Obstetric Laparoscopy is a procedure of action to diagnose and treat disorders or disorders that occur in the female reproductive system, especially disorders involving the uterus and ovarian cells. This procedure is an alternative method to open surgical procedures (conventional).
The obstetrical laparoscopy is performed using a laparoscope, a long thin tube-shaped device equipped with a camera and light at the edges. This method allows the doctor to access and obtain a clear picture of the inside of the patient's abdominal and pelvic cavities without having to make a wide incision on the patient's skin.
Womb laparoscopy can also be done as a treatment for certain conditions, such as hysterectomy (removal of the uterus) or removal of the ovarian cyst. This procedure will be performed by an obstetrician.
Indications Laparoscopy Gynecology
Obstetric laparoscopy can be used as a diagnostic procedure, treatment, or both. Some conditions that cause the patient to undergo a laparoscopic womb, including:
- Chronic or acute pelvic pain.
- Endometriosis.
- Ectopic pregnancy.
- Myoma, the growth of abnormal tissue that develops in a woman's uterus.
- Tumor or ovarian cyst, if the size is not too large.
- Inflammation.
- Pelvic abscess.
- Cancer of the reproductive system.
- Infertility (infertility).
However, not all of these conditions can be treated with laparoscopy, for example patients with tumors or large cysts will be recommended to undergo an open surgical procedure.
Warning:
- Tell your doctor if you have experienced an allergic reaction to the ingredients contained in anesthetic medicine.
- Tell your doctor if you have had abdominal surgery or have intestinal obstruction because this can increase the risk of gut perforation.
- Tell your doctor what type of drugs or supplements you are taking, especially anticoagulants. The doctor may advise the patient to stop taking the drug before undergoing uterine laparoscopy.
- Tell your doctor if you have a blood clotting disorder or have a history of heart, liver or lung disease.
- Tell your doctor if you are pregnant.
Before Laparoscopy Gynecology
Before the patient underwent a laparoscopic womb, the doctor will do a medical history check and ask questions about complaints from symptoms experienced by the patient, history of illnesses that have suffered, and a history of allergies.
Furthermore, patients will undergo blood tests and urine tests. If necessary, the doctor will perform several investigations, such as chest X-rays, ultrasound, CT scan, MRI, and electrocardiogram (ECG). The results of this examination will be used as a guide for doctors, so that it can improve the effectiveness of laparoscopy.
In addition, there are several other things that patients need to do before undergoing uterine laparoscopy, including:
- Fasting for approximately 8 hours.
- Invite a family member or friend to drive the patient home. This is done because the patient's condition makes it impossible to drive a vehicle due to the effects of the anesthetic.
Before entering the operating room, the doctor or nurse will insert an IV tube into a vein in the patient's arm to deliver medications and fluids during the laparoscopic procedure. After the doctor makes sure the patient's condition is stable, the patient will be taken to the operating room.
Womb Laparoscopy Procedure
The laparoscopic womb procedure is performed in an operating room equipped with a monitor. This procedure generally lasts for approximately 1 hour. The following are the steps for uterine laparoscopy, which are:
- The patient will be laid on the operating table with the foot slightly raised and supported by a support.
- The anesthesiologist will inject the anesthetic through an IV tube. The type of anesthesia used in uterine laparoscopy is total anesthesia, so the patient will fall asleep during the procedure.
- After the patient falls asleep, the doctor will insert a small tube or catheter into the bladder to pass urine.
- A small needle will be inserted to channel carbon dioxide gas into the patient's stomach, so that the stomach expands. This gas will hold the stomach wall, so the doctor can see the internal organs clearly.
- The doctor will make a small incision in the patient's navel and insert the laparoscope. This tool will send a picture of the condition of the abdominal and pelvic cavity in detail to a screen so that the doctor can get a clear picture of the disorder experienced by patients.
- If the patient's condition requires further action, the doctor will make another incision on the side of the patient's abdomen and insert the laparoscope through this hole. Next, the doctor will perform treatment using a laparoscope as a guide. There are several types of surgical procedures that may be carried out through the laparoscopic womb method, including:
-Hysterectomy, which is a procedure to remove the uterus
-Oophorectomy, which is the procedure for removing the ovaries.
-Myomectomy, which is the procedure for removing myoma.
-Ovarian cystectomy, which is the procedure for removing cysts from the ovaries.
-Tubectomy, which is a sterilization procedure in women.
-Procedure for handling ectopic pregnancy.
-Procedure for dealing with endometriosis
- After the procedure is finished, the doctor will remove all the tools and the incision is closed with stitches and bandages.
Laparoscopic technology with robotic techniques can also be used in uterine laparoscopic procedures. Robotic techniques have the advantage of being more stable and able to perform fine motor skills, such as complicated cutting procedures and special stitches that are difficult to do manually by laparoscopy.
After Laparoscopy Gynecology
After the laparoscopic womb procedure is completed, the patient will be placed in the recovery room until the effects of the anesthesia disappear completely. During the recovery period, the doctor or nurse will monitor the patient's heart rate and blood pressure.
During recovery, patients can feel nausea, bloating, and pain in the incision area. In addition, the gas used during the procedure can also cause pain in the chest and shoulders of the patient.
The duration of recovery generally depends on the type of uterine laparoscopic procedure performed and the patient's overall condition. Patients may be allowed to go home a few hours after the procedure, or be hospitalized for one or more nights.
Before the patient goes home, the doctor will explain how to treat the incision scar and control the side effects that can occur. In addition, doctors can also prescribe painkillers or antibiotics to prevent surgical site infections.
During recovery at home, the doctor will advise the patient to rest for several days or weeks. Patients may need one month before they can resume normal activities. To speed up the healing process, there are several things a patient can do, including:
- Try to undergo light activities, such as walking, to strengthen muscles and prevent the risk of blood clots. However, avoid strenuous activities, such as lifting weights.
- Wear clothes that are not too tight.
Risk of Laparoscopic Gynecology
Obstacle laparoscopy is a safe procedure. Common side effects are skin irritation, pain at the injection site, and bladder infections. In addition, there are risks of other complications, but they rarely occur. Among others are:
- Allergic reaction.
- Blood clotting.
- Difficulty urinating.
- Adhesions of internal organs (adhesion).
- Nerve Damage.
- Damage to blood vessels in the abdomen, bladder, intestine, uterus, and pelvic structures.
Carbon dioxide gas used to fill the abdominal cavity can also cause complications if it enters the blood vessels.
Contact your doctor immediately if you experience severe abdominal pain, nausea and vomiting continuously, fever with a temperature of 38oC or more, pus appears or bleeding occurs in the incision area, or pain when urinating.
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