Laparoscopic surgery, commonly known as “keyhole” surgery, is the most representative of gynecologic laparoscopic surgery. During the operation, three small incisions (0.3cm-1cm in diameter) are made in the abdominal wall and a trocar is inserted into the abdominal cavity to establish a channel between the abdominal cavity and the outside world. These channels are used to insert special laparoscopic instruments deep into the abdominal cavity, where a camera device clearly displays the image of the abdominal cavity on a monitor screen, and the surgeon looks directly at the screen to perform various surgical operations. At present, the role of laparoscopic technology in the treatment of gynecological diseases is gaining more and more attention, as it serves both diagnostic and therapeutic purposes, allowing surgical treatment to be performed at the same time as diagnosis. Compared with traditional open surgery, it has the advantages of less trauma, less pain, faster postoperative recovery, less complications, shorter hospital stay and no obvious scar, which is welcomed by female patients!
What diseases can be treated by minimally invasive gynecological laparotomy?
1.Ectopic pregnancy, tubal sterilization; 2.Infertility, tubal evacuation; 3.Ovarian cysts, tumors, ovarian corpus luteum rupture, polycystic ovary syndrome; 4.Uterine fibroids, uterine prolapse, dysfunctional uterine bleeding; 5.Endometriosis, uterine adenosis, ovarian chocolate cyst; 6.Pelvic inflammatory disease and pelvic abscess; 7.Cervical cancer, endometrial cancer and early ovarian cancer radical Surgery; 8, chronic pelvic pain of unknown etiology, ovarian tissue biopsy, etc.
Can one operation treat gynecological diseases and gallbladder stones at the same time?
If a patient has gynecological diseases (such as uterine fibroids, ovarian cysts, ectopic pregnancy, etc.) and gallbladder stones and cholecystitis, the traditional surgery is to perform cholecystectomy in surgery first and be hospitalized for 7~10 days, and then live in gynecological surgery for 2~3 months, which is 10~15 days, two hospitalizations, two anesthesias, two surgeries, which causes great damage to the patient, great pain, long hospitalization time, high cost, and long delay for family members to go back and forth to take care of the patient. family members need to spend more time to travel to and from the hospital to take care of the patient. If laparoscopic minimally invasive gynecological and surgical joint surgery is implemented, only one hospitalization is needed, about 3~5 days, one anesthesia, gallbladder and gynecological pelvic mass can be removed at the same time, and the patient can go down to the ground in 24 hours, eat early, and recover quickly after surgery.
Third, can the “eye” surgery be complete?
Some patients have concerns that “eye” surgery is not as intuitive and reliable as open surgery, but it is not. Laparoscopic surgery is made easier and more reliable by improving the surgical operation method and surgical instruments. Laparoscopic surgery has a clearer field of view, more detailed surgical operation, and less possibility of complications. At present, the United States, Singapore and other countries have legislation, such as doctors can not be the first to use the “eye” surgery, to the patient increased pain, it is considered illegal.
Fourth, can obese patients implement laparoscopic surgery for gynecological diseases?
Obese patients are more suitable for laparoscopic surgical treatment. Obese patients to implement open surgery, because the incision is large and deep, subcutaneous fat is easy to liquefy, so it is easy to cause postoperative incision infection, incisional hernia, etc.. In addition, the respiratory function of obese patients is significantly lower than that of those with normal weight, and postoperative complications such as pulmonary infection and pulmonary atelectasis are significantly higher than those with normal weight. If laparoscopic surgery is performed, there is no difference between obese patients and normal weight patients in terms of wound size, duration of surgery, damage to the muscle and incidence of postoperative complications. The incidence of complications such as incisional infection and pulmonary infection is lower in laparoscopic surgery than in open surgery. Therefore, obese patients are more suitable for laparoscopic surgery.
V. How to remove large pelvic masses (such as uterine fibroids, ovarian cysts, etc.) from the small orifice?
In case of ectopic pregnancy and removal of the fallopian tubes, the resected material can be easily removed directly from the small orifice. If it is a cystic ovarian mass, the fluid inside the cyst can be sucked out first with a thin puncture needle to shrink the mass and remove it through a small opening in the abdominal wall. In the case of larger solid masses, such as uterine fibroids, the masses can be cut into strips with special instruments and then removed through small incisions in the abdominal wall. All of the above specimens should be placed in a specimen bag and removed through a small incision in the abdominal wall. The entire mass can also be removed from the vagina. There is no large scar on the abdominal wall when the large mass is removed, only 3-4 small incisions (0.5~1cm), and no trace of surgery is visible at all after healing.
Can I get pregnant again after the tubal preservation laparoscopy?
Many data prove that in the absence of other factors of infertility, there is no difference in pregnancy rate between patients after tuboplasty and tubectomy, but the risk of persistent ectopic pregnancy and repeat ectopic pregnancy after tubal preservation surgery is significantly higher than that of tubal removal, therefore, existing guidelines do not recommend tubal preservation.
Can laparoscopic removal of ovarian cysts preserve the ovulatory function of the affected ovary?
Yes. Depending on the condition of the ovarian cyst, the cyst can be removed and part of the normal ovary can be preserved, so that the endocrine function of the ovary is preserved without affecting ovulation.
Can patients with polycystic ovary syndrome be treated by laparoscopy?
Yes. Polycystic ovary syndrome is a complex group of syndromes caused by abnormalities in hormone secretion and regulation between the hypothalamus, pituitary gland and ovaries. It is characterized by the absence of ovulation in the ovaries. Clinical symptoms include menstrual disorders, obesity, hirsutism, and bilateral ovarian enlargement. The traditional surgical treatment is open surgery with wedge excision of the ovaries. Laparoscopic treatment of polycystic ovary syndrome can restore ovulation in 90% of patients, with a postoperative pregnancy rate of 70%, and is simple to perform with few postoperative pelvic adhesions. Currently, laparoscopic treatment of polycystic ovary syndrome has replaced open ovarian wedge resection.
X. Can laparoscopy treat pelvic inflammatory disease and pelvic abscess?
Yes. Most surgical explorations for pelvic inflammatory disease via open treatment are considered inflammatory tissue edema, increased tissue fragility, surgery is easy to tear, tissue congestion, capillaries bleed very easily, hemostasis is not ideal, therefore, intraoperative blood transfusion is often required. Postoperatively, the presence of infection spread and incisional infection make the dosage of antibiotics larger. The minimally invasive laparoscopy has little damage, no need for blood transfusion and reduced postoperative medication, which is a good method with little damage and diagnostic and therapeutic effects, and can be used for the diagnosis and treatment of pelvic inflammatory disease and pelvic masses.
XI. What kind of patients can undergo laparoscopic treatment?
No serious cardiovascular disease, no cardiopulmonary insufficiency, no middle or late pregnancy, no coagulation dysfunction or hematological disease can be treated by laparoscopy.