Laparoscopy is considered a modern low-traumatic method of treating pathologies of internal organs. This is an alternative to traditional methods of therapy, it is considered more gentle for the body. At the same time, it should be borne in mind that complications after laparoscopy do occur. Like many types of treatment, such surgery has both positive and negative sides.
What is this
It should be taken into account that in general this surgery is minimally invasive, which reduces the risk of complications after laparoscopy. To gain access to the internal organs, doctors make small holes measuring 0.5 - 1 cm using a laparoscope.
This tool is similar to a tube, it is equipped with a small camera, a light source. In addition, it is connected to the monitor. Thanks to state-of-the-art matrices, the entire operation comes under complete control thanks to the high-precision image displayed on the screen. As a result, a significant part of the patient's abdominal cavity is examined. This leads to a reduction in the risks of complications after laparoscopy of the uterus,for example, even if we are talking about small adhesions in the fallopian tubes.
When compared with conventional surgery, there are a number of special positives. They consist in the fact that the chances of injuring the patient are minimized. This not only makes it possible to minimize complications after laparoscopy, but also to recover faster for the body. It also reduces the risk of infection in the wound. There are no coarse sutures at the site of the incisions, and blood loss is minimal. Hospitalization time is significantly reduced.
It is noteworthy that laparoscopy is carried out in the course of both therapy and diagnosis. Given the complications that occur after laparoscopy, we can say that this surgical intervention is perceived by patients relatively easily.
But at the same time, as with any operation, it is accompanied by anesthesia, incisions, and the use of surgical instruments. And this can cause complications after laparoscopy.
Restrictions
Even though this type of operation looks simple enough, there are certain requirements. Such an intervention is carried out only in the presence of special equipment, which is not available in all medical institutions. To avoid complications after laparoscopy, the operation is performed only by an experienced surgeon.
Indications in gynecology
Usually, operations of this kind are performed on the organs of the abdominal cavity, pelvic region. Most often, patients are concerned about the likelihood of complications afterlaparoscopy in gynecology, gallbladder. These are the most common operations. Often, hernias are removed using this method.
Approximately 90% of gynecological surgeries are performed using laparoscopy. Often it is necessary for a detailed diagnosis of the patient. Often, despite the risk of complications after laparoscopy of the ovary, it is the diagnosis using this method that allows those who have lost hope for motherhood to eventually have children.
The main indication for such an intervention is an emergency gynecological condition. These include: cyst rupture, ectopic pregnancy and some other dangerous cases. Also, the issue of complications after laparoscopy of an ovarian cyst may also concern women suffering from chronic pain in the pelvis, since this is one of the main indications for this kind of intervention in this disease. The operation is also performed for abnormal development of the uterus.
Laparoscopy is also recommended for women suffering from endometriosis, ovarian pathologies, tumors. Usually, the question of how likely it is to face complications after laparoscopy of a cyst worries women who want to get pregnant later, as well as before IVF. In this case, surgical intervention is mandatory. The frequency of laparoscopy is explained by the fact that this is the most organ-preserving operation.
Endosurgical complications
Although much less common than after conventional operations, complications after laparoscopy of the cyst still occur. Sometimes they maythreaten not only the he alth but also the life of the patient. In the United States, a patient's stay in the hospital after such a surgical intervention for more than a day is considered a complication. In Germany, only wounds and injuries are considered complications. In France, complications are classified as minor, major, and potentially fatal. Complications after laparoscopy in gynecology are not uncommon.
Contraindications
Like any surgical intervention, laparoscopy has a number of contraindications. They are divided into relative and absolute. The former include severe cardiopulmonary pathologies, exhaustion of the body, acute liver failure, coma, shock, asthma, severe hypertension, oncology, inability to take the Trendelenburg position, hernia in a number of organs.
Among the relative contraindications are pregnancy after 16 weeks, peritonitis, allergies, adhesions in the pelvis, fibroids for more than 16 weeks, poor results of blood and urine tests, SARS and a month after the end of this disease. The risks of complications after laparoscopy of a hernia and any internal organs increase if the operation is performed on people with the listed contraindications.
Preparation for laparoscopy
Many consequences of this surgical intervention in the body are due to improper preparation for its implementation. The operation is carried out either as planned or on an emergency basis. In the second case, there is little time for preparation, the risk of complications after laparoscopy of the gallbladder and other internal organs increases. But at the same time, the primarythe task is to save the life of the patient.
Preparation for the operation consists in conducting blood tests for the presence of dangerous diseases, urine, taking swabs from the vagina, fluorography, ultrasound and ECG.
Before the intervention, it is important to first find out how the body will cope with anesthesia. The anesthesiologist needs to find out if the patient has allergic reactions to the components of anesthesia. If necessary, light tranquilizers are used before the operation. Most often, it is necessary that the patient does not eat for 6 - 12 hours before surgery.
The essence of laparoscopy
If there are no complications after laparoscopy of the gallbladder and other internal organs, the patient is discharged on the same day or the next. In addition to a laparoscope with a camera and a light source, other instruments are also introduced into the body through incisions. For example, during surgery on the uterus, a manipulator can be used to move the internal organ in the desired direction. After the end of the operation, sutures and bandages are applied.
Post-operative period
In order to notice complications after laparoscopy of the gallbladder or other internal organs in time, you need to know what condition after the operation is considered normal. So, in the area of incisions, pain is not uncommon, sore throat may appear from the fact that a tube for endotracheal anesthesia was used.
As a rule, discomfort passes by itself in a fairly short time. Women may be concernedspotting from the vagina, but soon this also disappears. As a rule, good he alth returns on the fifth - seventh day.
Causes of complications
As a rule, in order to avoid complications after the operation, the surgeon, before proceeding with the manipulations, undergoes training for 5-7 years. Practice is important - about 4 - 5 laparoscopies per week.
Usually, complications arise due to the fact that the patient himself violates medical recommendations either before or after surgery. Sometimes they can be caused by a medical error. So, the rules of sanitation of the abdominal cavity may be violated. Inflammatory processes may begin, problems associated with anesthesia may appear.
A certain amount of risk during laparoscopy is associated with the fact that in fact the surgeon does not completely see the internal organs, as in open-type surgical interventions.
Problems may start due to the technical complexity of the operation. And if at least one device fails in the process, the result may be the wrong actions of the doctor. And in this case, an open operation will be necessary. Also, a laparoscope can narrow the field of view of a specialist, and he simply does not see the whole picture. In addition, this type of intervention does not imply a tactile sensation, by which the surgeon is able to identify pathologies in altered tissues. The picture may appear with errors due to the fact that the image the surgeon receives is not three-dimensional, but two-dimensional.
Varieties of complications
Among the most common consequences of laparoscopy, problems with the respiratory and cardiovascular systems are noted. This happens due to the fact that the movement of the lungs in this case is difficult, carbon dioxide negatively affects the myocardium and the level of pressure in the body. In addition, breathing can become oppressed. As a result, the operation increases the risk that a person will suffer from a heart attack, respiratory arrest.
The main prevention of such violations is the competent work of the resuscitator and anesthesiologist. They must monitor the level of pressure, pulse, monitor the ECG before and after the operation. In cases where the operation lasts longer than 1 hour, a chest x-ray is taken to check for complications in the lungs.
There is also the occurrence of blood clots in the body. Sometimes this is dangerous. Most often, this disorder after surgery is experienced by elderly women, patients suffering from cardiovascular pathology. We are talking about heart defects, hypertension, atherosclerosis, obesity, varicose veins, heart attacks.
The factors influencing the appearance of this group of complications are the patient's taking the wrong position on the operating table, the duration of the operation.
As a preventive measure, heparin is administered to the patient, elastic bandages are applied to the limbs.
Pneumoperitoneum is the introduction of gases into the abdominal region, which always accompanies laparoscopy and sometimes leads to the development of complications. Gas can cause harm directly, as well asmechanical damage to internal organs may occur during its introduction. As a result, the gas may be in the subcutaneous tissue, omentum, liver of the patient. The most dangerous is the penetration of gas into the venous system. In this case, immediately stop introducing gas into the body, turn the patient over to the left side, raise the end of the table, perform resuscitation in order to remove the substance.
Sometimes a number of mechanical damage to internal organs occurs during this surgical intervention. This complication of laparoscopy occurs only in 2% of cases. This happens when the surgeon is forced to introduce instruments into the body "blindly". Burns can also occur for the same reason, as well as due to defective instruments. If the burn goes unnoticed, it leads to tissue necrosis, peritonitis.
Sometimes blood vessels get damaged. So, this does not pose a threat to life, but in the end it can lead to a hematoma and the risk of suppuration. If the largest vessels are injured, this already poses a threat to life and requires immediate medical intervention. This can happen when a scalpel, trocar, Veress needle, and a number of other surgical instruments are used.
Prevention of these complications is extremely important, as they often lead to death. For this reason, before laparoscopy, the abdominal cavity is necessarily examined; in difficult cases, an open-type operation is used. To eliminate the problem that has arisen, right in the process of laparoscopy, they proceed to open surgery. Special protective caps are also usedfor surgical instruments.
Sometimes there are complications after laparoscopy of a different kind. These include suppuration around the wounds. This happens if the patient has reduced immunity, or due to a violation of medical recommendations. To exclude such consequences, it is necessary to observe bed rest, carefully handle catheters in wounds, and prevent cases of their loss. If this happens, the chances that the wound will become infected will increase.
In addition, metastases may appear in the region of the trocar holes. This happens when a malignant tumor is removed during laparoscopy. For this reason, before laparoscopy, the maximum amount of information is collected in order to exclude the possibility of oncological diseases in the body. In addition, during manipulations with a diseased organ, special sealed containers are used, where the removed organs are placed. Their main drawback is their high cost.
Another complication after laparoscopy can be a hernia. To avoid this, the doctor without fail sews up holes after surgery, the size of which is more than 1 cm. Then the surgeon palpates to detect invisible wounds.
Conclusion
Like any operation, laparoscopy carries a risk of complications. And yet it is significantly lower compared to other types of surgery. Risks can be reduced by strictly following instructions and recommendations.
