, it is necessary to fill the abdominal cavity with carbon dioxide in order to obtain a pneumoperitoneum. The camera enables the doctor to see the course of operation on the monitor screen. It also allows to capture close-ups of different parts of the patient’s organs, unattainable during a normal open cavity surgery. At the end of this procedure the carbon dioxide is released from the patient’s body and the small incisions are sutured with single stitches (which are removed after 7 days).

 

The main and unquestionable advantage of laparoscopic procedures is that they cause a significantly smaller operative trauma (since they are less invasive) with the same therapeutic effect compared with traditional abdominal surgeries. As a result, the pain is reduced, the recovery period is much faster and there are fewer postoperative complications. The patient is usually discharged home the next day after this procedure.

 

 

Indications

 

 

• Diagnosis of pelvic pain
• Endometriosis
• Infertility- laparoscopy allows a precise assessment of the body’s anatomy: the location and the permeability of the fallopian tubes, the location of adhesions in the pelvis, and it enables to obtain the material for histopathological tests to verify ovarian infertility and its surgical treatment.
• Fibroids- up to 3 myomas with a diameter not exceeding 10 cm
• Tumors, ovarian cysts
• PCO- polycystic ovary syndrome
• Ectopic pregnancy
• Pelvic inflammatory
• Malformation of the internal genitalia organs
• Pelvic organ dysfunction

 

 

Contraindications
 

 

 
Absolute:
 

• Lack of patient’s consent
• Diffuse peritonitis
• Severe bleeding disorder
• Bowel obstruction
• Patients with a history of extensive surgeries of gastro-intestinal cancer
• Extensive abdominal or diaphragmatic hernia

 

Relative:

 

• Advanced age
• Excessive obesity
• Hypertension grade III and IV
• Cardio-respiratory insufficiency
• Myocardial infarction
• Unstable coronary heart disease
• Arrhythmias - abnormal heart rhythm
• The presence of multiple peritoneal adhesions after a previous surgery or peritoneum inflammation
• Large tumors in the abdominal cavity
• Pregnancy over 12-16 weeks
• Pelvic peritonitis
• Mild diaphragmatic hernia
• Abdominal cavity pre-operations
   

 

Preoperative recommendations

 

The treatment is preceded by a consultation visit. The following tests must be performed (it is possible to conduct them on-site):
 
- blood group
- morphology
- urine analysis
- coagulation blood tests - APTT, INR, PT
- ECG after the age of 40
- HBS antigen
- electrolytes
- blood sugar level

 

Patients are not allowed to take neither aspirin (including its derivatives e.g. Acard), Vitamin E nor any cough and anti-flu medicine for the period of two weeks before the procedure. Thus these kind of drugs adversely affect the bleeding process.

 

If you are currently taking Metformin (Metformin, Siofor), it is advisable to discontinue talking this drug for 48 hours prior to the surgery. If you permanently take other medications, please consult it with your doctor.

 

Please limit smoking to 3-4 cigarettes a day 3 days prior to surgery.

 

Please inform the doctor about any infections that took place two weeks prior to surgery.

 

Patient should remain six hours of fasting (no eating or drinking) before the surgery

 

 

Post-operative period

 

 

After a diagnostic laparoscopy procedure the patient is discharged home after a few hours. After a laparoscopic procedure it is necessary for the patient to stay at our Clinic overnight. A follow up visit should take place after about 7 days. The patient may feel a slight pain around the sutures which should go away after OTC painkillers. In most cases, patients can take a shower the next day after the surgery. They usually return to the full physical activity within 1 week.

 

 

Scrupulous adherence to the recommendations described is a key operative for a rapid recovery and significantly affects the final result of the surgery.