laparoscopy

Laparoscopy




Laparoscopy is an examination of the abdominal cavity using a special set of instruments. As part of this procedure it is possible to perform treatments. A typical set consists of a laparoscope (endoscope with a camera that allows transfer images from the examined location to monitor), trocar (devices used to enter instruments), needles Veressa (first access is "blind"), insufflator (introduces air into the peritoneal cavity and causes edema for diagnosis and treatment), diathermy, and a set of surgical instruments.

General anesthesia is required before starting the procedure. Course of treatment begins with the implementation of a small cut or stab a Veresse needle, then foundation trocar and insertion a laparoscope. The next step is to put (already under visual control) remaining trocars, make insulfation and accession to the order procedure (diagnosis, treatment). In case of inability to complete the laparoscopically surgery (or if there are serious reasons: life-threatening complications, anatomic barriers) should be converted - open the abdominal walls and perform traditional surgery (laparotomy).


Indication



a) diagnostics (taking a tumor fragments, the search for endometriosis, diagnosis of liver, searching unidentified causes of inflammation);

b) treatment:

• excision of the gallbladder (cholecystectomy - a gold standard);

• antireflux operations - the gold standard;

• removal of adrenal tumors - the gold standard;

• treatment of morbid obesity;

• removal of the appendix (appendectomy);

• removal of bowel cancer lesions;

• inguinal hernia;

• removal of the spleen;

• removal of ovarian cysts or liver disease.


Contraindications



a) relative: older age, obesity, severe hypertension, heart failure, unstable angina, myocardial infarction, arrhythmias, the state with a history of abdominal surgery, presence of a large abdominal tumor, pregnancy> 12 weeks, active inflammation in lesser pelvis;

b) absolute: diffuse peritonitis, the patient's objection, impaired hemostasis, severe cardio-respiratory.
Possible complications: arrhythmia, subcutaneous emphysema, pneumothorax, pulmonary embolism, gastrointestinal tract failure, bleeding from large vessels.

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