1. How is laparoscopic surgery performed?
Two to three small holes of 5mm to 10mm are punched in the abdomen and a laparoscope is placed in one hole, which is connected to the monitor through optical fiber for observation; the other two holes are placed with special surgical instruments for laparoscopy, and the surgery can be performed under the mirror.
2.What are the advantages of laparoscopic surgery compared with open surgery?
Small incision, less bleeding, fast recovery, can eat and move on the ground on the day of surgery, and be discharged from the hospital 2-3 days after surgery, no scars on the incision after surgery, and no intestinal adhesions are formed.
Laparoscopic surgery is an advanced treatment method with little damage to the patient, most of the laparoscopic surgery does not require the insertion of a urinary catheter, fast recovery after surgery, anesthesia is mostly used for general anesthesia, the patient is in a sleep state during the operation and awake at the end of the operation.
3.What are the indications for laparoscopy?
Diagnosis: infertility, endometriosis, etc.
Treatment: ectopic pregnancy, pelvic adhesions, tubal umbilical obstruction, ovarian tumors (endometriosis cysts, benign ovarian teratoma, ovarian cysts), uterine fibroids, tubal sterilization, tubal recanalization.
4. Is laparoscopic surgery a thorough treatment?
Some people think that laparoscopic surgery is not as intuitive and thorough as open surgery, but it is not. The laparoscope has magnification and fluoroscopic effect, the operation field is clearer, and the resection and hemostasis are more complete. The laparoscopic instruments are small and more suitable for separating adhesions.
5. How to remove large ovarian tumors and uterine fibroids from the abdominal cavity?
After ovarian cysts are peeled off laparoscopically, they are placed in special specimen bags, and after the liquid is sucked off, the mouth of the specimen bag is pulled out of the abdominal cavity, and the solid components are removed from the bag without contaminating the abdominal cavity; after the uterine fibroids are peeled off, there is a special device for laparoscopy to crush them and remove them from the abdominal cavity.
6.What patients are not suitable for laparoscopic surgery?
Patients with severe cardiopulmonary disease, diffuse peritonitis, intestinal obstruction, history of multiple abdominal surgeries and severe blood disorders.
7.What are the discomforts after laparoscopic surgery?
A. Due to the stimulation of diaphragm by residual gas, there is mild distension and pain in the abdomen and back of the right shoulder for 1 to 2 days after surgery, which can disappear without treatment.
B. Due to tracheal intubation, there may be sore throat after surgery, which can disappear after taking lozenges and drinking more water.
C. There is a small amount of vaginal bleeding after surgery due to the use of uterine lifters, which does not require treatment and will stop 2 to 3 days after surgery.
8.What should I pay attention to after laparoscopic surgery?
After the operation, you should eat liquid and easy to digest food; you can work normally one week after the operation; the stitches of the abdominal incision can be removed in 4-5 days; you can take a shower 1~2 days after the stitches are removed; you can have intercourse 2~3 days after the vaginal bleeding stops; 2 hours after the operation, the patient can drink and turn over in small amount after he/she is fully awake, without waiting for 6 hours (according to the regulation of general anesthesia, it takes 6 hours, but the patient will be very hard). That night, you can drink a small amount of rice porridge. We still need to listen to the bedside doctor.
9. Why should laparoscopic surgery be performed 3 to 7 days after menstruation?
Since most laparoscopic surgeries require placing uterine lifters in the uterine cavity, swinging the uterus and performing tubal lavage, the endometrium is thinner at this time, the endometrial damage and bleeding is less, and intraoperative lavage is less likely to cause retrograde endometriosis into the abdominal cavity and cause medically induced endometriosis.
10.Do I need contraception after laparoscopic surgery?
Contraception is generally not needed after laparoscopy, and the pregnancy rate is high within 3 months after laparoscopy. It is best to use contraception for one month if X-ray was performed before surgery.
11.Is it necessary to have a laparoscopy before IVF?
Most doctors recommend a laparoscopy for patients who have undergone tubal imaging and found bilateral tubal obstruction and need to undergo assisted reproduction IVF. Laparoscopy can evaluate and treat pelvic pathologies, diagnose and treat endometriosis, pelvic tuberculosis, and hydrocele in the pelvis, and has a positive impact on the success rate of IVF.
Some patients can also become pregnant on their own after laparoscopic treatment. It is also advisable to undergo a hysteroscopy procedure to understand the endometrial condition prior to IVF. IVF technology requires a lot of money, time and effort, so it is important to clarify the condition of the pelvic and uterine cavities before proceeding.
12. Can laparoscopic surgery treat malignant tumors?
If the equipment and technology reach a certain level, it is feasible to use laparoscopic techniques to treat malignant tumors in gynecology, including cervical cancer, endometrial cancer and ovarian cancer. However, it is better to use open surgery or laparoscopy-assisted open surgery for the best benefit of patients.
13.Is the cost of laparoscopic surgery high?
Laparoscopic surgery requires special laparoscopic equipment and instruments, and a set of equipment basically costs more than 1 million yuan. General anesthesia is used for the surgery. It is decided that the cost of laparoscopic surgery is higher than that of traditional open surgery, about 2,000 to 3,000 yuan higher (slightly different for different diseases and different hospitals). In fact, the difference in the cost of surgery must be directly proportional to the quality and effectiveness of the surgery, for example, cutting with ultrasonic knife is 1500 RMB higher, but the operation time is shorter and the complications of the surgery are lower. The application of anti-adhesion agent on the trauma surface is another 500 RMB more, but the chance of adhesions after the surgery is reduced. The incision is closed with non-invasive sharp sutures and less incisional scar formation, but it also costs an additional $200. Therefore, it is better to fully communicate with the surgeon before surgery and express your needs and wishes clearly.
14.Problems before and after laparoscopic surgery
Laparoscopic surgery requires intestinal preparation, just take some laxatives; if the surgery is large, a clean enema is needed; the day before the surgery, the umbilical fossa and the umbilical area need to be cleaned; generally no skin preparation, hanging off the pubic hair; whether to leave a urinary catheter depends on the size of the surgery and the anesthesia, when you need to insert a urinary catheter must be inserted, living people can sometimes be suffocated by urine. After laparoscopic surgery, analgesic pumps and pain medications are generally not needed, as they can cause dizziness and nausea in patients. Patients will experience pain in the right upper abdomen and right shoulder after surgery, which will naturally get better in 1~2 days. If patients have stomach problems, there is a possibility that stomach problems may be aggravated after laparoscopic surgery, and they need to take medication for stomach problems.
15.Is there any risk in laparoscopic surgery?
Laparoscopic surgery has many advantages, but as a surgical procedure, like conventional open surgery, there are certain risks, which can be life-threatening in serious cases. There are two types of complications: minor and major.
Minor complications: subcutaneous emphysema, skin bruising, and incisional infection.
Severe complications: injury to the bowel, omentum, retroperitoneal vessels, bladder, ureter.
Complications of laparoscopic surgery can be controlled and avoided, depending on the skill and experience of the surgeon. Statistically, most complications occur during the first 300 laparoscopic procedures performed by a single surgeon. For an experienced gynecologic laparoscopist, the incidence of surgical complications is so low that a foreign expert once compared laparoscopic surgery to the risk of being seven times safer than riding in a car. Dare to walk and ride in a car on the street, and dare to undergo laparoscopic surgery if you are sick.