Consider what is the method of removing an ovarian cyst - laparoscopy, and reviews of the operation. Ovarian cysts are a common cause of infertility and pain in the lower abdomen. They are of different structure and nature of origin, however, a cyst of any kind at a certain stage of its formation may require surgical treatment. A modern, sparing surgical method for removing ovarian cysts is laparoscopy, which allows you to shorten the patient's stay in the hospital and speed up the postoperative period.
Basic concepts
Cysts are called rounded hollow benign formations in the thickness or on the surface of the ovary, resembling a bubble in shape. The contents of the cyst and the structure of the walls directly depend on the causes and type of tumor. Although ovarian cysts are classified asbenign formations, some of their types are capable of being reborn with the appearance of oncological cells, such a process in medicine is called malignancy.
It also happens that similar formations occur in ovarian cancer, when a cavity is formed inside the tumor as a result of central decay. When examining a patient, paraovarian cysts can also be detected. The fallopian tubes take part in the processes of their formation, while the ovarian tissue remains unchanged.
Varieties
All ovarian cystic tumors are divided into the following types:
- A follicular cyst that arises from a follicle that has not burst in the ovulatory phase. Blood streaks are sometimes noted in the internal contents of the cyst.
- Endometrioid, arising from the growth of endometrial cells outside the lining of the uterus. Such a cyst undergoes cyclic changes during the menstrual cycle and contains a thick dark liquid. Removal of an endometrioid ovarian cyst by laparoscopy is very common.
- Luteal, which occurs at the site of a follicle ruptured during ovulation (in the corpus luteum), inside contains serous fluid and blood impurities from injured small vessels.
- Dermoid cyst, which may contain germinal tissues and is formed at the site of an egg that has begun to develop independently (often congenital). Reviews about the removal of a dermoid ovarian cyst by laparoscopy are available in a largequantity.
- Mucinous cyst - different multi-chamber and contains mucus. Such formations can reach large sizes - up to 40 cm.
Follicular-type cysts are multiple, and in this case we are talking about a disease such as polycystic ovaries. In this case, the egg does not ovulate in each cycle, the follicle grows and turns into a cyst under the outer surface of the ovary. Other types of cysts are mostly solitary.
When does a cyst need treatment?
Luteal and follicular cysts are considered hormone-dependent and can resolve on their own. However, if they reach a large size and their reverse development is not noted, the formations must be removed. When diagnosing endometrioid formations, conservative therapy is first performed, but in case of its ineffectiveness and in the presence of a large cystic formation, specialists, as a rule, decide on the appointment of an operation.
All other types of cysts are treated only by surgery. In case of infertility, removal of even small neoplasms may be recommended, after which hormonal treatment is prescribed.
The main purpose of the operation is to remove the pathological neoplasm. In patients of reproductive age, doctors try to preserve the ovarian tissues as much as possible, carrying out only their resection. And in the postmenopausal period, when sex hormones in the female body are practically no longer produced, the entire organ can be removed without negative he alth consequences.
The operation is carried out in the classical way(through an incision on the abdominal wall) or laparoscopic removal of the cyst. In both cases, the patient is admitted to the hospital.
The advantages of this method
According to reviews, the removal of an ovarian cyst by laparoscopy is very effective. It belongs to the category of sparing interventions. All manipulations are performed through 3 punctures in the abdominal wall. In this case, the abdominal muscles are not dissected, the inner thin serous membrane of the cavity (peritoneum) is minimally injured, doctors do not have to manually move the internal organs away from the operation area.
All this determines the main advantages of laparoscopy over classical surgery:
- low risk of later adhesive disease;
- a small number of surgical wounds, their rapid healing;
- small chance of developing a postoperative hernia, which may appear due to the insolvency of the dissected muscles of the abdominal wall;
- fewer postoperative restrictions, early hospital discharge;
- sparing effect on nearby organs during the operation, which significantly reduces the likelihood of postoperative intestinal hypotension;
- complete absence of deforming scars - traces of punctures during laparoscopy can be easily hidden under underwear.
Ovary cyst removal surgery by laparoscopy allows the patient to quickly return to normal life without feeling discomfort about her appearanceand without worrying about the possible development of negative postoperative consequences.
Preparation for surgery
Reviews about the removal of ovarian cysts by laparoscopy are mostly positive. Before the operation, a woman needs to undergo a diagnostic examination, which in most cases is performed on an outpatient basis. Diagnosis can also be carried out in a hospital if a woman is urgently admitted to the hospital with severe pain in the pelvic area or when a cyst ruptures.
Examination includes laboratory blood tests: general and biochemical tests. Urine is also examined, blood is taken for hepatitis, HIV and syphilis. It is mandatory to conduct an ultrasound of the small pelvis, fluorography of the lungs, determine the blood type and Rh factor, take a swab from the vagina, showing the presence of infectious pathologies. In certain cases, there is a need to do an ECG, study the features of the blood coagulation system, get a consultation from a therapist about the absence of restrictions on surgical intervention, and determine the hormonal status. The volume of diagnostic studies is determined by the doctor, based on the clinical picture of the disease.
Before elective laparoscopic surgery to remove a cyst, it is recommended that a woman use reliable contraception. If pregnancy is suspected, the specialist should be informed in advance.
A few days before the intervention should be excluded fromdiet foods that cause excessive gas formation in the intestines: cabbage, carbonated drinks, legumes, black bread. If there is a predisposition to flatulence, the doctor may recommend that the woman take carminative drugs and sorbents, often a deep bowel cleansing is prescribed.
On the eve of the operation, the last meal should be no later than 18:00. You can take liquid until 22:00. On the day of the operation, it is forbidden to drink and eat; if you are very thirsty, you can rinse your mouth and wet your lips with water.
Immediately before laparoscopy, it is necessary to shave off the hair in the perineum and pubis, take a hygienic shower. After that, you should not apply creams, lotions and other care products to the abdomen. How is the removal of an ovarian cyst by laparoscopy, we will describe below.
How is surgery performed?
Laparoscopic surgery to remove an ovarian cyst is performed under general anesthesia. On the day of this medical event, a woman should be consulted by a resuscitator and an anesthesiologist to determine possible contraindications and decide on the type of anesthesia. Most often, tracheal intubation is used, which allows you to control the patient's breathing during the intervention and maintain the required level of immersion in anesthesia. Before this, premedication is carried out, when sedatives with a hypnotic effect are administered intravenously to a woman. In this case, tranquilizers are most often used.
The operating table is tilted with its head end down 30º so that the intestines move slightly towards the diaphragm and provide access to the ovaries. Next, the surgical field is processed, a puncture is made in the navel, through which the abdominal cavity is filled with carbon dioxide. This event makes it possible to increase the distance between the internal organs and create the necessary space for operational manipulations. A laparoscope is inserted into the same hole - a special device with a light source and a camera. It is advanced down to the small pelvis, where the ovaries are located. Under the control of the video image, two more punctures are made in the lateral sections of the abdomen, in the groin area, which are necessary in order to introduce the rest of the instruments.
Next, the surgeon performs a thorough examination of the ovaries and cysts and decides whether to continue the laparoscopic intervention or whether it is necessary to organize a wide access to the pelvic cavity (which is quite rare). In the latter case, all devices are removed from the abdominal cavity, and the classical operation begins.
During laparoscopy, a specialist can perform a wedge resection of a fragment of an ovary with a cystic formation, complete removal of the ovary, or enucleation of the cyst. The volume of surgical intervention, as a rule, is determined by the type of cyst and the condition of the tissues surrounding it. At the end of the operation, a check is made for the presence of bleeding. If the vessels are not damaged and there is no bleeding, the instruments are removed from the patient's body, carbon dioxide is sucked off. External seams are applied to the puncture sitesand sterile dressings are applied.
Next, the anesthesiologist removes the endotracheal tube, checks the patient's breathing and her general condition. If all vital signs are normal, this specialist gives permission to transfer the patient to the recovery room.
Placement of a woman in the intensive care unit in most cases is not required, since violations of the functions of vital organs and extensive blood loss during the operation, as a rule, do not occur. This is confirmed by the reviews about the removal of the endometrioid ovarian cyst by laparoscopy.
Operation duration
Such an intervention is a high-precision operation that requires the utmost concentration of the surgeon, since it is carried out under high magnification and very carefully, which minimizes the risk of tissue and vascular injury.
How long does laparoscopy to remove an ovarian cyst, it is impossible to say for sure. It depends on many factors - the severity of the pathological process, its variety, as well as on the individual characteristics of the woman's body. On average, such operations take from 15 minutes to an hour. However, with the introduction of anesthesia, all the preparations and the exit from the state of anesthesia, the operation can generally take up to 3 hours. Its duration may also depend on the qualifications of the surgeon.
On average, for women with moderate pathologies, the actual laparoscopic intervention lasts approximately 40 minutes.
With reviewsabout the removal of an ovarian cyst by laparoscopy and the postoperative period, it is better to familiarize yourself in advance.
What is the postoperative period?
After surgery, getting out of bed early is recommended. With the stability of blood pressure after a few hours, it is advisable for the patient to sit down, get up, move around the ward. She is also put on a low-fat diet that includes dairy products, stewed vegetables and meat, soups and fish.
What else does the postoperative period involve when removing an ovarian cyst by laparoscopy? Every day, the patient is treated with postoperative sutures, and the body temperature is monitored. An extract from the hospital is made approximately on the 3rd-5th day, however, in some cases, women are allowed to go home already on the second day. The sutures are removed on the 7-10th day on an outpatient basis. Full recovery usually occurs within two weeks. According to reviews, the postoperative period when an ovarian cyst is removed by laparoscopy usually passes quickly and does not cause problems.
Possibility of pregnancy
After laparoscopy to remove the ovarian cyst until the end of the current cycle, it is advisable for women to exclude sexual contact. If this recommendation is not followed, contraceptives should be used. Pregnancy after surgery can occur immediately, but this is highly undesirable. You can plan conception only from the next cycle. However, in each case, such recommendations are purely individual. A woman after laparoscopy to remove an ovarian cyst may be prescribed hormonal treatment, so pregnancy in this case will have to be postponed for several months.
After the elimination of functional cysts (follicular and luteal) and with polycystic ovaries, conception is most often allowed after the first menstruation, provided that the operation and the recovery period proceeded without complications. After removal of endometrioid cysts, drug therapy is prescribed in most cases.
According to reviews, the consequences of removing an ovarian cyst by laparoscopy are also not excluded.
Consequences
The most common complication is pain. Pain after removal of an ovarian cyst by laparoscopy can be pulling or acute, and they are noted not in the puncture zone, but in the right region of the body. This is due to the accumulation of carbon dioxide in the liver zone, which strongly irritates the phrenic nerve. At the same time, women may also experience muscle pain, slight swelling of the legs. Reviews of the consequences of removing an ovarian cyst by laparoscopy confirm this.
In the first days after laparoscopy, subcutaneous emphysema can be observed, characterized by the accumulation of gas in the layers of fatty tissue. This is considered a consequence of violations of the technique of the operation and does not pose a serious he alth hazard. Such a complication usually does not require treatment and resolves on its own.
In some cases, in the postoperative period, adhesive disease occasionally develops, although the likelihood of its occurrence after laparoscopymuch lower than after traditional surgical treatment.
When do periods come after laparoscopic ovarian cyst removal?
One of the important signs of the normalization of the reproductive functions of a woman's body are timely periods. By the nature of the flow of menstruation after laparoscopy, it is easy to conclude about the state of he alth of the woman and the need for further treatment.
The cycle of menstruation after laparoscopy should be stable. This is due to the fact that the planned operation is carried out on a certain day of the cycle, which does not affect the hormonal background, on which the arrival of menstruation depends. Bloody discharge in a moderate volume may appear in the first days after surgery, but this is considered a normal manifestation, which is associated with a violation of the integrity of the ovaries and traumatization of the vessels. Later, they become sanious and take on a yellowish tint.
Specialists note that there may be a slight change in the cyclical nature of menstruation. They can also be profuse, but this should not be considered a pathology. The norm is also considered a shift in menstruation for several days, a long delay, heavy or meager periods. If such manifestations are not aggravated by complications, the woman is not bothered by severe pain, then the delay should not cause concern, but a visit to the gynecologist is mandatory.
Reviews about laparoscopy to remove ovarian cysts
Women who have undergone this type of cystic surgeryeducation, in the reviews characterize this procedure as effective and painless. According to them, the procedure is fast, complications are quite rare. The intervention is often performed under epidural anesthesia. Already on the first day after the operation, they were allowed to get up, eat, and carry out hygiene procedures.
What other reviews can you find about the removal of an endometrioid ovarian cyst by laparoscopy? The recovery period is also characterized as quick and easy. Patients say that work can be started within a few days after the intervention. The stitches heal around the seventh day.
