Laparoscopy . Laparoscopy describes a group of operations carried out with the help of a camera placed on the abdomen or pelvis .
Its origin dates back to the beginning of the 20th century, and its use as a diagnostic medium became popular.
- “lapara”: abdomen (in Greek).
- “skopein”: look, inspect (in Greek).
The laparoscope allows doctors to carry out minor and complex surgeries with a few small incisions in the abdomen. This technique is known as laparoscopic assisted surgery.
Laparoscopy can also be done to diagnose a condition. In this case, the procedure is called diagnostic laparoscopy.
Its frequent use causes infertility although its utility is very limited and its risks are serious. Requires general anesthesia but is usually performed on an outpatient basis. It produces a disability of 4 days if there are no complications.
Summary
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- 1 Form of realization
- 2 uses
- 3 Risks
- 4 Sources
Form of realization
The procedure is usually carried out in the hospital or in an outpatient surgical center, under general anesthesia (while the patient is unconscious and painless). However, on very rare occasions, this procedure can also be done under local anesthesia, in which only the affected area is desensitized for surgery and allows the patient to be awake.
The surgeon makes a small incision below the navel and inserts a needle into the area. Then, it injects carbon dioxide into the area to help move the abdominal wall and any organs, thereby creating a larger space to work. This allows the surgeon a better view of the area.
A tube is inserted through the incision into the abdominal area, which carries a tiny video camera (laparoscope) that is used to look inside the pelvis and abdomen. Likewise, other small incisions can be made if other instruments are needed to achieve a better visualization of certain organs. After the exam, the laparoscope and instruments are removed and the incisions are closed. The patient will wear bandages over these areas.
Laparoscopy offers many benefits over other types of abdominal surgery also carries certain risks.
Applications
Laparoscopy has various uses. A common use is to detect a medical problem , such as chronic pelvic pain (pain that lasts more than six months). Laparoscopy is used for some procedures and to treat certain conditions, such as:
- Endometriosis: During this procedure, the affected tissue is removed using laser, heat, or other methods.
- Fibroids. Fibroids are tumors that form on the wall or outside the uterus . When fibroids cause severe bleeding and pain, laparoscopy is sometimes used to remove them, this depends on the number of fibroids present, their size, and their location.
- Ovarian cysts: Some women have cysts (fluid-filled sacs) that form on the ovaries. These cysts can cause only mild discomfort. Over time, ovarian cysts often go away on their own. When they do not, however, the doctor may recommend removing them by laparoscopy.
- Ectopic pregnancy. Laparoscopy can be used to remove an ectopic pregnancy from a fallopian tube .
- Sterilization: During this operation, the doctor uses the laparoscope as a guide to block the fallopian tubes, either by cutting them, holding them with instruments, or burning them. After this procedure, the woman can no longer become pregnant. Therefore, it is used as a permanent method of contraception.
- Laparoscopic guided vaginal hysterectomy: This is a type of hysterectomy where the uterus is removed through the vagina . Laparoscopy will be used to guide the procedure.
- Laparoscopic hysterectomy. In this procedure, the uterus is detached from the inside of the body. Small incisions are then made in the abdomen to use the laparoscope and other instruments to remove the uterus. The uterus is removed through these incisions in small portions.
- Pelvic problems. Laparoscopic surgery is used to treat urinary incontinence and pelvic support problems, such as uterine prolapse.
Risks
The main danger of laparoscopy is perforation of the aorta since the introduction of the instruments is blind and under strong pressure. It can also perforate the intestine , stomach , cysts and uterus , among others, and can cause electrical burns and serious infections in the areas surrounding the operated organs. As it is almost impossible by this means to completely eliminate the lesions, it is very easy to spread them, which is serious in case of infections, endometriosis and cancer.
The risk is greater when there are cardiac or respiratory diseases, obesity , diaphragmatic hernia , pregnancy , pelvic inflammatory disease or its antecedent (due to the possibility of reactivating it), extensive or multiple abdominal scars, or close to the umbilical area and previous abdominal surgery.