Diagnostic laparoscopy in gynecology: what is it. Preparation and performance of laparoscopic surgery Laparoscopy when it can be done

Surgeons like to repeat: “The belly is not a suitcase; it cannot just be opened and closed.”. Indeed, surgical operations on the abdominal organs are traumatic, full of risks and negative consequences. Therefore, when bright minds came up with a laparoscopic method for treating surgical diseases, doctors and patients breathed a sigh of relief.

What is laparoscopy

Laparoscopy is an introduction into the abdominal cavity through small (slightly more than one centimeter in diameter) holes, when a laparoscope comes out with the hands and eyes of the surgeon, which is inserted into the cavity through these holes.

The main parts of a laparoscope are:

The tube serves as a kind of pioneer, which is carefully inserted into the abdominal cavity. Through it, the surgeon sees what is happening in the inner kingdom of the abdomen, through another hole he introduces surgical instruments, with the help of which he performs a series of surgical manipulations in the abdominal cavity. A small video camera is attached to the end of the laparoscope tube that is inserted into the abdominal cavity. With its help, an image of the abdominal cavity from the inside is transmitted to the screen.

The word “laparoscopy” reflects the essence of this method: from the ancient Greek “laparo” means “stomach, belly”, “skopia” means “examination”. It would be more correct to call an operation using a laparoscope laparotomy (from the ancient Greek “tomia” - section, excision), but the term “laparoscopy” has taken root and is used to this day.

Let's say right away that Laparoscopy is not only surgery “through a tube”, but also the detection of diseases of the abdominal organs. After all, the picture of the abdominal cavity with all its insides, which can be seen directly with the eye (even through an optical system), is more informative than “encrypted” images obtained, for example, from radiography, ultrasound or computed tomography - they still need to be interpreted.

Scheme of laparoscopic treatment

With laparoscopy, the manipulation algorithm is significantly simplified. There is no need to perform complex access to the abdominal cavity, as with the open method of surgery (with traditional surgical intervention, it is often delayed due to the need to stop bleeding from damaged vessels, due to the presence of scars, adhesions, and so on). There is also no need to waste time on layer-by-layer suturing of the postoperative wound.

The laparoscopy scheme is as follows:

The range of diseases that can be treated using laparoscopy is quite wide.:

and many other surgical pathologies.

Benefits of laparoscopy

Since, unlike the open method of surgical intervention, large incisions do not need to be made in the abdomen for examination and manipulation, the “advantages” of laparoscopy are significant:

Disadvantages of laparoscopy

The laparoscopic method has made, without exaggeration, a revolutionary revolution in abdominal surgery. However, it is not 100% perfect and has a number of disadvantages. There are often clinical cases when, having started laparoscopy, surgeons were not satisfied with it and were forced to switch to the open method of surgical treatment.

The main disadvantages of laparoscopy are as follows::

due to observation through optics, depth perception is distorted, and significant experience is needed for the surgeon’s brain to correctly calculate the true depth of insertion of the laparoscope;
the laparoscope tube is not as flexible as the surgeon's fingers, the laparoscope is somewhat clumsy, and this limits the range of manipulations;
due to the lack of tactile sensation, it is impossible to calculate the force of pressure of the device on tissue (for example, gripping tissue with a clamp);
it is impossible to determine some characteristics of internal organs - for example, the consistency and density of tissues in a tumor disease, which can only be assessed by palpating with fingers;
a spotty picture is observed - at some specific moment the surgeon sees in the laparoscope only a specific area of the abdominal cavity and cannot visualize it as a whole, as with the open method.

Possible complications during laparoscopic treatment

There are significantly fewer of them than with the open method of surgical intervention. However, you need to be aware of the risks.

The most common complications during laparoscopy are:

Achievements of laparoscopy

The laparoscopic method is not only considered the most progressive in abdominal surgery - it is constantly evolving. Thus, the developers have created a smart robot equipped with micro-instruments that are significantly smaller in size than standard laparoscopic instruments. The surgeon sees a 3D image of the abdominal cavity on the screen, gives commands using joysticks, the robot analyzes them and instantly turns them into jewelry movements of micro-instruments inserted into the abdominal cavity. In this way, the accuracy of manipulations increases significantly - as if a real living surgeon, but of reduced size, climbed through a small hole into the abdominal cavity and performed all the necessary manipulations with reduced hands.

Content

For a thorough diagnosis of the pelvic organs and peritoneum, there are a number of invasive methods. Among them is laparoscopy, which is prescribed for suspected fibroids, cysts, adhesions, endometriosis, infectious processes of the abdominal cavity, pathologies of the fallopian tubes and ovaries. The method and operation are informative and are often used by modern gynecology.

What is laparoscopy

Before treating the source of pathology, it must be detected and examined in detail. In this case, patients will learn what laparoscopic surgery is, to whom it is recommended, and for what therapeutic purposes it is performed. Essentially, this is a surgical intervention, since all the specialist’s actions take place under general anesthesia with incisions made in the peritoneum. During the operation, a special instrument is used, after which rehabilitation is required, complications are possible. If laparoscopy is necessary, an experienced doctor will tell you what it is.

Diagnostic laparoscopy

In most clinical cases, this is an informative diagnostic method, but some experts associate the procedure with a full-fledged operation. This is an alternative to abdominal surgery, which requires a deep incision in the abdomen. Diagnostic laparoscopy involves only small incisions in the peritoneal area for further insertion of thin tubes into the cavity. This is necessary to study the general condition of the peritoneal organs, identify affected areas and their characteristics, and perform surgery.

How is laparoscopy done?

Before proceeding with the implementation of the method, the doctor selects the anesthesia that will be used for the operation. More often this is general anesthesia during laparoscopy, when during surgical procedures the patient remains unconscious, all his reflexes are temporarily disabled. In gynecology, the operation is performed by a gynecologist, in surgery - by an experienced surgeon; for other areas of medicine, this diagnostic method is used extremely rarely. The sequence of actions during laparoscopy is as follows:

First of all, the patient is given special medications to prevent complications during the rehabilitation period after surgery.
In the operating room, a drip is installed for future administration of anesthesia and electrodes for monitoring cardiac activity.
Before the operation, anesthesia is administered to relax the muscles and make the operation painless.
An endotracheal tube is installed in the trachea to increase the information content of the selected diagnostic method and maintain natural ventilation of the lungs.
During surgery, gas is injected into the abdominal cavity to improve visibility of suspected foci of pathology and reduce the risk of complications in relation to neighboring organs.
Hollow tubes are inserted through small incisions in the abdomen to allow passage of endoscopic instruments.
In case of obstruction of the fallopian tubes, their plastic surgery is indicated.
To normalize the menstrual cycle and restore ovulation, incisions are made on the ovaries, and in case of polycystic disease, a wedge-shaped resection is performed.
The pelvic adhesions are separated, cysts and fibroids must be immediately removed from the pelvic organs.

Where is laparoscopy performed?

You can get a free service at a district clinic or gynecological departments of city hospitals, subject to the provision of standard documents. Specialists monitor not only the operation itself, but also the postoperative period. Many patients choose the services of private clinics and medical centers and agree to the high cost of the session. The laparoscopy operation should be performed exclusively by a gynecologist or surgeon, and it is advisable to trust your health only to experienced doctors.

Price for laparoscopy

This is one of the most expensive diagnostic methods not only in gynecology. The answer to the question of how much laparoscopy costs sometimes shocks patients, but there is nothing left - they have to agree to the operation. The price of the procedure depends on the city, the rating of the clinic and the professionalism of the specialist who will perform such surgical procedures. Prices vary, but in the provinces they start from 8,000 rubles. Prices in the capital are higher, starting from 12,000 rubles, depending on the characteristics of the pathology.

Preparation for laparoscopy

During pregnancy, such an invasive diagnostic method is carried out in exceptional cases when the life of the mother and child is threatened. This is not the only contraindication; for some patients, surgery is simply not suitable. Therefore, it is necessary to undergo tests before laparoscopy to eliminate the risk of complications. A laboratory blood test is required to determine compatibility with anesthesia and collection of medical history to study general health.

Recovery after laparoscopy

After a careful study of the internal organs and systems, a short-term restoration of the body is required. Rehabilitation after laparoscopy involves proper nutrition and a minimum of physical activity on muscle mass for the first 2-3 hours. Then physical therapy in a hospital setting or walking in the fresh air will not hurt. Within 7 hours after the operation, general health will return to normal. As for pregnancy, after laparoscopy it can be planned after 2-3 months.

Nutrition after laparoscopy

A special diet after surgery is not required, but doctors still recommend somewhat limiting the diet. For the first 2 weeks, nutrition after laparoscopy should exclude spicy, fatty and salty foods so as not to overload the stomach and intestines. Be sure to drink more fluid - at least 2 liters per day; otherwise, act according to the indications of a specialist.

Consequences of laparoscopy

If a cyst was removed using such a progressive method, the patient may face unpleasant consequences in the postoperative period. Doctors warn in advance that complications after laparoscopy are possible, which require additional conservative therapy. Therefore, it is important to know not only the cost of the operation, but also the consequences it can cause. This:

formation of adhesions with subsequent infertility;
massive uterine bleeding from the peritoneal organs;
injury to large vessels;
injury to internal organs and systems;
subcutaneous emphysema.

It is very strange to see how many women still do not know that now most operations can be performed in a gentle way, without an incision, with a short recovery period and with a minimal likelihood of adhesions and relapses. Currently, most operations are performed using a (minimally invasive) laparoscopic approach.

In this section we will be able to answer some questions:

So, what is laparoscopy?

- This is an examination of the abdominal cavity through an opening in the abdominal wall using the optical system of a laparoscope. The operation is carried out under the control of an endovideo camera, the image from which is transmitted to a color monitor with sixfold magnification, using special instruments inserted inside through small holes - punctures with a diameter of about 5 mm.

A laparoscope is a metal tube with a diameter of 10 or 5 mm with a complex system of lenses and a light guide. The laparoscope is designed to transmit images from the cavities of the human body using lens or rod optics and having a rigid outer tube. The laparoscope is the first link in the image transmission chain. In general, a laparoscope consists of an outer and an inner tube, between which an optical fiber is laid to transmit light from the illuminator into the body cavity. The inner tube contains an optical system of miniature lenses and rods.

Endovideo camera designed to display a color image of the surgical field from various endoscopic devices - laparoscopes, cystourethroscopes, rectoscopes, hysteroscopes, flexible endoscopes, etc. during surgical operations and diagnostic procedures.

A little about the history of the development of laparoscopy

In our country, as well as throughout the world, the development of laparoscopy continues. Unfortunately, in the outback, such operations still remain the exception and not the rule, although laparoscopy has existed in the world for more than 100 years.

The first experience of laparoscopy was described back in 1910, and until the mid-twentieth century, laparoscopy was of a diagnostic nature, it developed, more and more complex equipment was created, and safe lighting systems were developed.

Consultation with MD, professor of obstetrician-gynecologist
Preoperative examination in 1 day!
Expert ultrasound of the pelvic organs with Doppler ultrasound
Carrying out simultaneous operations by combined teams if necessary (gynecologists, urologists, surgeons)
Postoperative management
Histological examination in leading institutions of Russia
Consultation on results and selection of preventive measures
Preconception preparation

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 found wide application in other areas of medicine.

Areas of use

Laparoscopy is a minimally invasive method of diagnosis and surgical treatment. During its implementation, all 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 umbilical and inguinal hernia;
liver cystectomy;
pancreatectomy;
adrenalectomy;
elimination of obstruction of the fallopian tubes;
elimination of varicose veins of the spermatic cord;
surgical methods for treating obesity.

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, ascites of the abdominal cavity, purulent inflammation of the peritoneum, and neoplasms in the internal organs. Laparoscopy is performed both routinely and in emergency cases. 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 immediate elimination of 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 surgery.

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;
abdominal pain and severe flatulence;
postoperative hernia at the site of the scar;
severe cardiovascular pathologies;
brain damage;
liver and kidney failure;
severe pathologies of the respiratory system;
malignant formations of the appendages.

In addition, there are a number of other restrictions:

carrying a child for up to 16 weeks;
benign tumor of large muscle tissue;
suspicion of oncopathology of the pelvic organs;
acute respiratory infection in the 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 the gastrointestinal tract with an enema and emptying the bladder. The most necessary tests are taken - a clinical blood and urine test, RW, the heart is checked on an electrocardiogram and blood clotting is assessed 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 taken on an ongoing basis, allergic reactions to medications.

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

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;
empty your 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. The manipulation involves injecting carbon dioxide into the abdominal cavity to improve visualization and movement of instruments.

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 decide on further treatment tactics. 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 laparoscopy is performed 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

The 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 bleeding may be observed for 1–2 days. 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.

The level of development of modern medicine allows some surgical operations to be performed without large incisions. Laparoscopy is one such method that allows you to examine and operate on internal organs. The procedure is widely used in gynecology, both in our country and abroad.

In contact with

What is the essence of the method

Laparoscopic intervention - popular method of diagnosis and treatment many diseases and processes affecting the genitourinary area.

This is a low-traumatic operation, which is performed through a small incision in the anterior wall of the abdomen, using high-precision instruments and a special video camera.

The advantage of this procedure is that after it there are rarely complications recovery is quick, and within a few days the patient can live an active and fulfilling life.

You should not be afraid of the procedure: the doctor informs you in advance about all important aspects:

what tests need to be taken before laparoscopy;
what manipulations are performed during the procedure;
how long will it take to recover;
what regimen to follow and what you can eat after laparoscopy.

Features of diagnostic laparoscopy

Diagnostic laparoscopy is different from the usual purpose of carrying out. In the first case, it means first examining and identifying the pathology, and then eliminating it, in the second case, an operation is performed immediately.

In one procedure, the doctor can discover the cause of the ailment and eliminate it, but this does not always happen. Example: During diagnostic laparoscopy, a cyst may be detected. To remove it, a separate operation is needed.

The diagnostic procedure is highly accurate, as powerful equipment is used that can repeatedly magnify the area under study. Not only the abdominal cavity is examined, but also the surrounding area.

Medical examination

Laparoscopy is required in cases where:

the patient complains of pain in the pelvis or abdomen;
neoplasms of unknown origin have appeared;
the cause of tubal obstruction is unknown;
it is necessary to determine the causes of infertility;
it is necessary to check whether the fallopian tubes are passable along their entire length.

To clarify the diagnosis Laparoscopy is performed in the following situations:

a woman has (or regularly experiences) abdominal pain, and there is a suspicion that they are caused by internal bleeding, appendicitis, adhesions, or;
upon examination, the doctor or the patient herself discovered a tumor;
there is fluid in the abdominal cavity;
another study showed pathological changes in the outer tissue of the liver;
for some reason it is necessary to artificially make the fallopian tubes obstructed.

There are other situations where laparoscopy in gynecology allows one to obtain accurate information about the condition of the organ.

Important! When an internal organ is examined, the doctor has the opportunity to take a tissue sample to conduct a more thorough analysis after the procedure.

Features of preparation

The specialist tells the patient in advance what laparoscopy is, why it is needed in a particular case, and how long it will take.

The patient is also notified in advance about possible complications after or during the procedure.

Preparation for laparoscopy varies depending on whether it will be performed emergency or planned intervention.

If there is an emergency surgery, the blood pressure is measured, the blood is checked for clotting, and the group is determined (in case a transfusion is needed). Before the planned procedure, blood and urine tests, a cardiogram and fluorography are performed.

Preparing the patient for laparoscopy begins after the test results are ready. During the day you need to reduce the amount of food and liquid consumed. The last meal should be no later than 17:00. An enema is done in the evening and in the morning, the remaining preparatory manipulations are also carried out in the morning, before the operation. On the day of laparoscopy you should not eat or drink!

Carrying out laparoscopy

Laparoscopy in gynecology is almost always done under general anesthesia. Exceptions include diagnostic procedures or short-term interventions. They can be carried out with anesthesia of a limited part of the body. In such cases, regional anesthesia or spinal epidural anesthesia is used.

Important! General anesthesia is not used during the procedure if the woman cannot tolerate a particular drug.

When choosing an anesthetic and calculating its amount, the anesthesiologist takes into account the patient’s gender, weight, height, age and existing chronic diseases.

First, anesthesia is administered, then the woman is connected to an artificial respiration apparatus and a catheter is inserted. Once the anesthetic has taken effect, three small holes (incisions) are made in the peritoneum or other area.

How the cuts are made depends on the type of operation. For example, to remove a cyst, an incision is made in the lower part of the anterior wall of the abdomen.

The hole for the video camera is larger than others and is usually made below or above the navel. A camera and instruments are passed through the incisions into the cavity. A special gas is pumped into one of the holes so that the instruments can be moved. After completing these steps, an image appears on the monitor. Focusing on it, the surgeon performs manipulations in the body cavity.

The duration of the operation depends Depending on the nature of the pathologists, diagnostic laparoscopy usually lasts from 15 minutes to 1 hour. When the procedure is completed, the instruments and chamber are removed and the gas is pumped out. Two holes are sutured, and a drainage tube is installed in the third to remove the contents of wounds, ulcers, as well as postoperative remains in the form of bloody particles from the peritoneum. In this case, it is necessary to install drainage, because it prevents peritonitis.

Since the procedure takes place under anesthesia, pain is not felt, but it may occur subsequently when the anesthetic wears off.

Postoperative period

Recovery after laparoscopy in most patients is quick and without complications. Already in the first few hours, starting from the time when the anesthesia stops working, you can turn over in bed, sit up and lie down on your own.

After 5-7 hours, if the patient feels well, she can begin to walk.

In the first 5-6 hours, painful sensations in the lower back and abdomen persist, but do not be afraid of this. If the pain is mild, you can do without analgesics, otherwise it is recommended to take a pill.

On the day of laparoscopy and the next day, some patients have a fever; usually it does not exceed 37.5 degrees. Discharge in the form of ichor and clear mucus from the genital tract is possible. Usually they stop after 1 or 2 weeks, but if this does not happen, you need to consult a doctor.

How to eat after the procedure

A special diet after the procedure is recommended due to weakened intestines. On the first day, he is not able to fully perform his functions. In addition, nausea and vomiting sometimes occur. The reason is that the body has not yet fully recovered from anesthesia, and the intestines and other organs have been irritated by laparoscopic instruments and gas.

You can drink after the procedure no earlier than 2 hours later. 1 time allowed drink 2-3 sips regular or mineral water, strictly without gas! You can drink the next portion in an hour, and so on.

The amount of water consumed is increased gradually, bringing it to the usual volume in the evening. If the next day there is no bloating or nausea, you can start eating light food, but only if there is active intestinal motility. Water is allowed to be drunk without restrictions.

If nausea and vomiting do not go away, the patient is left in the hospital and measures are taken to ensure that the intestines work. Treatment includes stimulation, starvation diet and administration of electrolytes through an IV.

Consequences and complications

Negative consequences of laparoscopy are rare and mainly arise due to the individual characteristics of the body.

Possible consequences

The most dangerous phenomena:

pneumothorax;
subcutaneous emphysema with mixing or compression of mediastinal organs;
perforation of the wall or damage to the outer lining of the intestine;
gas embolism (the result of carbon dioxide entering a vessel);
massive bleeding resulting from injury to a vein, artery or large vessel.

Long-term complications after laparoscopy - adhesions, which, depending on location, can lead to infertility and dysfunction of the gastrointestinal tract. Adhesions form both against the background of existing pathology and as a result of inept actions of the surgeon, but more often they are caused by the characteristics of the body.

It is extremely rare, but it also happens that during the procedure a small vessel is damaged or the liver capsule ruptures, and this goes unnoticed. In the postoperative period, slow bleeding develops. In such a situation, repeated surgery is required.

Non-hazardous consequences- a small amount of gas or hematoma in the places where instruments were inserted. Such formations resolve on their own.

Caring for seams

Sutures after laparoscopy are lubricated with antibacterial drugs daily, and if necessary, several times a day. The doctor explains in detail how to do this. First use an alcohol solution, and then brilliant green or, if there is a burning sensation, a hypertonic solution.

For processing you need to use gauze swab, but under no circumstances use cotton wool, as its particles can get caught in the seam and cause inflammation. If the wound is not sealed, it will heal faster, but in this case the risk of injury increases, so the final decision remains with the doctor. Sutures are removed through 7 days after the procedure, and when using self-absorbable threads this is not necessary.