Laparoscopy. Laparoscopy: all about the modern method of surgery and diagnosis. Where is surgery or laparoscopy better?

Laparoscopy is gaining popularity every year, and this method is preferred by doctors from different fields of medicine. To perform it, you need modern equipment that allows you to make precise incisions and visually monitor the process in order to avoid erroneous actions by the surgeon.

This technique becomes safe only in the hands of professionals. They should not only know what laparoscopy is, but also have extensive experience in operating in this way. Learning this technique requires a long time and dedication. Laparoscopy is most often used by gynecologists, but it has also been found in other areas of medicine wide application.

Areas of use

Laparoscopy is a minimally invasive diagnostic method and surgical treatment. In the process of its implementation, everything surgical procedures are performed through a small (about 10–15 mm) hole in the abdominal cavity using special instruments. A laparoscope, which is equipped with a video system, allows you to visualize what is happening during the procedure.

Most often, laparoscopy is used when performing the following operations:

• removal of the gallbladder or stones in it;
• ovarian cystectomy;
• myectomy;
• operations on the small and large intestines;
• appendectomy;
• gastric resection;
• removal of the umbilical and inguinal hernia;
• liver cystectomy;
• pancreatectomy;
• adrenalectomy;
• elimination of obstruction fallopian tubes;
• elimination varicose veins veins of the spermatic cord;
• surgical methods obesity treatment.

Using the laparoscopic method, it is possible to perform all traditional operations and at the same time maintain the integrity of the tissues of the abdominal wall. In addition, laparoscopy is also used for diagnostic purposes in the following cases: serious damage to the abdominal organs with irritation of the peritoneum, pathologies of the hepatobiliary system, pathologies of internal organs caused by injuries.

The list continues with effusion of blood into the body cavity, abdominal ascites, purulent inflammation peritoneum, neoplasms in internal organs. Laparoscopy is performed both routinely and in case of emergency. Hydrosalpinx is a pathology of the fallopian tubes caused by the accumulation of transudate in their lumen.

Laparoscopy is an operation, so the risk of serious complications is inevitable

Gynecological practice

In gynecology, a combination of hysteroscopy and laparoscopy often occurs, when it is necessary to make an accurate diagnosis and immediately carry out a series of therapeutic actions. Thus, hysteroscopy allows for diagnostics, sampling of material for histological analysis or immediately eliminate minor defects in the uterus (septums or polyps). And laparoscopy, unlike the first procedure, allows even tumors to be removed. It can completely replace abdominal surgical intervention.

These diagnostic procedures cannot be avoided when a woman is examined for infertility. If, during hysterosalpinography, obstruction of the fallopian tubes was confirmed, then, according to indications, hydrosalpinx laparoscopy is performed under general anesthesia. After its removal, the chances of successfully getting pregnant increase to 40–70%. If it is necessary to remove the tube, then the woman can resort to IVF.

Contraindications

With all its advantages, laparoscopy has a number of absolute and relative contraindications. It is strictly forbidden to perform this procedure in the following cases:

• acute blood loss;
• proliferation of connective tissue cords in the peritoneum;
• purulent cavities on the walls of the peritoneum;
• pain syndrome in the stomach and severe flatulence;
• postoperative hernia at the site of the scar;
• severe cardiovascular pathologies;
• brain damage;
• hepatic and renal failure;
• pronounced pathologies respiratory system;
• malignant formations appendages.

In addition, there are a number of other restrictions:

• carrying a child for up to 16 weeks;
• benign tumor from muscle tissue large sizes;
• suspicion of oncopathology of the pelvic organs;
• acute respiratory infection V acute stage;
• allergic reaction to anesthetics or other drugs.

In such cases, laparoscopy is not completely ruled out, but optimal options are sought for each individual patient.

Preparing for surgery

If emergency laparoscopy is recommended, preparation is limited to cleansing gastrointestinal tract using an enema and emptying the bladder. Most available for rent necessary tests - clinical analysis blood and urine, RW, check the heart on an electrocardiogram and evaluate blood clotting on a coagulogram.

Preparation for the planned diagnosis is carried out in more detail and for a long time. The patient is carefully examined within 3–4 weeks. It all starts with collecting an anamnesis, since the success of the operation largely depends on it. The doctor must find out the following nuances: the presence of injuries, damage or previous operations, chronic diseases And medications accepted on permanent basis, allergic reactions for medicines.

Then a consultation with specialized specialists (cardiologist, gynecologist, gastroenterologist) is recommended. In addition, all necessary laboratory research and if necessary additional diagnostic procedures(ultrasound, MRI).

Successful operation depends on compliance with the following rules:

• 3–5 days before surgery it is forbidden to drink alcohol;
• take medications that reduce gas formation for 5 days;
• immediately before surgery, cleanse the intestines using enemas;
• on the day of laparoscopy, take a shower and shave your hair in the necessary places;
• no later than 8 hours before surgery you should refrain from eating;
• release bladder 60 minutes before laparoscopy.

If there is a need to perform emergency laparoscopy, then menstruation is not a contraindication for this. If the operation is planned, then it can be performed starting from the 6th day of the cycle.

As a rule, laparoscopy takes from 30 minutes to 1.5 hours

Performing laparoscopy

In connection with the planned operation, patients are often concerned about how laparoscopy is performed, under what anesthesia and how long the sutures take to heal. Performing laparoscopy includes the following steps. Application of pneumoperitoneum - a Veress needle is used for these purposes. Manipulation involves pumping carbon dioxide into abdominal cavity to improve visualization and movement of tools.

Insertion of tubes: when the required amount of gas is injected into the peritoneum, the Veress needle is removed, and hollow tubes (tubes) are inserted into the existing puncture sites. Trocar insertion: As a rule, during therapeutic laparoscopy, 4 trocars are inserted, the first one being blindly inserted. They are necessary for the further introduction of special instruments (preparing probes, spatulas, clamps, aspirators-irrigators).

Visual examination of the abdominal cavity is carried out using a laparoscope. The image is transmitted from the camera to the control unit, and from it the video is displayed on the monitor screen. After examining the insides, specialists make a decision on further tactics treatment. During the process, biomaterial can be taken for further research. At the end of the operation, the tubes are removed, gas is removed from the peritoneum and the subcutaneous tissue of the canal is sutured.

Diagnostic laparoscopy is performed under local anesthesia, therapeutic - under general anesthesia. In many cases, doctors prefer spinal anesthesia, since it does not require putting the patient into medical sleep and does not cause significant harm to the body.

Rehabilitation period

Postoperative period, as a rule, passes quickly and without significant complications. After a few hours you can and even need to move. You can drink and eat in the usual amount only after 24 hours. Discharge from the surgery department occurs the next day. The pain in the lower abdomen, as a rule, only occurs in the first 2–3 hours after manipulation.

Some patients have a slight increase in temperature (37.0–37.5 °C). If the operation was performed on the gynecological part, then within 1–2 days you may experience bloody issues. On the first day, patients may experience indigestion, and in subsequent days, bowel problems (diarrhea or constipation).

In the photo you can see post-operative scars

Patients who were examined in this way due to the inability to have children may try to get pregnant just a month after the procedure. If a benign tumor was removed during the process, then you can try to conceive a child only after six months. Sutures are removed after laparoscopy after 7–10 days. This is decided by the attending physician. If the suture does not heal for a long time, then the period may increase to one month, and throughout this time they should be properly cared for.

Laparoscopy is a low-traumatic method of diagnostics and surgical intervention.

Laparoscopy is carried out by penetrating the abdominal cavity to the pelvic organs using several punctures, and then manipulating instruments are inserted through them.

The manipulators are equipped with micro-instruments, lighting and micro-cameras, which allow visually controlled operations without making large incisions, which reduces the risk after surgical complications, minimizes surgical tissue trauma and reduces rehabilitation time.

When performing laparoscopy, to abdominal wall did not interfere with the examination and operations, it is raised by pumping air into the abdominal cavity - pneumoperitoneum is applied (the abdomen is inflated).

The operation is accompanied by incisions and painful stimulation, so it is performed under anesthesia.

Indications

Laparoscopy is very widely used in gynecology:

• for infertility of unknown cause, which was not revealed by a detailed non-invasive study.
• in case of ineffectiveness hormone therapy in case of infertility,
• during operations on the ovaries (sclerocystosis, ovarian cysts, ovarian tumors),
• if you suspect endometriosis, adhesive disease,
• for chronic pelvic pain,
• with endometriosis of the uterine appendages, ovaries, pelvic cavity,
• with myomatous lesions of the uterus,
• during tubal ligation, ectopic pregnancy, tubal rupture,
• with ovarian torsion, cysts, ovarian apoplexy, internal bleeding,
• during pelvic examination.

Contraindications to laparoscopy

Laparoscopy in gynecology is absolutely contraindicated

• for severe cardiovascular and pulmonary diseases,
• at in a state of shock, in a state of coma,
• with severe exhaustion of the body,
• for disorders in the coagulation system.

Surgery by laparoscopy is also contraindicated for hernias of the white line of the abdomen and anterior abdominal wall, and for hernias of the diaphragm.

Planned laparoscopy is contraindicated for acute respiratory viral infections; it is necessary to wait at least a month from the moment of illness. Surgery is also prohibited for severe changes in blood and urine tests, for bronchial asthma, and for hypertension with high blood pressure.

Preparation

Laparoscopy operations can be planned or emergency.

At emergency operations preparation may be minimal when it comes to saving the patient’s life.

For planned operations it is necessary full examination with passing all tests:

• blood (general, biochemistry according to indications, for hepatitis, syphilis and HIV, for coagulation),
• blood for glucose.

Blood type and Rh factor testing is required.

Mandatory before surgery gynecological smear, ECG and fluorography, ultrasound of gynecological organs, and if any chronic diseases- the therapist’s conclusion about the safety of anesthesia.

Before the operation, the surgeon explains the essence of the procedure and the scope of the intervention, and the anesthesiologist examines and identifies the presence of allergies and contraindications to anesthesia.

If necessary, medication and psychoprophylactic preparation for surgery are prescribed.

In the absence of contraindications to surgery and anesthesia, the woman signs a written consent to the operation separately on this type anesthesia

Carrying out the operation

Planned operations are usually scheduled for the morning, and before that a light diet is prescribed for several days, and in the evening before the operation, a bowel cleansing is performed with an enema.

Eating is prohibited, and after 22.00 water is prohibited, and the enema is repeated in the morning. Drinking and eating are prohibited before the operation.

If there is a risk of thrombosis, elastic leg bandaging or wearing anti-varicose compression stockings is indicated before surgery.

The essence of laparoscopic surgery

Depending on the volume of the operation and its location, three or four punctures are used.

One of the trocars (a device for puncturing the abdominal cavity and carrying instruments) is inserted under the navel, the other two are inserted on the sides of the abdominal cavity. At the end of one trocar there is a camera for visual inspection, at the other there is a light installation, a gas blower and instruments.

Carbon dioxide or nitrous oxide is injected into the abdominal cavity, the volume and technique of the operation are determined, an audit of the abdominal cavity is carried out (its thorough examination) and manipulations begin.

On average, laparoscopic operations last from 15-30 minutes to several hours, depending on the volume. Anesthesia can be inhalational and intravenous.

At the end of the operation, an inspection is carried out again, the blood or fluid that accumulated during the operation is removed. Carefully check the sealing of the vessels (for bleeding). Eliminate the gas and remove the instruments. To the trocar insertion sites on the skin and subcutaneous tissue sutures are placed on the skin - cosmetic.

After laparoscopy

The patient regains consciousness on the operating table, doctors check her condition and reflexes, and is transferred to the recovery room on a gurney.

During laparoscopy, early rising from bed and intake of food and water are indicated; the woman is lifted to the toilet and to activate blood circulation within a few hours.

Discharge takes place two to five days after the operation, depending on the extent of the intervention. Sutures are cared for every day with antiseptics.

Complications

The percentage of complications during laparoscopy is low, much lower than during operations with large incisions.

When a trocar is inserted, there may be injuries to internal organs, damage to blood vessels with bleeding, and when gas is injected, there may be subcutaneous emphysema.

Complications also include internal bleeding due to insufficient clamping or cauterization of blood vessels in the area of ​​the operating area. All these complications are prevented by strict adherence to the technique and a thorough inspection of the abdominal organs during surgery.

• Compared to abdominal and highly traumatic operations in gynecology, laparoscopy has a number of undoubted advantages, especially in at a young age: there are practically no scars left from the operation,
• less risk of postoperative complications and adhesions,
• the rehabilitation period is significantly reduced.

Laparoscopy surgery is minimally invasive, which is why it is so popular in gynecology. Its main advantage is the ability to carry out complex operations without severe tissue damage. This allows you to significantly reduce the rehabilitation period, down to 1-2 days.

Laparoscopy is a minimally invasive method for diagnosing and treating pathologies of the pelvic organs. During laparoscopy, all manipulations are performed using special instruments through small holes in the abdominal cavity. The advantage of the method is the ability to visually monitor the progress of the operation, since a telescopic tube with a video system (endoscope) is attached to the instruments. Laparoscopy can be performed by a surgeon and a gynecologist.

The operation consists of penetrating through the abdominal cavity into the pelvis through just a few punctures. This became possible thanks to the invention of an innovative device, the manipulators of which are equipped with microtools, lighting and a camera. For this reason, laparoscopy is considered an exceptional operation that gives good review with minimal tissue trauma.

Surgery is performed under general anesthesia. To prevent the abdominal wall from obstructing vision, it is raised by filling the abdominal cavity with air (pneumoperitoneum).

What operations are performed laparoscopically:

• diagnosis of infertility;
• conservative myomectomy (removal of fibroids);
• hysterectomy (removal of the uterus);
• removal of formations from the ovaries and fallopian tubes (cyst, cystadenoma, polycystic disease);
• emergency assistance for acute conditions ( , );
• adnexectomy (removal of the ovaries and fallopian tubes).

Gynecological surgeries via laparoscopy are becoming standard. The method allows for interventions of varying volume and complexity with minimal tissue damage. Previously, many operations required open access and extensive transection, which caused severe postoperative discomfort and many complications. In comparison, laparoscopy is truly an exceptionally innovative technique.

Indications and contraindications for laparoscopy

Today, laparoscopy is the standard for diagnosing and treating the causes of female and male infertility. In comparison with abdominal operations, which severely injure the pelvic organs and negatively affect general state patient, laparoscopy has a number of important advantages. No wonder this best method treatment of young patients.

Indications for laparoscopy:

• infertility of unknown etiology;
• lack of effect from hormonal therapy;
• acute and chronic pathologies of the uterus, ovaries and fallopian tubes;
• adhesive process;
• ectopic pregnancy;
• diagnosis of disorders in the pelvis.

Contraindications:

• blood clotting disorder;
• pronounced changes in clinical tests;
• exhaustion of the body, weakened immunity;
• shock, coma;
• severe pathologies of the heart and blood vessels;
• severe lung diseases;
• hernia of the diaphragm, linea alba and abdominal wall.

Planned laparoscopy should be postponed for a month if acute respiratory disease develops. viral infection. For hypertension and bronchial asthma surgery is prescribed in case of urgent need.

Advantages and disadvantages of laparoscopy

Laparoscopic surgery remains an elective procedure. The doctor must take into account the nature of the pathology, the presence of complications and contraindications when choosing a treatment method. Until now, laparoscopy has not been improved enough, so pathologies remain that are better to be operated on traditional methods. If there are no conflicting factors, laparoscopy should be chosen, since the minimally invasive approach is safe and easier to tolerate by patients.

Advantages of laparoscopy:

• no large scars;
• reduction of pain and postoperative discomfort;
• fast recovery;
• short period of hospital stay;
• minimal risk of complications, including adhesions and thromboembolic disorders.

After laparoscopy, patients quickly return to their usual activities due to the low trauma of the operation, so hospitalization takes 1-2 days. Since laparoscopy is often performed as part of gynecological treatment, good cosmetic effect is very important.

Another advantage of laparoscopy is accuracy. Endoscopic devices allow the surgeon to clearly visualize the desired area. Modern equipment can magnify images up to forty times, which helps when working with small structures. Thereby diagnostic laparoscopy and therapeutic are often carried out in one procedure. The disadvantages of laparoscopy include the presence of complications, but there are consequences after any other intervention in the body.

Application area

Laparoscopy cannot be performed without modern equipment, so such operations are performed exclusively in equipped clinics. The method is used for the diagnosis and treatment of pathologies of the peritoneum and pelvic organs.

Laparoscopy capabilities:

• diagnosis of tumors in the peritoneum and pelvis;
• determination of treatment for various states(endometriosis,);
• identification and treatment of causes of infertility;
• obtaining tissue for biopsy;
• assessment of the spread of the cancer process;
• damage detection;
• sterilization;
• determining the causes of pelvic pain;
• removal of the uterus, ovaries, gall bladder, appendix, spleen;
• complex resections (removal of the colon).

Laparoscopy is performed according to all surgical rules. It is allowed to carry out as planned operations with additional training and examination, as well as emergency ones necessary to save a person’s life.

Indications for elective laparoscopy:

1. Sterilization.
2. Endometriosis (overgrowth of the endometrium of the uterus).
3. Recurrence of endometrial hyperplasia.
4. Myoma and others benign pathologies uterus.
5. Pathologies causing infertility.
6. Tumors and cysts in the ovaries.
7. Defects in the anatomy of the genital organs (congenital and postoperative).
8. Chronic pelvic pain syndrome.

Indications for urgent laparoscopy:

1. Ectopic pregnancy.
2. Cyst rupture.
3. Ovarian apoplexy (tissue rupture accompanied by hemorrhage).
4. Complications of benign formations in the uterus (hemorrhage, tissue death).
5. Torsion of the appendages.
6. Bleeding due to adenomyosis (growth of the endometrium into the layers of the uterus).
7. Acute lesions of the fallopian tubes, accompanied by inflammation.
8. Differential diagnosis in the presence of unclear symptoms of acute pathology.

Thanks to innovative devices, the doctor is able to monitor the process and make cuts with perfect precision. Laparoscopy significantly reduced the percentage medical error, however, such an operation can only be trusted by a professional.

Preoperative diagnosis

Preparation for laparoscopy must be thorough, but in case of emergency it is reduced to save time. Before planned operation it is necessary to undergo tests, it is important to determine the degree of blood clotting and glucose levels. Checking your blood type and Rh factor is mandatory.

Within a month before laparoscopy, the patient is tested for syphilis, hepatitis and HIV. Before the operation, an ECG and fluorography are prescribed, a control ultrasound of the pelvic organs and a gynecological smear are performed.

If there are any individual characteristics body and chronic pathologies The therapist's permission is required, in particular, for anesthesia. The anesthesiologist should check for allergies and contraindications to anesthesia. Before surgery, you need to tell your doctor about severe loss history of bleeding (if any) and taking medications that increase bleeding. The possibility of pregnancy in the future should also be discussed.

In some cases, psychological or medicinal preparation for laparoscopy may be prescribed. Immediately before the operation, the surgeon should tell the patient about the procedure and list all the steps. In the absence of contraindications, the patient signs a written consent to the treatment and the selected type of anesthesia.

Stages of laparoscopy

Planned operations are carried out in the morning. It is usually recommended to follow a light diet before the procedure. On the day before surgery, you should not eat or drink after ten in the evening. Keeping food and liquid out of the stomach prevents vomiting during surgery.

Before the patient is sent to the operating room, additional bowel cleansing is performed using an enema. If there is a risk of thrombosis, the legs are bandaged with elastic material or anti-varicose veins are worn. compression stockings. You need to remove your glasses before laparoscopy. contact lenses and dentures.

Both inhalation and intravenous anesthesia are possible. During the operation, an endotracheal tube is placed in the trachea to support breathing, and a catheter is placed in the bladder to monitor kidney function.

The number of punctures during laparoscopy will depend on the location of the pathology and the scope of the intervention. Usually 3-4 punctures are made. The doctor inserts a trocar (a device for piercing tissue and inserting instruments) under the navel, and two more on the sides of the peritoneum. One of the trocars is equipped with a camera, the others with instruments, and the third illuminates the cavity.

Through a trocar, the abdominal cavity is filled with carbon dioxide or nitrous oxide to improve access to the pelvis. Typically, the technique and scope of the operation are determined after the introduction of instruments and examination of the pathology.

Laparoscopy without surgical complications can last from 15 minutes to several hours. It all depends on the severity of the disease. At the end of the manipulations, the doctor examines the cavity again, checks the results, and removes blood and fluids that have accumulated during the process. It is very important to check for bleeding.

After the control audit, the gas is eliminated and the trocars are removed. The punctures are sutured subcutaneously, and cosmetic sutures are applied to the skin.

Rehabilitation after laparoscopy

Typically, patients are brought to consciousness on the operating table to check reflexes and condition. They are then transported to the recovery room for monitoring. After the operation, you feel drowsy and tired.

When laparoscopy is performed correctly, postoperative pain is insignificant. Depending on the anesthesia chosen, pain may persist for several days. There are also discomfort in the throat after the tube is there, but they can be eliminated with the help of medicinal gargling.

Depending on the complexity of the intervention and the presence of complications, discharge occurs within 2-5 days. After laparoscopy, no special care of the sutures is required, only the use of antiseptics.

Possible complications

Quantity unpleasant consequences after laparoscopy is minimal, as is the chance of their development. After traditional operations with large incisions, complications occur much more often. The low invasiveness of the method allows you to reduce the list possible complications during the operation and after it. This became possible with the use of special instruments that almost do not affect tissues and organs that are not subject to surgery.

However, there is always a risk of injury to internal organs and blood vessels from trakars. Sometimes after laparoscopy bleeding occurs, usually minor. When gas is injected, subcutaneous enphysema may form. Complications of laparoscopy include bleeding that occurs when the vessels in the operated area are insufficiently cauterized. Most of the consequences of the operation are mild and reversible.

Undoubtedly, laparoscopy is a tremendous achievement in medicine. This operation greatly simplifies the treatment of many gynecological pathologies, allowing women to quickly return to their normal rhythm of life without complications.

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Gynecology has come a long way since laparoscopic operations became possible in any clinic. This method of surgical intervention has made it possible to combat many problems and diseases that previously could not be eliminated in the usual way. Laparoscopy in gynecology is so low-traumatic and safe that it has long since moved from the category of surgical interventions to a diagnostic method.

Laparoscopic diagnosis and treatment of problems associated with infertility has the most positive reviews from both patients and surgeons.

Thousands of women every year have the opportunity to experience the joy of motherhood thanks to the opportunity to study the condition reproductive organs and eliminate adhesions, cysts, foci of endometriosis and other problems that interfere with natural conception. If you watch a video of such an operation, you will see that high technology is already being successfully used in treatment. Through tiny incisions, the doctor can remove it from your life in just an hour. terrible diagnosis"infertility".

Laparoscopy in gynecology has incomparably more advantages than disadvantages. First of all, it is minimally traumatic; in videos and photos from medical sites you will see that the scars from this operation are barely noticeable. These three small holes are 0.5–1 cm in size and are arranged in a triangle. The top incision is often made in the belly button, so it won't be visible at all, and the bottom two scars will be hidden by underwear or a swimsuit. Inside the cavity, damage from the operation is also minimal, because through special optics the doctor sees on video exactly where to start working with a scalpel.

Compared to abdominal surgery, where you often have to cut at random, not knowing where exactly to look for the problem, the laparoscope has become simply a magic wand that allows you to get by with little blood - literally and figuratively. Thanks to it, you can avoid large tissue incisions to get to your destination. And this means that not only will there be less pain, but significantly less blood will enter the abdominal cavity during the operation, so the risk of adhesions during the healing process will be much lower.

The second advantage of laparoscopy is the very short rehabilitation period. After a routine exploratory operation or adhesions dissection procedure, you may be discharged from the hospital within 3-4 days. More serious operations such as removal ectopic pregnancy, tumors, fibroids or pelvic organs, may require a longer stay under medical supervision. But all the same, you will be discharged in no more than 6-10 days, and you will begin to get up and walk the next day. But it's not just about deadlines, although they are important in our busy times.

Main - painful sensations after laparoscopy several times less than after abdominal surgery. In a few weeks you will already feel completely healthy person, although there are still some restrictions. For example, you should not lift weights or exercise for several months. active sports to avoid seams coming apart. According to reviews from most patients, within a week after discharge they returned to their normal routine.

Another advantage of such a quick recovery and low trauma during laparoscopy is the ability to plan a pregnancy after 1-3 months, while after abdominal surgery it is recommended to use protection for at least 6, and sometimes 12 months. Although here the period of protection may be a little longer, it is determined by your surgeon based on the nature of the operation performed and the condition of your body.

Last but not least on the list is the convenience of the laparoscope for the surgeon. All internal organs are perfectly visualized on video, the doctor can accurately determine the problem and eliminate it as accurately as possible. During the operation they are placed accurate diagnoses, sometimes problems are revealed that no examination has shown. For example, during a planned operation to dissect the surface of polycystic ovaries, the surgeon can detect adhesions and dissect them so that they do not interfere with conception or become a risk factor for ectopic pregnancy.

What are the disadvantages of this operation?

Among the disadvantages of laparoscopy, one can first of all mention the risk of formation of adhesions. Even such a minimally invasive operation is still a surgical intervention. Incisions, small blood leaks, natural inflammatory process, accompanying the operation, and some other factors lead to the formation of adhesions. To avoid the occurrence of adhesions, you need to follow all the surgeon’s instructions: take anti-inflammatory and absorbable medications, be sure to undergo a course of physical procedures and do not forget about sports, or at least exercise and hiking. This entire set of measures is aimed at preventing the formation of new adhesions.

General anesthesia It also does not have a very beneficial effect on the body, it is not for nothing that it is done only in case of emergency and is selected individually. After anesthesia, complications at work are possible:

• gastrointestinal tract;
• cardiovascular;
• nervous systems;
• skin reactions.

There is a risk of complications with any treatment method, even with medication, let alone surgical interventions. All organisms are different, and surgeons are not gods and cannot accurately predict and guarantee the result. There's always a possibility adverse reactions, but you should be reassured by the fact that there are hundreds of thousands of reviews from happy patients about laparoscopy and the statistics of this operation indicate a minimal risk of unpleasant consequences.

Therefore, the decision about surgery should be made carefully and based on the ratio of expected benefits and possible risk. It is worth consulting with several doctors and comparing their recommendations in your particular case.

Of course, now we are talking about laparoscopy as a diagnosis or to eliminate adhesions and cysts, which can be treated with medication. If you need to remove the fertilized egg during an ectopic pregnancy, remove tumors or organs, then the choice will definitely be in favor of laparoscopy before abdominal surgery.

In cases where surgery is medically necessary and there is a choice between laparoscopy and abdominal surgery, most doctors recommend laparoscopy, and this is not surprising, given all the benefits. If you are going to have an operation, it is better to do it with the least risk to the patient’s health.

But what if laparoscopy is recommended solely for diagnostic purposes? Still, this is a rather serious operation, which has its own risks and consequences. For example, if you just need to check the patency of the fallopian tubes, then you can get by with metrosalpingography.

If we are talking about comprehensive examination, when the presence of adhesions has already been established, there is suspicion of:

• cysts;
• fibroids;
• fibroids;
• endometriosis;

or other diseases that are difficult to detect during external examination, then surgery makes sense.

Laparoscopy is often prescribed as a diagnosis for infertility of unknown origin or mixed problems, for example, adhesions and endometriosis together, as well as in the presence of chronic pelvic pain and serious disorders of the monthly cycle.