LAPAROSCOPIC SURGERY IN GYNECOLOGY
Laparoscopy literally means observation of the inside of the abdomen. By definition, it is the procedure of inflating the inside of the abdomen with gas (carbon dioxide; CO2) and observing the intra-abdominal organs with the help of an optical camera and performing surgical procedures when necessary. Laparoscopy in gynecology is the observation of female internal genital organs and performing the necessary surgical procedures.
Laparoscopy procedure;
A 5-10 mm incision is made on the abdominal wall from the belly button and a trocar of the same diameter is made. The inside of the abdomen is reached with auxiliary tools called. After making sure that the inside of the abdomen is reached, the inside of the abdomen is inflated with carbon dioxide (CO2) gas at a pressure of 12-15 mmHg through this trocar. Then, additional trocars (usually 2 or 3 additional trocars for gynecological surgeries) are placed depending on the surgical procedure to be performed. Thus, for gynecological surgery, a total of 3 or 4 trocars are placed: one in the belly button, two in the patient's left lower abdomen and, if necessary, one in the right lower abdomen. The incisions made in the abdominal skin to insert these trocars are usually 5 or 10 mm. While the inside of the abdomen is observed with the help of a camera passing through the trocar placed through the belly button, holding clamps, scissors, prostheses, bleeding stop (vessel sealing / cutting energy modalities) forceps, aspirator for intra-abdominal cleaning and endobags to remove tissues are passed through the other trocars to perform the surgical procedure. is used in the procedure. After laparoscopic surgery is completed, skin incisions of 5-10 mm in size on the abdominal skin are closed with thin stitches.
Advantages of laparoscopy;
Since there is no large incision in the abdomen with laparoscopy. Pain, bleeding, hospital stay are less, faster recovery and earlier return to work are possible. In addition, there are no large cosmetic scars. In addition, observation of the intra-abdominal organs is better and intra-abdominal adhesion is less after surgery.
Use of laparoscopy in gynecology;
Laparoscopy in gynecology is diagnostic. ) and treatment (therapeutic) is used for this purpose. Diagnostically; While it is used for unexplained chronic pelvic pain and unexplained infertility, it is used for treatment purposes in the treatment of myomas, endometriosis, ovarian cysts and tumors, ectopic pregnancy, tuboovarian abscess, uterine / vaginal prolapse, urinary incontinence and gynecological cancers. Gynecological surgeries performed laparoscopically; hysterectomy (removal of the uterus), oophorectomy (removal of the ovary), cystectomy (removal of the ovarian cyst), salpingectomy (removal of the tubes), myomectomy (removal of myoma), tubal ligation (tying the tubes), adhesiolysis (removal of intra-abdominal adhesions), opening of the tubes, sacrocolpopexy (correction of uterine prolapse) and uterine cancer surgery.
Complications in laparoscopic surgery;
Similar to the complications seen in open surgery, large vessel, bowel, Urinary bladder injury, nerve damage and vascular clot formation may occur. If a situation such as severe abdominal pain, prolonged nausea and vomiting, fever, bleeding and inflammation at the incision site, or pain during urination is encountered after laparoscopy, the doctor who performed the surgery should be contacted.
In addition to the great advantages of laparoscopy in gynecology described above, As with other surgical methods, it also has risks and complications. Low complication rates and great success rates are achieved by appropriate patient selection and preparation, especially in experienced centers and experienced hands.
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