Laparoscopy is a method of surgical access, when the operation is performed under control of a special video camera special thin instruments. Instruments and optical tube with a camera inserted into the abdominal cavity through small incisions on the skin (~ 1 cm). They are introduced through special conduits – trocars – making it easy to enter, retrieve, and change instruments during surgery without damaging the skin. Usually administered three trocars: one in the navel (for optics with a video camera) and two in the abdomen (for tools). However sometimes there is a need for another tool, then enter the fourth trocar between the two lower.
To perform the operation in the abdominal cavity is typed carbon dioxide, which raises the anterior abdominal wall and creates visibility for the surgeon. The operation is special long, thin instruments, looking at the monitor.
Many patients are interested in a fairly large ovarian cyst can get through such small incisions. It’s very simple. Remote the tumor is placed in a special sealed bag. In it the cyst safely emptied and after reducing the volume safely removed from the abdominal cavity.
the benefits of laparoscopy compared with traditional open surgery is difficult to underestimate. After all, in just a few hours after surgery, the patient can freely get up and walk. But after 1-2 days can be discharged home.
the Small size of the incisions on the skin avoid prolonged healing, infection of the joints, pains and restrictions on the mode. The rehab process, unlike abdominal operations, takes only a few days to a month.
Features laparoscopy ovarian cyst
But in addition to listing the advantages of laparoscopy, I would like to highlight those features that must be considered during surgery to achieve the best result.
Remove the ovarian cyst during laparoscopy can be of two types: removal of cysts directly (this operation is also called cystectomy, husking of the cyst, resection of the ovary) or removal of the cyst along with the ovary (ovariectomy, adnexectomy).
Complete removal of the ovary must be necessarily carried out only in menopause or at high risk of malignant tumor growth. In all other cases it is necessary to leave unaffected tissue of the ovary.
However, there are times when long-existing tumor completely replaces the ovarian tissue and after wylosowane cysts and only a small piece. But even in this situation the ovary (or rather what’s left of it) you need to save and give a chance for rehabilitation.
not to mention about another danger during laparoscopy to remove ovarian cyst. Some surgeons use to stop bleeding from the ovary is quite aggressive techniques. This allows you to quickly stop the bleeding and finish the operation. However after this “burning” the ovary is recovering much longer, and in some cases not recovering at all. In fact, this operation amounts to a removal of the ovary. Unfortunately, the woman had this long may not even realize, because the second ovary at the time takes on increased hormonal load.
Remove ovarian cyst during laparoscopy preferably without opening the capsule, to ensure that the content is not streamed into the abdominal cavity. This is especially important for the following types of tumors: dermoid cyst, mucinous and papillary cystadenoma. This technique allows to avoid serious complications in the future.
Special attention is needed for the surgery to remove the endometrioid ovarian cysts. During laparoscopy is necessary to remove the maximum number of endometriotic lesions, otherwise the effect of the operation will be highly conditional.
Laparoscopy to remove ovarian cyst often combined with other types of operations. Usually this separation of adhesions, to check the patency of fallopian tubes, removal of fibroids and some others.
Complications of laparoscopy
About possible complications of laparoscopy rarely write and say. However, to ignore that would not be correct.
According to different studies, the rate of complications of laparoscopic surgery ranges from 1% to 10% (depending on equipment and operating skills of the surgeon).
the Most serious complication is injury during surgery of the abdominal organs such as the intestines or major blood vessels. This usually leads to changes the normal arrangement of organs due to various intra-abdominal pathology: tumors (including ovarian cyst), adhesions, anatomical abnormalities.
This fact surgeon requires not only knowledge of normal anatomy, but also the ability to predict how this anatomy may change from individual patient. But in normal anatomy, in case you neglect basic rules of safe surgery, your doctor may cause injury to neighboring organs.
Another possible problem is infectious complications. A big role in their development are the foci of chronic infection and the temporary decline in immunity in response to surgical intervention. This should be considered when conducting the postoperative period.
As mentioned above, to perform surgery in the abdominal cavity is typed carbon dioxide. Sometimes, inappropriate introduction of the first instrument, the gas falls into the abdominal cavity, and retroperitoneal space. In the postoperative period, it can cause very unpleasant sensations.
Important in prevention of serious complications that the surgeon and equipment operating is allowed to prevent them at the beginning of development. All serious complications often develop due to the fact that time has not recognized their initial manifestation, and not taken to eliminate them.
But, I think we should not continue to exaggerate. After all, in the end, laparoscopy — this is a great online method that is ideal for removal of ovarian cyst. Especially if the laparoscopy is made according to the rules of surgery ovarian!
As I have repeatedly mentioned, the ovary is an extremely sensitive organ. Therefore, your task I set not just the ovarian cyst removal, not just the implementation of laparoscopy, and the conducting of maximum sparing surgery.
it just So happens that in order to collect as much information as possible about ovarian cyst and methods of its removal, I had to drive around a large number of clinics in Russia and in Europe. This experience allowed me to gather the best approaches to surgery of the ovary and put them into practice.
the Result was not long in coming. Using exclusive techniques and modern equipment allows to obtain excellent results from operations on the ovary. This can significantly reduce the risks of surgical complications and improve the tolerance of the operation. For me it is important not to just leave the ovary, and to retain its functionality.