In 1901, Ott, a gynecologist in Petersburg, Russia, made a small incision in the anterior abdominal wall, inserted a speculum into the abdominal cavity, and used a cephaloscope to reflect light into the abdominal cavity to examine the abdominal cavity, and called this examination laparoscopy.
In the same year, Kelling, a German surgeon, inserted a cystoscope into the abdominal cavity of a dog for examination and called this examination endoscopy of the laparoscope.
The term laparoscopy was first used in 1910 by Jacobaeus of Stockholm, Sweden, who used a trocar needle to create a pneumoperitoneum. Zhao Haitao, Department of General Surgery, Lianyungang City Hospital of Traditional Chinese Medicine
1911 Bernhein, a surgeon at Johns Hopkins Hospital in the United States, inserted a rectoscope into the abdominal cavity through an incision in the abdominal wall and used emitted light as the light source.
In 1924 Stone, an internist in Kansas, USA, inserted a nasopharyngoscope into the abdominal cavity of a dog and recommended a rubber gasket to help close the puncture cannula to avoid air leakage during the operation. In 1938 Veress, a Hungarian surgeon, introduced an air-injection needle that could be safely made into a pneumothorax; when doing a pneumoperitoneum, the tip of the needle could be prevented from damaging the internal organs under the needle. The idea of making a pneumoperitoneum with an eclectic safety puncture needle was generally accepted and is used today.
The inventor of true targeted laparotomy was Kalk, a German gastroenterologist, who invented a lenticular system with a straight forward oblique view of 135°. He is considered to be the founder of laparoscopy for diagnosing liver and gallbladder diseases in Germany. He was the first to advocate the double trocar puncture needle technique in 1929.
In 1972 the American Association of Gynecologic Laparoscopists planned to perform nearly 500,000 laparoscopies in the following years, and this method of examination has become widely accepted by gynecologists. Nearly 1/3 of the gynecologic procedures performed at Cedars-Sniai Medical Center in Los Angeles used diagnostic or therapeutic laparoscopic techniques.
In 1986 Cuschieri began animal experiments with laparoscopic cholecystectomy, and in 1988 at the First World Congress of Surgical Endoscopy he reported a successful laparoscopic cholecystectomy in experimental animals, which was applied clinically in February 1989.
The first successful laparoscopic cholecystectomy in man was performed by the French surgeon Philipe Mouret, who in 1987 performed a successful but unreported laparoscopic treatment of gynecological disease in the same patient with a diseased cholecystectomy.
In May 1988, Dubois in Paris also applied laparoscopic cholecystectomy in pigs on the basis of an experiment, the results of which were first published in France and shown on video at the annual meeting of the American Society of Gastrointestinal Endoscopists in April 1989, and became a world sensation. The results were first published in France and shown in a video at the annual meeting of the American Society of Gastrointestinal Endoscopists in April 1989, which became a world-wide sensation.
In February 1991, Xun Zuwu completed the first case of laparoscopic cholecystectomy in China, which was also the first case of laparoscopic surgery in China. 10 years later, more than 40 types of laparoscopic surgeries have been carried out in China, and the number of cases has exceeded one million. Eat something light before the operation, be hospitalized one day in advance and follow the doctor’s prescription into the preoperative preparation.
Postoperative recuperation.
I. Wound care.
Usually the laparoscopic wound is one centimeter long at the navel, and 0.5 centimeter wound on each side of the lower abdomen, after the surgery, the one centimeter wound usually or do a simple suture, at this time may use absorbable or non-absorbable thread suture, if the use of non-absorbable thread suture, should be removed seven days after surgery, if the absorbable thread suture does not need to remove the suture; as for the 0.5 centimeter wound, use breathable But sometimes, in order to increase the neatness of wound healing, stitches and simple sutures may be used.
For the care of these wounds, it is important to keep the wound clean and dry until it is completely healed (about ten days) before showering or getting wet. Most importantly, because of laparoscopic patients, the hospitalization days are extremely short, so patients must pay attention to the redness, swelling, heat and pain of the wound every day after returning home to prevent the occurrence of infection and inflammation, although inflammation of the wound after laparoscopy is quite rare.
II. Nutritional intake.
In principle, the nutritional intake after surgery is the same, and more water should be taken to replenish the loss of body fluids during surgery. Usually, after recovery from laparoscopic surgery, you should be able to resume eating, at first, drink some warm water, no discomfort, you can start to eat liquid food (for example: thin rice), the next day you can resume the normal diet, because the wound healing needs to use protein, so take high protein food (for example: fish, lean meat, eggs …..) Since protein is needed for wound healing, foods high in protein (e.g., fish, lean meat, eggs ) should be consumed to accelerate wound healing and avoid stimulating foods that may stimulate acid secretion and cause gastrointestinal discomfort (e.g., chili peppers, cigarettes, oil, coffee).
The biggest difference between postoperative laparoscopy and general open surgery is that because carbon dioxide needs to be instilled during the surgery to create a pneumoperitoneum to facilitate the operation, it is easy to have residual carbon dioxide gas in the abdomen after surgery, so it is advisable to increase the intake of vegetables and high-fiber fruits after surgery and avoid gas-producing foods such as: groundnuts, beans, onions ….. This will reduce the discomfort caused by abdominal distension after surgery. As for larger surgeries, such as hysterectomy, intestinal adhesion reduction surgery, cervical cancer eradication surgery ……, because of the longer anesthesia time and longer surgery time, more gas is absorbed by the gastrointestinal tract, so it is easier to have abdominal distension, so it is more appropriate to eat after 24 hours. For patients who are prone to postoperative nausea, vomiting and idiosyncratic body, they do not need to force themselves to eat, and can eat after the anesthesia has completely faded.
Placement of catheter.
For outpatient laparoscopic surgery, it is usually not necessary to place a catheter in the bladder through the urethra before surgery, but rather to place it after anesthesia and remove it after surgery. For larger laparoscopic surgery or inpatient surgery, a catheter is usually placed before surgery so as to avoid bladder injury during surgery and to avoid painful wounds after surgery when patients need to get up immediately to urinate.
It can be seen that the catheter is placed mainly to help post-operative patients and reduce the discomfort of moving after surgery. Therefore, as long as the patient feels well recovered after surgery and can get up to use the toilet, he or she can ask the physician to remove the catheter! Try to urinate on your own, and then catheterize if you have difficulty in doing so. In general, for larger laparoscopic procedures, we usually leave the urinary catheter in place for two hours before removing it so that the patient can get sufficient rest and not have to worry about the livelihood of the patient in terms of toileting.