What is Laparoscopic Surgery?
Laparoscopic surgery, often referred to as diagnostic laparoscopy, is a surgical procedure used to examine abdominal organs. It is a low-risk and minimally invasive procedure where only small objects are made below the areas of the navel of women that cannot conceive. In this process, a small device called a laparoscope is used with high intensity light and a camera in front. Many doctors recommend the procedure to look inside the abdomen in real time without open surgery.
During the procedure, your doctor may also take Biopsy samples. The camera shows the image of the organs on the TV monitor in the uterus. The video camera becomes the eye of the surgeon in the process of laparoscopic surgery, and thus helps the surgeon to determine if there are any abnormalities with the patient. Traditional treatment methods for laparoscopic surgery But is often chosen because it involves minimal post-operative discomfort, rapid recovery, less time to stay in hospital, return to daily functioning and Fei contain small traces.
What does Laparoscopic Surgery mean?
Laparoscopy can be described as a method of surgery where small incisions are made in place of large cuts. There are two types of laparoscopic surgery – an advanced device with a hand-held device and robot-assisted surgery. Advanced surgery performs various tasks during human hand surgery ( Executed) which is difficult to reproduce with the help of laparoscopic devices. It is not possible to go to the subtle areas within the stomach.
This has led to the development of handheld devices that can easily reach the liver, pancreas, and bile duct. It is very easy to reach the areas in case of Robotic Support Surgery, The doctor operates two devices that are similar to joysticks. It makes three objects in the stomach through which two robot weapons and a camera are inserted. The camera shows high resolution and depth sensitive images. In most modern countries, robot-assisted laparoscopic surgery is performed and recovery time occurs.
Who is eligible for treatment of Laparoscopic Surgery? (When is treatment done?)
Your doctor may advise you to undergo laparoscopic surgery to reconstruct the bile duct, change the way the bile duct is blocked by a tumor, the gastrointestinal tract. Reconstruction of and suit for pancreatic duct. This is often helpful if you are suffering from remote pancreatectomy, laparoscopic cholecystectomy, and adrenalectomy. Laparoscopic surgery, with organs of reproduction, gall bladder, pancreas, liver, appendix, stomach, spleen, Helps in evaluation of small and large intestine. In the abdominal cavity and liver diseases, the doctor helps to find out if there is an abdominal mass or tumor or unwanted fluids.
Who is not eligible for treatment?
There are no restrictions as to which laparoscopic surgery may not lead. But like all other surgical procedures, people with very high blood sugar and blood pressure may not be able to undergo treatment. High cholesterol (Cholesterol) levels and smoking are also used for laparoscopic treatment.
Laparoscopic surgery side effects
The most common side effects of laparoscopic surgery are infection and bleeding. Thus, it is important to understand the symptoms of the disease. If your abdominal pain becomes intense with the passage of time with fever and cold, it should be reported to the doctor without delay. In addition, you may also experience swelling, redness, bleeding at the site of incision. Other side effects include mild headache, persistent cough, difficulty in urination (Difficulty in urination), and persistent feeling of nausea. You should not ignore them and contact a doctor, some people experience complications from general anesthesia, inflammation of the abdominal wall and blood clots that occur in your pelvis and lungs (Lungs). ) Can cause trouble.
What are the post-treatment guidelines after treatment?
After undergoing laparoscopic surgery, the symptoms subside from the second day of surgery. There is no restriction on the work you can do after surgery but make sure you listen to your body. If you feel that physical exertion, you should avoid sex for at least two weeks if you join the vagina or uterus.
how long does your stomach stay swollen after laparoscopic surgery
The most frequent annoyance is swelling in the belly , linked to the carbon dioxide used to operate in laparoscopy.
“After general anesthesia, this gas is injected into the abdomen until it becomes tense and voluminous like that of a woman in the last month of pregnancy,” explains Professor Riccardo Rosati, head of the Gastroenterological Surgery Unit and Week surgery unit of the IRCCS San Raffaele Hospital in Milan.
“Thus, through a fiber optic instrument, the surgeon clearly sees the organs on which he has to intervene and has the space necessary to operate the mini surgical instruments that he uses to operate from the inside”.
At the end of the intervention, the gas is completely released and the belly returns to its usual size, but it can still feel swollen and the sensation can last for days: «The fault is not of the carbon dioxide residues (the gas it is completely reabsorbed and disposed of in a few hours), or a gas-induced irritation as is often believed, but it depends on the abdominal muscles », underlines our expert.
«By inflating the belly, they undergo a sort of stretching, they lose tone and their” pancera “effect on the intestine decreases. Result: the belly is more pronounced “.
The swelling is usually destined to disappear on its own : within a few days if the duration of the intervention was short, within a couple of weeks if the abdomen remained tense for 2-3 hours in a row.
“As soon as possible, it is good to walk and, occasionally, simply pull the belly in to tone the abdominal muscles, ” suggests Rosati. “Then you can put in a real program for their reinforcement: even after just one week if you have performed a laparoscopy for diagnostic purposes, after at least a month in case of more complex surgery”. As long as the swelling does not pass, it is useful to follow a diet that does not increase it.
“Initially, it is better to put a few carbohydrates on the table, eat slowly and in small bites , avoid legumes and whole foods that increase fermentation processes and give up carbonated drinks”, suggests Professor Silvio Danese, gastroenterologist, head of the Center for chronic inflammatory bowel diseases by Humanitas.
Shoulder pain after laparoscopic surgery
Immediately after laparoscopy and during convalescence, it is easy to experience pain in the right shoulder .
“It really depends on the use of carbon dioxide, especially if the gas is injected quickly,” explains Rosati. «It relaxes the diaphragm and, from there, inflames the sensitive endings of the phrenic nerve that radiates right to the shoulder. The solution: use a non-steroidal anti-inflammatory, on prescription, to be taken for the time necessary to overcome the inflammation ».
The lazy intestine
The constipation is a disorder lurking in the postoperative. “The” fault “is often the type of cocktail used for anesthesia or the painkillers used: some molecules, such as opioids, slow down peristalsis and the intestine needs time to get back on its feet. To facilitate this process, just drink and move more », explains Rosati.
“If you have had a gynecological operation and the constipation is irreducible, ok to the sachets based on macrogol , an intestinal regulator that accelerates the transit of the fecal mass in the intestine and favors the evacuation”, suggests Danese.
An increasingly popular technique
In centers of excellence, about 80% of abdominal diseases are now resolved by laparoscopy. With this method, gallstones, diverticula and functional diseases of the esophagus (hiatal hernia or achalasia), inguinal hernias, adrenal and spleen diseases, but also colorectal, stomach and esophagus tumors are used.
In gynecology it is used for diagnostic-therapeutic purposes to clarify many problems: pelvic inflammatory disease, endometriosis, fibroids, extrauterine pregnancy, ovarian cysts or infertility problems, linked for example to the suspicion of a closure of the tubes, but also for tumor diseases with indication of removal of the uterus (hysterectomy).
In urology for kidney, bladder and, above all, prostate cancers, the latter often with robot-guided laparoscopic access.
How long does it take to recover?
Once the laparoscopic surgery is over, your doctor will observe you to find out if there is any complication. Anesthesia is being used. Time to send home will depend on factors such as your physical condition, like anesthesia. Sometimes, you may have to stay in the hospital at night. You can start your daily work within a week but make sure that you see a doctor for follow-up treatment.
Laparoscopic surgery cost in India?
It is still a surgical procedure that is affordable for everyone. Price around 20,000, but it may be slightly more on the quality of health care and your health complications. But many people get treatment every year, and some insurance also covers it.
Are the results of the treatment permanent?
If the doctor takes a biopsy, he is prone to adhesions and scars, hernia, appendicitis, tumors and cysts, cancer and pelvic inflammation. Will look for examples. Since laparoscopic surgery is an invasive procedure, it will reduce the risk factors and ensure that your organs are healthy. But for this, you have to follow the instructions given by the doctor.
What are the treatment options?
There is only one option for laparoscopic surgery which is HSG, although many gynecologists agree that it is a complimentary procedure rather than an option. The second procedure is laparotomy, which is a major surgery. Where the stomach is cut, and the patient needs to stay in the hospital for about 4 to 6 days.
Laparoscopic surgery for infertility
Laparoscopic surgery has made it possible to successfully treat many women and mainly infertile patients whose infertility is secondary to adhesions, pelvic and ovarian endometriosis, sacro-hydrosalpinx, ovarian polycystosis resistant to medical therapy. It also allowed us to make a diagnosis in many cases of unexplained infertility.
There are some causes of infertility that cannot be diagnosed without diagnostic laparoscopy , such as infertility secondary to post-surgical or post-inflammatory adhesions, or to minimal superficial endometriosis .
SURGERY SHOULD BE DONE AT THE SAME TIME AS DIAGNOSTIC LAPAROSCOPY
Ideally this should be done but in practice it often does not happen, for several reasons:
1 because this is not foreseen before, therefore there is no informed consent
2 because the surgeon who does the diagnostic laparoscopy does not have sufficient experience in laparoscopic surgery
3 due to the lack of adequate instrumentation
(For example, the absence of a CO2 laser, can compromise the quality of surgery if it is a question of adhesions or superficial endometriosis as a slow or less experienced surgeon causes more postoperative adhesions, because the surgery is longer duration and exposure to tissue trauma also.)
Hernia laparoscopic surgery
The inguinal hernia can also be treated with a laparoscopic minimally invasive technique. The approach can be performed Pre-peritoneally (TEP) or Trans-peritoneally (TAPP).
Through some small accesses to the abdominal cavity (generally three: one at the level of the umbilical scar for the optics and two lateral, from 5 – 10 mm) it is possible to work on the inside of the hernial door and apply a particular type of mesh (mesh ) suitable for closing the wall defect.
After reducing the hernial content, the peritoneum is opened and a pocket is made in which the net is placed, which can be fixed in place with biological glue. We have now abandoned physical fixation means such as points or spirals, which have given rise to postoperative pain problems in the past. The tissue adhesives, being less traumatic, allow to fix the prosthesis without causing vascular and / or nerve damage and can reduce the complication rate in this type of surgery.
A particular type of net (Progrip – Covidien) is particularly interesting as it is equipped with “pedicels” similar to velcro, which allow the correct fixing of the net without having to resort to glues or points.
Furthermore, we are now using pre-shaped nets, of an optimal size for the preperitoneal pocket in which they are positioned, which therefore remain positioned in place by their very shape.
The peritoneal flap is then sutured to cover the network, in order to avoid the onset of adhesions with the intestinal loops.
The instruments are extracted and the umbilical access – the largest, approximately 1 cm – is sutured with a resorbable stitch.
Advantages and disadvantages
The traditional technique , although performed with “tension free” techniques, ie limiting the sutures on the fascias and muscles in order to reduce postoperative pain, still requires the surgical approach through an incision of a few centimeters in the groin region.
Afterwards, the muscular and fascial components are separated until the wall defect is highlighted. A “plug” and a net of non-absorbable material are then placed, in which the scar tissue goes to definitively close the hernial door. A fairly frequent occurrence is damage to the ileoinguinal nerve, which passes into the region to be treated, with consequent alteration of the sensitivity in the inguinal-scrotal area. Most of the time this causes hypo / anesthesia in the area, with a decrease in skin sensitivity in the groin region. Sometimes the nerve, affected by the scarring process, can cause intense postoperative pain (neuralgia), which can last a few months.
Furthermore, the risk of hematoma or wound site collection is relatively frequent, with slowing down of healing and the need for daily medications for several days.
The recovery time for moderate physical activity is about 15 days, while the recovery of sports activity or heavy work is recommended at least one month after the intervention.
The big advantage of this technique lies (for hospitals) in the fact that it is cheaper and (for patients) it can almost always be performed under local anesthesia, with admission to Day Hospital.
The laparoscopic technique , on the other hand, necessarily requires the approach under general anesthesia , usually with an overnight stay after the surgery.
The operation is technically more difficult and requires a good experience of laparoscopic technique, in order to minimize the risks related to the passage inside the abdominal cavity.
The big advantage of this technique lies in the clearly faster and less painful postoperative recovery , with resumption of physical activity and light sports in a few days. In addition, the prosthesis positioned intraperitoneally has a higher resistance to physical loads, and is therefore particularly suitable for patients who practice intense sports , amateur or professional, or who need a rapid postoperative recovery. Furthermore, it is a perfect indication for young patients, with robust tissues, in which traditional surgery can be of greater weight. A classic indication is the presence of a bilateral hernia
. In laparoscopy, the extent of the defect on both sides can be assessed very well, including the possible presence of particular associated hernias (for example a crural hernia). It is therefore possible to repair both defects in one go.
The laparoscopic technique is then of choice in the treatment of relapses , in which the tissues have already been “processed” by the traditional way and therefore disrupted by scarring. Passing through the transperitoneal route, it is easier to get to isolate the defect and place the preperitoneal network in an area not yet “ruined” by previous surgery.
Laparoscopic surgery video
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