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Laparoscopy

During last decades laparoscopy has made true revolution in medicine, breaking the rules and settings shaped during centuries.

95 % of all gynecological procedures can be performed by laparoscopy.

Limiting factors are  surgeon’s experience  and equipment of operation room.

Some conditions, for example, genital endometriosis can't be treated without laparoscopy. This tŠµtechnology opens new era in diagnosis and treatment of infertility with improving  results of treatment.

Laparoscopy doesn't warrant good results without surgeon excellent experience

 

Benefits of minimally invasive or laparoscopic procedures are

§  less post operative discomfort since the incisions are much smaller

§  quicker recovery times

§  shorter hospital stays

§  earlier return to full activities

§  much smaller scars

§  there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery.

§  Ability of performing concomitant surgical procedures- appendectomy, cholecystectomy)

§  During procedure video recording can be done for patients information and residents training

Limitations of laparoscopic procedures

Laparoscopic procedures have specific complications,due to the gas used to fill the abdominal cavity can cause complications, if it enters a blood vessel ,this is very rare and avoidable complication.

Equipment and laparoscopic instruments are very expensive

Surgeon's good experience and high skills is an important  factor for minimizing all laparoscopic complications. Specialist training process is very long and hard.As everysurgical  procedure, laparoscopy has several complications, but they are  rare, if procedure is performed by highly qualified surgeon. In some cases  procedure cannot be completed by laparoscopy- in such cases conversion to laparotomy( abdominal open surgery) is performed.

Procedure

 Laparoscopic surgery also referred as minimally invasive surgery describing the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient.

 Contraindications

Absolute contraindications for operative laparoscopy include the following:

·         Surgeon's lack of skills

·         Inadequately equipped operating room

·         Shock

·         Markedly increased intracranial pressure

·         Retinal detachment

Relative contraindications include:

·         Compromised cardiopulmonary status

·         Ventriculoperitoneal shunt [3]

·         Pregnancy

·         Large pelvic masses

Laparoscopy is routinely performed under general anesthesia. Pre-surgical preparation doesn't  differ from preparation before abdominal operations.

In your doctor recommends surgical procedure, ask him, if it possible to do by laparoscopic route.