laparoscopyWhat is (closed surgery)?
Laparoscopy is a surgical method performed by inserting a telescope and camera with a diameter of 1 cm through the navel and inserting auxiliary trocars with a diameter of 0.5 cm (tubes through which instruments pass).
It is done with general anesthesia. After the patient is put to sleep, a thin needle is inserted into the abdominal cavity through the navel and the abdomen is inflated with carbon dioxide gas. After a certain head is reached, a 1 cm diameter trocar is inserted through the navel into the abdominal cavity. A telescope (with a camera head attached at the end) is inserted through this tube. All intra-abdominal organs are examined. (Liver, gallbladder, stomach, etc., which are the upper abdominal organs). The lower intra-abdominal organs are then visualized (womb, both eggs, both tubes, bladder, intestines, and Douglas cavity). Then the patient is given the Trendelenburg position (with this position, the head is taken down). Then, depending on the type of surgery to be performed, auxiliary trocars (1, 2, 3 or 4 pieces) with a diameter of 0.5 cm are inserted into the abdominal cavity from the sides. Surgical procedure is performed by inserting instruments through these pipes. After the surgery is over, the trocars are removed and the gas in the abdomen is evacuated. Generally, the patient is sent home with recommendations after being followed up in the recovery section for 3-4 hours.
If the surgeon’s experience is sufficient, all kinds of gynecological operations can be performed with laparoscopy. Laparoscopy (closed surgery) has numerous advantages over open surgery. For this reason, laparoscopy should always be preferred if the surgeon’s experience is sufficient. Please click to see the advantages of laparoscopy (closed surgery) over open surgery. You should discuss the laparoscopic method in detail with your doctor.
laparoscopyWhat to do before
There is no special procedure related to the laparoscopy procedure. You should not eat or drink anything in the 8-hour period before the procedure (Smoking should not be allowed. Medicines such as blood thinners (aspirin, Clexan, etc.) should never be taken. If these drugs have been taken within 1 week, your doctor should be informed. Before the operation, your doctor should ask for sedatives for anxiety-related insomnia. For example, 5 mg Diazem tablet in the evening before the procedure allows you to spend the night well.
Wear comfortable clothes on the way to the hospital. Make-up should not be applied. Any lipstick or nail polish should be removed. Jewelry such as rings and earrings should not be brought. If there are drugs that you use routinely, they should be brought together. It is useful to take a shower or bath the day before the procedure.
On or before you arrive at the hospital, your doctor will ask you to read and sign the consent form. Click here for the laparoscopy consent form.
If you are applying to the operating room as an outpatient before the laparoscopy procedure, you usually enter the daily surgery section. Here, you will be dressed in a surgical suit and taken to the surgery room with the help of a stretcher. Here, an intravenous catheter is inserted by the anesthesia technician, usually over your arm or hand. Within the principles of safe surgery called time-out, your name, the name of your doctor and the surgical procedure to be performed are said loudly. Then the anesthesiologist will give you drugs to sleep and relax you. You will not feel any pain during the surgery. A deep sleep takes place.
laparoscopyadverse events that may occur during
Laparoscopy must be performed by experienced, experienced hands who have received special training in this regard. Although anesthesia-related adverse events are rare because you are receiving anesthesia, they can happen. Due to intestinal perforation, your intestines can be temporarily (approximately 2 months) out of the abdomen, which is taken inside after 2 months. If the great vessels are damaged, life-threatening can be seen, albeit rarely.
laparoscopyWhat to do after
After the laparoscopy procedure, you stay in the recovery room for about 3-4 hours. Afterwards, you can usually go home. Even if the carbon dioxide gas, which is used to inflate the abdomen in laparoscopy, is removed when the procedure is finished, some amount may not be released. For this reason, pain may be felt in both shoulders, especially when you stand up. In this case, lying down can reduce the pain. If your doctor has not recommended any antibiotics, there is usually no need for antibiotics after surgery. Some painkillers can be taken (Medicines containing paracetamol can be taken 3 times a day). Stitches do not need to be removed as they are usually glued or hidden stitched. If there are stitches, they usually dissolve on their own. When the stitches start to itch, it is a sign that the healing is complete.
There may be bruising at the incision sites. They usually go away on their own.
Although the incision scars differ from patient to patient, they become invisible within 1-2 months.
Sterile bandages at the incision sites can be removed after 24 hours. If there is bleeding or fluid coming from the incisions, it can be bandaged again. It is normal for light red or clear fluid to come from the incision site. However, in case of inflamed yellow liquid or greenish, foul-smelling liquid, the doctor should be contacted immediately.
Liquid foods should be taken for the first 12 hours (Fruit juices, ayran, etc.). If nausea and vomiting do not occur, solid foods are started. In case of nausea, vomiting or swelling in the abdomen, you should inform your doctor.
You can take a bath 48 hours after the surgery. Incisions should be protected during bathing. However, very hot sauna or pool should not be entered.
Chills, fever, excessive swelling in the abdomen, inability to pass gas, inability to urinate, inability to make stool, nausea, vomiting, excessive pain in the abdomen, etc. In such cases, you should inform your doctor.
From the patient’s point of view, closed surgery has numerous advantages over open surgery. However, closed surgery is a method that is much more difficult for the surgeon than open surgery and requires experience. Unfortunately, in inexperienced hands, the possibility of undesirable problems is higher in closed surgeries (obligation to pass stool out of the abdomen for about 2 months with intestinal perforation, death as a result of large vessel injury, etc.). For this reason, closed surgeries (laparoscopy, hysteroscopy) must be performed by obstetricians with special training and experience. Before closed surgery, your doctor should definitely check whether he has received this special training and whether he has sufficient experience.
Some instruments used in laparoscopy
Some trocars used in laparoscopy
To make an incision for gas delivery from the navel (Patient lying flat on his back)