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Laparoscopic and gisteroskopichesky operations
The urinogenital system at women is especially vulnerable system of an organism. Under the influence of a number of factors the quantity of female diseases in the modern world constantly increases. Besides many women prefer to postpone visit to the gynecologist, an effect of what are the serious complications of illnesses of urinogenital system conducting to infertility and need of surgical intervention.
Modern achievements of medicine allow to perform some surgeries with the minimum negative effects. A laparoscopy in gynecology are an opportunity to resolve a number of problems of gynecologic character, avoiding at the same time a trivmatization and the difficult recovery period.
Features of carrying out laparoscopy
Use of a method of a laparoscopy allows to perform internal inspection or surgical intervention, avoiding carrying out a big section. In the course of a laparoscopy several small cuts are made that reduces a sensation of discomfort and morbidities during operation and after its implementation. After recovery of the patient it practically does not have hems, the risk of development of complications in the postoperative period considerably decreases. It is not necessary for the patient stay in a hospital is long: in most cases after operation it is written out home in one days.
At laparoscopic operation three openings in a front abdominal wall are made. The special optical device – the endoscope is entered into one of such openings. Through two other openings manipulations with use of surgical tools are carried out. To facilitate the course of operation or survey, CO2 gas under pressure is entered into an abdominal cavity of the patient.
The laparoscopy is appointed at many gynecologic diseases. In particular, this method allows to remove some causes which provoked infertility to cure effects of a polycystosis of ovaries. In certain cases such operation is performed also at endometriosis. The laparoscopy is applied also at an extrauterine pregnancy provided that the patient has no bleeding.
As for contraindications for carrying out of this kind surgical intervention, them exists slightly. First of all, the laparoscopy is not done to the women having high degree of obesity, to the patients having infectious illnesses, disturbances of process of coagulability of blood. Women who stay on big durations of gestation cannot make such operation. It is also necessary to note that the price of a laparoscopy directly envy from complexity of such operation in each case.
Laparoscopy of uterine tubes
One of the most important bodies of reproductive system of the woman are uterine tubes. Their main function — connection of ovaries with a uterus. There is a number of diseases of this body at which the laparoscopy of uterine tubes is shown. It is, first of all, impassability and commissures of pipes, and also an extrauterine pregnancy.
Also with use of laparoscopic tools bandaging of uterine tubes is made for sterilization. Such operative measure prevents conception.
In the course of treatment of impassability of uterine tubes which becomes frequent the reason conducting to infertility at women initially the exact diagnosis is established. After that impassability treatment is carried out directly. Similarly there is an elimination of commissures of uterine tubes. Commissures generally arise as an effect of inflammations. By means of special tools in the course of carrying out a laparoscopy the section and the subsequent removal of commissures is made.
If at the woman the extrauterine pregnancy develops, then most often the attachment of fetal egg occurs in uterine tubes. If the embryo in the course of pregnancy continues to grow, then as a result the woman is threatened by a rupture of a uterine tube. On condition of development of pregnancy in a uterine tube use of a laparoscopy is reasonable both for establishment of the correct diagnosis, and for removal of fetal egg if there was a rupture of uterine tubes. In the latter case the operational emergency laparoscopy practices. Diagnosis by means of a laparoscopic method gives the chance to establish whether really fetal egg is located in uterine tubes. The emergency laparoscopy allows to recover a pipe after the occurred gap. Thus, operation with use of this method, unlike a usual operative measure, helps to keep not only a uterine tube, but also its functions.
The laparoscopy of uterine tubes practices also at women with the diagnosis "hydrosalpinx". At such illness in uterine tubes a certain amount of liquid collects. It occurs or owing to an inflammation of pipes, or in view of disturbance of a blood-groove. The disease constitutes special danger to the woman as the uterine tubes filled with liquid can be overwound. By means of a laparoscopy at such diagnosis the uterine tube completely is removed.
Laparoscopy of ovaries
In modern medicine the laparoscopy of ovaries practices process of treatment of an oothecoma. At development of this illness on an ovary the cyst is formed - it is a cavity in which there is a liquid. Both small, and rather impressive size can have such education. If on an ovary multiple cysts develop, then make to the woman the diagnosis a syndrome of polycystic ovaries. At this illness the patient often suffers from disturbances of a menstrual cycle, the polycystosis can become the infertility reason also.
The laparoscopy of a cyst of ovaries is made using the general anesthesia. To avoid severe bleeding in the course of operation, make coagulation of vessels. Those zones of an ovary which were damaged in the course of operation either spray the laser, or destroy in other ways. Sometimes during such procedure the doctor takes a fabric sample for carrying out a biopsy. Such type of an operative measure sometimes also practices at endometriosis, an adenomyosis, a hysteromyoma.
At a disease of ovaries the laparoscopy is one of the fastest and safe ways of treatment of an illness. It allows to avoid injuries, to considerably reduce the term of postoperative recovery and, respectively, treatment in a hospital. At operation the woman loses rather small amount of blood: if to compare such blood loss to usual operation, then here at the patient bleeding with a loss of blood, ten times smaller is observed, than at operation. One more undoubted plus – a possibility of use of the optical device and, respectively, significant increase for ensuring accuracy of carrying out operation.
Laparoscopy of a gall bladder
The gall bladder near bottom edge of a liver is located. Its defining function – bile accumulation, and also biliation in a certain phase of digestion of food.
If at the person some illnesses develop, there is an inflammatory process in a gall bladder that, as a result, leads to need removal of a gall bladder.
The laparoscopy of a gall bladder is carried out using the general anesthesia. Such operation continues about one hour. There is a laparoscopy of a gall bladder of similarly similar operation on other bodies: in an abdominal cavity three punctures are made. Through one of them it is entered laparoskop with a video camera for supervision over operation process. Two other cuts are used for introduction of endoscopic tools. After the gall bladder is removed, on the vesical canal and vessels brackets are imposed. Punctures at a laparoscopy small: they make about 4-5 mm. When postoperative sewing up of punctures is made, the patient still stays in a hospital several days. After an exit from hospital it is recommended to avoid several weeks heavy exercise stresses and to adhere to the diet excluding alcohol, fat, fried. After a laparoscopy of a gall bladder the patient is almost completely recovered in a week. One more plus – absence of severe postoperative pains that allows the patient to avoid reception of strong analgetics. In view of lack of contact with external environment after a laparoscopy commissures do not develop inside.
Most often the laparoscopy of a gall bladder is carried out at calculous cholecystitis of which existence in a gall bladder of stones is characteristic. However a number of states which are direct contraindications to carrying out a such operative measure is allocated. In this case it is about existence of commissures and hems which were formed in an abdominal cavity as an effect of earlier performed surgeries. People cannot carry out a laparoscopy of a gall bladder with high degree of obesity, subjects for whom a large number of stones in a gall bladder, to people with abscess in a zone where the gall bladder is located is diagnosed. Besides, the laparoscopy is not carried out to patients with cardiovascular diseases, illnesses of a respiratory organs at a dekompensatsionny stage, to women in the third trimester of pregnancy. However in most cases the laparoscopy is the most sparing way of removal of a gall bladder. Therefore the cost of laparoscopic operation completely justifies a number of its advantages.
Pregnancy after a laparoscopy
Often it is very important to the women who in due time transferred laparoscopic intervention to know about when it is possible to plan pregnancy after a laparoscopy. First of all, it is necessary to consider the fact that the laparoscopy in gynecology is carried out rather often because of infertility. In the course of treatment to the woman the adhesiotomy is made, passability of pipes is recovered, cysts are removed, and also other necessary manipulations are carried out. In the course of treatment by means of a laparoscopy at the patient processes of an ovulation are recovered, obstacles for movement of an ovum therefore conception can happen after the successful end of treatment are eliminated.
Thus, the woman has to consider that approach of pregnancy after a laparoscopy perhaps already soon. However at approach of pregnancy it is important to such patients to be observed constantly at the gynecologist, to pass complex inspection. Sometimes reception of medicamentous drugs for the normal course of pregnancy after a laparoscopy is required. Means for maintenance of a normal hormonal background are in that case appointed.
In the absence of pregnancy after laparoscopic intervention the doctor can sometimes appoint carrying out such procedure repeatedly.
One more often applied method of research and treatment of female diseases is hysteroscopy. Such procedure is considered the safest for health of the woman. Carry out such intervention using intravenous anesthesia, at the same time the special medical tool — the hysteroscope is used. It is the thin tube equipped with optical fiber. Such tube is used for obtaining the enlarged image of a uterus inside. For obtaining accurate data it is made a raspravleny uterus for what it is filled with sterile solution. Hysteroscopy of a uterus allows the doctor to establish the exact diagnosis as other researches do not give the chance so accurately to define existence of changes and deviations. Except other, such research allows to estimate disturbances of a mucous membrane of a uterus visually.
Modern physicians appoint hysteroscopy at different diseases of women's reproductive system. This method of research practices at a hyperplasia of a mucous uterus, and also at suspicion on existence of polyps of an endometria or development of oncological pathologies. Carrying out hysteroscopy is reasonable for establishment of the diagnosis at uterine bleedings, disturbances of a monthly cycle, in the presence of unions in a cavity of the uterus, at infertility, and also when determining existence of parts of fetal egg owing to an extrauterine pregnancy, during removal of the remains of intrauterine contraceptives, for control at some types of treatment of diseases.
Except high-quality diagnosis the method of hysteroscopy makes some operative measures. For example, if diagnosis of high-quality educations is made, the doctor in certain cases can remove at once such tumors, or take a material sample for the further analysis.
Before gisteroskopichesky inspection it is necessary to consult surely with the gynecologist. The doctor performs preliminary inspection, and also researches on existence of infectious diseases. It is important to consider that hysteroscopy categorically cannot be carried out at pregnancy therefore it is necessary to be convinced of its absence. The hysteroscope is entered into a uterus via the channel of a neck of uterus. The general duration of such procedure – 5-10 minutes.
There is also a number of contraindications for carrying out hysteroscopy. Procedure is not practiced at infectious diseases at an aggravation stage, at heart troubles, a liver, lungs, kidneys in a decompensation stage, at pregnancy.
If to the patient operational hysteroscopy is carried out, then in parallel with the hysteroscope different tools are used to surgical manipulations. The recovery period after an operative measure with use of the hysteroscope proceeds several days, and after diagnostic procedure the woman comes back home several hours later. After hysteroscopy the minimum quantity of complications is noted now. Effects of hysteroscopy create the minimum discomfort for the woman. Therefore, despite hysteroscopy cost, this procedure is widely demanded in the course of treatment of many diseases today.
Pregnancy after hysteroscopy
To define, pregnancy after hysteroscopy is how probable, it is necessary to consider what pathological phenomena became the reason of carrying out such procedure. Often hysteroscopy is appointed to women to exclude or confirm existence of the factors influencing infertility.
After carrying out gisteroskopichesky intervention the woman should pass ultrasonography in one month and through half a year after procedure. If treatment took place successfully, then specialists advise to plan pregnancy approximately in half a year after carrying out operation. But, as many testify To hysteroscopy, very often conception happens in several months after use of this method of treatment of female diseases.