Laparoscopy is a modern endoscopic diagnostic and treatment method. It is successfully used in gynecology. There are situations when the symptoms and analyzes do not give a clear picture, and the doctor’s experience alone is not enough to make an accurate diagnosis. Then laparoscopy comes to the rescue.
With the help of this diagnostic method, it is possible to identify the latent forms of some diseases, to start treatment on time. This method was first proposed by the Russian gynecologist D.O. Ott . His proposal was considered and accepted. Scientists at home and abroad have begun to develop and improve laparoscopy. Already in 1944, using this method, a gynecological operation was successfully performed.
Varieties of laparoscopy
The procedure is applied on an emergency basis or as planned , before or after surgery. In gynecology, therapeutic, diagnostic and control laparoscopy are distinguished. In the first case, there is a division into operational and conservative. The essence of conservative laparoscopy is to carry out therapeutic manipulations under the control of a laparoscope… The operative procedure can be considered a full-fledged surgical operation, with the help of it tissue dissection, coagulation or drainage are performed. Diagnostic laparoscopy refers to the final stage of diagnosis, in gynecology it is very informative. This technique is based on a visual examination of the internal organs of the small pelvis, their tissues. Together with the diagnosis, it is possible to take a biopsy for analysis. Control laparoscopy is used to control the recovery processes in organs, the result of a surgical operation.
Indications and contraindications
Laparoscopy is carried out exclusively as prescribed by a doctor, only he will be able to determine whether it is necessary in your case or not. The indication may be the inability to make an accurate diagnosis based on the clinical picture and the tests performed. Suspicion of an ectopic pregnancy is a valid reason for such a diagnosis. Also, with the help of it, the patency of the fallopian tubes is determined before performing an operation for tubal infertility. A laparoscope is used to check the ovaries and sacro-uterine ligaments for endometrial overgrowth. If cancer and benign growths are suspected, this method helps to find tumors. In gynecology, there are cases of moving an intrauterine contraceptive into the abdominal cavity, and a laparoscope is again used to determine its location . There are still many indications, for example, acute pain in the lower abdomen, the likelihood of a cyst rupture, suspicion of pathology, and others.
For such an informative method, we can say that there are few contraindications. But they are still there and it is worth paying attention to them. If you have any disease from the list below, then it is worth informing the gynecologist who is referring you for laparoscopy. So, contraindications include:
- acute infectious diseases;
- pulmonary, hepatic, or renal failure;
- diseases of the cardiovascular system during the period of decompensation;
- diabetes;
- period of menstruation;
- uterine pregnancy;
- hypertension in the acute stage;
- adhesions in the abdominal cavity of extensive localization;
- hemorrhagic diathesis.
But even these contraindications are not absolute, much depends on the specific case, the degree of importance of laparoscopy and the severity of the disease.
Preparation for the procedure and its technique
The patient needs to be prepared for laparoscopy. To do this, he is given directions for general blood and urine tests, ECG, ultrasound. If the test results are normal, the therapist issues a conclusion about the possibility of carrying out this manipulation. The patient is advised to refrain from eating 8 hours before the procedure. Already immediately before the intervention, the patient is given general or local anesthesia. The procedure begins by pumping carbon dioxide into the abdomen. This is necessary to raise the abdominal wall and facilitate laparoscopy. After that, a small puncture is made under the navel using a special needle, the skin is pretreated with an antiseptic. A laparoscope is introduced through the hole . It is a thin tube with a micro-video camera at the end. The captured video is transmitted to the screen in real time. In addition to the laparoscope, for ease of examination, a manipulator is inserted through the incision. This is a device that helps to displace organs, examine them from all sides. If it is necessary to carry out the operation under the control of a laparoscope , then there may be more punctures on the skin due to the need to use several devices at once. But these wounds heal quickly and practically do not leave scars.
Advantages and disadvantages of the method
In gynecology, laparoscopy has become a new step in the diagnosis and treatment of a number of diseases. Its advantage is the absence of postoperative sutures and, accordingly, pain. Bed rest is no longer as strict as after a conventional operation, the recovery period is significantly reduced. After the diagnosis, the patient can go home on the same day, but if the operation was performed under the control of a laparoscope , then she will stay in the hospital for about three days. The advantage of the procedure is the lack of contact with gloves, napkins and other means. This minimizes the possibility of infection and adhesion formation. Of the disadvantages of laparoscopy, only the inevitability of the use of anesthesia can be distinguished, but this cannot be avoided during conventional operations.
For the first time after laparoscopy, many women try to refrain from a possible pregnancy, fearing that this procedure may cause problems with bearing a baby. In fact, I want to dispel this delusion. Often, gynecological operations of this type are carried out specifically so that a woman can become pregnant and bear a fetus without problems. So there is no special treatment after laparoscopy. All recommendations on this matter are given to each patient individually by her attending physician.