Laparoscopic Surgery

Laparoscopy is an alternative surgical method to open surgery (laparotomy) that has been used in gynecology for the last 30 years. In laparoscopy, a camera inserted through a small hole is used to look at the patient's abdomen, instead of through large incisions as in open surgery.

Advantages of laparoscopic surgery compared to open surgery:

1. Short hospital stay (1-2 days)

2. Fast recovery time and quick return to normal daily activities (5-7 days)

3. Less post-operative pain

4. Less need for antibiotics and pain relievers

5. Less blood loss during surgery

6. Small incision scars (Cosmetic advantages)

7. Opportunity to start radiation therapy (radiotherapy) or drug therapy (chemotherapy), if necessary, without delay after cancer surgery

Laparoscopic surgery offers patients significant comfort and quality of life. It is the right of all women to benefit from these opportunities. Of course, in addition to all these advantages of laparoscopy, it also has risks and complications as in other surgical methods. It takes many years to train a laparoscopic surgeon. Serious vascular and bowel complications may occur, especially in inexperienced centers. For this reason, doctor and patient selection and preparation should be done very well.
 

LAPAROSCOPY INDICATIONS

Laparoscopy can be used for both diagnostic and therapeutic purposes. All kinds of gynecological surgeries can be performed laparoscopically in experienced hands.

Areas where laparoscopy is used:

Diagnostic:

unexplained pelvic pain

unexplained infertility

For therapeutic purposes:

Abnormal uterine bleeding

Endometriosis

Myoma uteri

Ovarian cysts and tumors

Ectopic (ectopic) pregnancy

Pelvic and tuboovarian abscess

Infertility

Uterine or vagina prolapse and urinary incontinence

gynecological cancers
 

LAPAROSCOPIC GYNECOLOGICAL SURGERIES;

Laparoscopic Hysterectomy (removal of the uterus)

Laparoscopic Cystectomy (removal of ovarian cysts)

Laparoscopic ectopic pregnancy surgeries (clearing ectopic pregnancy)

Laparoscopic Endometriosis surgery (clearing endometriosis)

Laparoscopic Oophorectomy (removal of the ovary)

Laparoscopic Salpingectomy (removal of tubes)

Laparoscopic Myomectomy (removal of fibroids)

Laparoscopic Adhesiolysis (opening of adhesions)

Laparoscopic Tubal ligation (tying the tubes)

Opening Laparoscopic Tubes

Laparoscopic Sacrocolpopexy (correction of uterine prolapse)

Laparoscopic Burch (correction of urinary incontinence)

Laparoscopic Radical Hysterectomy (removal of the uterus in a cancer patient)

Laparoscopic Lymphadenectomy (removal of lymph nodes in cancer patients)

Laparoscopic Omentectomy

Laparoscopic surgery is performed under general anesthesia. The abdominal cavity is inflated with gas with the help of a needle through an approximately 1 cm incision made into the navel, and a trocar is inserted from the navel into the abdomen, and the camera is inserted and the image inside the abdomen is projected onto a screen without opening the patient's abdomen. The surgeon can see the organs clearly using the camera's magnification and zoom feature. Then, surgery is performed by looking at the 2 or 3 dimensional image on the screen with 2 or 3 trocars and surgical instruments inserted through the 5 or 3 mm incisions made in the patient's inguinal region. Thus, the same operation performed in open surgery is performed with only a few small holes.

A fasting period of 6 hours before the operation of the patient is necessary for anesthesia. Intestinal cleansing may be required before some complicated surgeries. A temporary catheter is inserted into the urinary tract to prevent bladder complications and to monitor urine output during surgery. During the surgery, the patient remains in an upside down position of 20-30 degrees, and the longer this period is, the higher the probability of shoulder pain in the postoperative patients.

HEALING AFTER LAPAROSCOPY

After laparoscopic surgery, the patient goes to the room after being kept in the anesthesia recovery room until the effects of the anesthesia wear off. Vital signs are checked by nurses. Since he will not take anything by mouth for 4-6 hours, serum will be available in the intravenous line. In the meantime, the catheter will stay in the urinary tract for 4-6 hours until you can stand up. During this period, the patient may have some pain and nausea. Necessary drugs to reduce these are given via serum. Depending on the difficulty of the surgery, the patient can be sent home within 8-48 hours and can usually return to his normal daily work and social life within 5-10 days.

Serious complications in laparoscopy are rare. However, in some cases after leaving the hospital, the doctor should definitely call:

Very severe abdominal pain

Prolonged nausea and vomiting

Fever of 38 degrees or higher

Bleeding and pus from the incision site

Pain when urinating or inability to urinate

Absence of bowel movements, bloating and pain after 24 hours

RISKS OF LAPAROSCOPY

The risk of serious complications is low; Some of these complications are noticed and repaired during surgery. Some of them occur in the postoperative follow-up of the patient.

Great vessel injuries and bleeding

Bowel injuries

Bladder and ureter injuries

Nerve damage

Thrombosis (vessel clot) formation