What is Laparoscopy (closed surgery)?
Laparoscopy involves inserting a 1 cm diameter telescope and camera through the umbilicus and 0.5 cm diameter auxiliary trocars (pipes passing instruments through them). It is a surgical method.
It is performed with general anesthesia. After the patient is put to sleep, a thin needle is entered into the abdominal cavity through the navel and the abdomen is inflated with carbon dioxide gas. After a certain pressure is reached, a 1 cm diameter trocar is inserted into the abdominal cavity through the umbilicus. A telescope (with a camera head attached at the end) is inserted through this pipe. The upper abdominal organs are examined. (Upper abdominal organs such as liver, gallbladder, stomach, etc.). The lower abdominal organs are then visualized (uterus, both ovaries, both tubes, bladder, intestines and Douglas cavity). Then the patient is given the Trendelenburg position (with this position, the head is brought down). Then, depending on the type of surgery to be performed, auxiliary trocars (1, 2, 3 or 4) with a diameter of 0.5 cm are inserted into the abdominal cavity from the sides. Surgery is performed by inserting instruments through these pipes. After the surgery is completed, the trocars are removed and the gas in the abdomen is evacuated. Generally, the patient is monitored in the recovery area for 3-4 hours and then sent home with recommendations.
Surgeries performed with laparoscopy:
If the surgeon has sufficient experience, all kinds of gynecological surgeries can be performed with laparoscopy. Laparoscopy (closed surgery) has numerous advantages over open surgery. Therefore, if the surgeon's experience is sufficient, laparoscopy should always be preferred.
Surgeries in which laparoscopy is most frequently used:
Diagnostic laparoscopy (Examination of the uterus, tubes, ovaries and surrounding tissues)
Surgery to open blocked tubes
Removal of adhesions
Surgery to remove myomas
Surgical treatment of ectopic pregnancy
Removal of ovarian cysts (Chocolate cyst, dermoid cyst, simple cyst, mucinous cyst, serous cyst, etc.)
Treatment of ovaries that have rotated around themselves
Burning and removal of endometriosis foci
Surgery to remove the uterus
Surgery to remove the ovaries
Uterus and removal of the ovaries together
Surgeries for persistent groin pain (Presacral neurectomy, LUNA (“Laparoscopic uterine nerve ablation”))
Surgery to place the ovaries upwards in cancer patients who will receive radiotherapy
Hanging the pelvic floor upwards in cases of uterine prolapse and strengthening
Enterocele (intestinal prolapse) surgery
Surgeries for urinary incontinence (Burch etc.)
Surgery to drill 15-20 holes on the ovaries in polycystic ovarian disease
Surgery to remove previously connected tubes Re-opening surgery The process of examining the organs of the digestive system with a tube-shaped instrument is called endoscopy.
When is it necessary?
Problems with swallowing and chewing,
Ongoing heartburn and burning,
While sleeping cough, snoring fits and hoarseness,
Stomach aches and pains after meals or on an empty stomach
Abdominal pain,
Bleeding from the upper digestive system,
Vomiting,
Accidental foreigner swallowing an object,
Changes in your bowel pattern,
Bleeding with defecation in the toilet,
Need for control of a previously diagnosed digestive system disease,
Bowel laziness, constipation or diarrhea that does not improve for a long time,
If there are abnormal findings in the stomach and intestine films;
Endoscopy is required
How is endoscopy performed?
8-10 During gastroscopy, an extremely soft tube with a thickness of millimeters is guided and accessed from the esophagus to the stomach and duodenum. In colonoscopy, the entire large intestine is examined. The device, which is approximately 110-120 centimeters long, has a camera at the end and reflects the areas it passes through on a television screen. By looking at these images, the doctor sees the inner surface of the patient's examined area and can make a diagnosis.
What are the risks of endoscopy?
Risks seen in endoscopy are very rare. is. Gastroscopy and colonoscopy have certain risks, depending on both the procedure and the anesthesia applied. Procedure-related risks include risks such as intestinal perforation and bleeding, which do not exceed 0.2%. The risks associated with the anesthetics administered to the patient vary depending on the comorbidities the patient has. Therefore, the same amount of anesthetic medication cannot be administered to every patient. Depending on the comorbid disease the patient has, sometimes even endoscopy is not performed because it is considered risky.
In light of all we have said, endoscopic devices are one of the most important trump cards of today's medicine. Nowadays, it is seen that the number of esophagus, stomach and large intestine cancers has increased significantly due to the changes in our eating habits and the hormonal foods we consume. These cancers, which were previously detected at the last stage, have now been detected at the early stage with the widespread use of endoscopy. For example, since stomach cancer is the most common cancer in Japan, Japan provides endoscopy screening for all its citizens free of charge. Thus, Japan is the country where stomach cancer is most common but has reduced the death rate from stomach cancer the most. With the development of auxiliary equipment in endoscopy, cancer detected at an early stage can be treated endoscopically without the need for surgery.
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