Dr. med. Eduarda Jurševiča Estētiskās medicīnas klīnika
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Laparoscopic surgery: a modern approach to the treatment of gynaecological problems

Laparoscopic surgery: a modern approach to the treatment of gynaecological problems

The advantages of this method are shared by the gynaecologist of our clinic - Anton Babushkin.

Up to 90% of gynaecological operations are performed laparoscopically

Laparoscopic surgery is a surgical procedure performed under general anaesthesia through small incisions in the abdomen. These procedures ensure reduced pain during the recovery period. Initially, in gynaecology, the method was used only to diagnose obstruction of the fallopian tubes. Now, depending on the pathology and qualifications of the doctor, it is used in 90% of all gynaecological operations, including for the treatment of infertility. For example, a very large myoma (30-40 centimetres) cannot be operated laparoscopically: due to the fact that it takes up a lot of space in the abdominal cavity and it is difficult to "approach" it with minimally invasive instruments.

At the same time, laparoscopy is excellent for removing adhesions in the abdominal cavity, ovarian cysts, fibroids, foci of endometriosis, uterus, ovaries and fallopian tubes. The method is also used for malignant gynaecological diseases. Laparoscopy allows to examine the abdominal organs in order to detect pathologies, carry out operations (both planned and urgent), and take tissue samples for research.

With a classic incision (laparotomy), a large area of the abdominal cavity is affected and all tissue layers are opened, while laparoscopy is performed through 1-4 small incisions in the anterior wall of the peritoneum. Optical instruments are inserted into the desired area, and a camera is inserted through an incision near the navel, which transmits an image from the abdominal cavity to a monitor. This allows to monitor the progress of the operation at a high magnification. Carbon dioxide (CO2) is injected into the abdomen to create space.

Thanks to this approach, adjacent tissues are not damaged during the operation, the internal environment of the abdominal cavity is not disturbed, which guarantees the best result. The advantages of laparoscopy also include the minimum number of complications and a short recovery period.

Indications for laparoscopy in gynaecology:

  • Ovarian neoplasms;
  • Endometriosis of the peritoneum and uterine appendages;
  • Uterine fibroids (benign tumour of smooth muscle tissue);
  • Adhesion process in the pelvic cavity;
  • Tubal infertility;
  • Syndrome of chronic pelvic pain;
  • Acute inflammation of the uterine appendages (oophoritis, salpingitis, tubo-ovarian abscess);
  • Polycystic ovary syndrome

Questions most frequently asked by patients before surgery

A patient spends about 1-2 days in our hospital. The day after the operation, a control ultrasonographic examination is carried out: the doctor assesses the patient's state of health and, if everything has gone well, the patient is discharged. In most cases the patient can return to her usual life in 4-5 days.
The cosmetic effect is important after any surgical intervention. The absence of visible postoperative scars is another plus of laparoscopy. Scars of 5-6 mm (the largest - 10-12 mm) on the skin are practically invisible. If necessary, one can subsequently undergo scar correction procedures or cover the scars with tattoos.
It all depends on the initial diagnosis, but on average, after 2-3 weeks, a woman can return to her physical activities. In comparison, after an open surgery, 4-5 weeks of stable rest are recommended, not to mention sports.
If the patient has had a Covid-19 infection, it is recommended to refrain from operations for 1-3 months, depending on the severity of the infection.
Usually, a woman can start planning a pregnancy no earlier than six months after the operation.
An elevated body mass index is always a risk for any surgery, but laparoscopy provides an additional advantage. With the help of cameras and special instruments, doctors can visualize the lesions, even if the patient has an excessive accumulation of adipose tissue in the abdomen.

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