Laparoscopy

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Laparoscopy

Laparoscopy is also called a minimally invasive surgery that allows a procedure to be conducted through very small incisions of about half inch, facilitating faster recovery and reduced pain and blood loss.

 

A laparoscopy may be used for diagnosis of a condition or for treating a condition. For example, laparoscopy is used to diagnose appendicitis, female infertility, fibroids, endometriosis, pelvic inflammatory disease, and unexplained abdominal pain. It can also be used in performing surgeries such as removal of the uterus (hysterectomy) and for  treating ulcerative colitis, rectal prolapse, diverticulitis, etc.


Pre-surgery care


Before beginning the surgery, the doctor will:

 

  • Inform the patient of the details of the procedure and the type of anesthesia to be used during the procedure.
  • Inform the patient of the risks and complications of the procedure as well as the need for a blood transfusion that may arise during the procedure.
  • Advise fasting from the evening before the surgery.
  • Prescribe medications to cleanse the patient’s bowel before the surgery.
  • Solve any concerns or queries arising in the mind of the patient.


Laparoscopy procedure

  • A laparoscopy is usually performed in the outpatient department.
  • Anesthesia will be given just before the surgery. General anesthesia is commonly used for performing laparoscopic procedures. Local anesthesia may be used in some cases to numb specific areas.
  • A small incision is then made usually near the belly button through which a cannula is inserted to inflate the abdomen using carbon dioxide gas. This inflation of the abdominal cavity with gas increases the clarity of the pelvic organs when viewed through the camera.
  • The laparoscope with an attached camera is then inserted through the incision. Another small incision can be made for surgical instruments if laparoscopic surgery is being performed.
  • In a laparoscopic surgery involving the uterus in females, a uterine manipulator can be used to help move the uterus in the field of the camera.
  • After the completion of the procedure, the surgical instruments, laparoscope, and any other instruments used are removed through the incision.
  • The incision is then closed with surgical tape or stitches.


Post-surgery care


The following care will be taken while in the hospital after the surgery:

  • Blood pressure, pulse rate, and respiratory rate are monitored carefully.
  • Wound care will be provided, and the patient will be kept under observation.
  • Medications and wound care instructions at home will be given at discharge.
  • A follow-up appointment will be given to check the patient’s progress.


Post-surgery care at home


Following are some do’s and don’ts once you are home after the laparoscopy:


Do’s

  • You can climb stairs, take a shower, and drive a vehicle 72 hours after your surgery.
  • You can perform light household chores and other minor activities. Moving about will help you recover faster.
  • If you have had a major procedure performed laparoscopically, you should wait 6 weeks or as advised by your doctor before beginning any exercise. You can exercise or swim 2 to 3 weeks after the surgery if a minor laparoscopic surgery has been performed.
  • You can use over-the-counter medications for treating pain only after consulting your doctor.


Don’ts

  • You can engage in intercourse as per your doctor’s advice; however, after major surgeries such as hysterectomy, avoid sexual activities for at least 6 weeks or as advised by your doctor.
  • Do not lift weights heavier than 20 pounds for about two weeks.


Complications of laparoscopy


The possible complications after laparoscopy are:

  • Fainting
  • Worsening pain
  • Swelling, redness, or discharge from the incision
  • Heavy bleeding from the vagina in females
  • Fever
  • Difficulty in urination
  • Infection
  • An allergic reaction that may occur due to medicines or blood transfusion
  • Chest infection
  • Heart attack or stroke due to excess strain on the heart


Complications that are linked to the laparoscopy procedure are:


If the laparoscopic procedure is performed by an experienced and skilled surgeon, the chances of risks are minimal. In rare cases, the few complications that have been experienced are as follows:

  • Pain in the abdomen
  • Tenderness
  • Abdominal bloating caused by the gas used during the procedure
  • Nausea
  • Injury to the organs or blood vessels
  • Pain and wound cellulitis occurring around the incision area


References

https://www.acog.org/Patients/FAQs/Laparoscopy?IsMobileSet=false
https://www.healthdirect.gov.au/laparoscopy
https://www.mayoclinic.org/tests-procedures/minimally-invasive-surgery/about/pac-20384771
https://my.clevelandclinic.org/ccf/media/files/Florida/Gynecology/22-post-op-laparoscopy-instructions.pdf
http://www.afg.org.in/dtevents_news/consent_afg2014.pdf
https://www.nhs.uk/conditions/laparoscopy/why-its-done/
https://www.fascrs.org/patients/disease-condition/laparoscopic-surgery-what-it

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