A huge area of surgery is called endoscopy. The main difference with the classical surgery is that the operation does not require incisions. Surgery on the abdominal and pelvic organs is called laparoscopy. It is performed in 3-4 pinholes in the anterior abdominal wall. After one of them, located in the navel, thin telescope inserted through which the image through a digital mini-camera is transmitted to the monitor, which shows everything that is happening inside the abdomen. Through other punctures introduced thin handles that look like a tube length of 40 cm and a diameter of 5 mm from one end of which - a convenient function handle for the surgeon, and the other - miniature pliers, or scissors, or other electrical or laser instrument.
The advantages of laparoscopy before the cavityoperation appeared fairly quickly after the start of this new type of surgery. One of the most important - the absence of the anterior abdominal wall incision, which for a long time hurts and heals after surgery, due to which a woman is forced to remain in the hospital for 10-15 days. Already 2-3 hours after laparoscopy, the patient begins to rise. Usually in the evening or the next day morning, the state already allows you to return to normal physical activity, 2-3 days to return to work. Footprints in the skin puncture heal quite quickly and after a few months they can be detected only if you know where they were.
In addition, the technology of laparoscopy,in which from the abdomen image is displayed on the screen, can be considered the smallest pathology, which is not visible in the classical surgery. This is possible due to the fact that on the monitor, you can magnify the image up to 10 times the bodies that can not only see the pockets of disease, but also to remove their most delicate and gentle manner, without affecting healthy tissues.
Stages of laparoscopic surgery
Laparoscopy is performed by well-spent andstrictly abide by the scheme. Despite the outward differences from the classical open surgery, laparoscopy - the same surgery performed on all the classical canons of surgery and, accordingly, all the requirements and standards of surgery.
After the patient falls asleep under the influenceanesthesia and the anesthesiologist will give permission to start the operation, proceed to the first stage - "pneumoperitoneum". This means that the abdominal cavity is pumped through a thin carbon dioxide cavitary special needle (Veress needle). Carbon dioxide was specifically chosen, as it is completely safe. Gas is supplied as long as the pressure in the abdominal cavity reaches 14-15 mmHg The pressure is determined by the most sensitive instrument that delivers the gas and called endoflator. This device works at all times and constantly pumps up operation gas, the pressure is at the same level. This gas is needed, as it draws in the internal organs, protecting them from injury, and lifts the abdominal wall than the space is created for the job.
After this phase is introduced to the optical trocarinstrument - a telescope, which is called a laparoscope. The laparoscope is inserted through the puncture in the bottom of the navel. Consistently examine the abdomen, including the liver and the diaphragm. After that, examine where it is better to introduce trocars for manipulators. Punctures for making manipulators on the pubic hairline, one on the right of the center line, the other - on the left.
After the introduction of manipulators inspectfemale internal organs strictly on well-established pattern - clockwise, starting with the front-uterine space - right appendages - pozadimatochnoe space - left appendages. It is noted all kinds of pathologies. After that, proceed to remove the detected pathology.
Despite the effectiveness and sensitivitythe impact of laparoscopy - a full surgery, which may be accompanied by complications. Complications can be divided into complications from anesthesia, infectious and surgical directly. For surgical complications include subcutaneous emphysema and injured vessels and intestines. Subcutaneous emphysema occurs when you hit the gas in the subcutaneous fat, it takes 1-2 days. The injured blood vessels or bowel, or the introduction of trocars during the operation - requires suturing of the injured organ.