Laparoscopy is considered a modern less traumatic way of treating pathologies of internal organs. This is an alternative to traditional methods of therapy, it is considered more gentle for the body. At the same time, it should be borne in mind that complications after laparoscopy surgery occur. Like many types of treatment, such surgery has both positive and negative sides.
What it is
It should be borne in mind that, in general, this surgical intervention is minimally invasive, which reduces the risk of collision with complications after laparoscopy. To gain access to the internal organs, doctors make small holes 0.5 - 1 cm in size using a laparoscope.
This tool is similar to a tube, it is equipped with a small camera, a light source. In addition, it is connected to a monitor. Thanks to modern matrices, the entire operation is suitable for full control due to the high-precision image displayed on the screen. As a result, a significant part of the patient’s abdominal cavity is examined. This reduces the risk of complications after laparoscopy of the uterus, for example, even if we are talking about small adhesions in the fallopian tubes.
If we compare such surgical intervention with conventional operations, a number of special positive aspects are revealed. They are that the chances of injuring the patient are minimized. This not only makes it possible to minimize complications after laparoscopy, but also to recover faster. It also reduces the risk that an infection will be introduced into the wound. No rough seams remain at the incision site, and blood loss is minimal. The hospitalization period is significantly reduced.
It is noteworthy that laparoscopy is performed during both therapy and diagnosis. Given what complications after laparoscopy occur, we can say that this surgical intervention is perceived by patients relatively easily.
But at the same time, as with any operation, it is accompanied by anesthesia, incisions, and the use of surgical instruments. And this can cause complications after laparoscopy.
Limitations
Even though the operation of this type looks quite simple, there are certain requirements. Such an intervention is carried out only in the presence of special equipment, which is not available in all medical institutions. To avoid complications after laparoscopy, the operation is performed only by an experienced surgeon.
Indications in gynecology
Typically, operations of this kind are carried out on the organs of the abdominal cavity, pelvic area. Most often, patients are concerned about the likelihood of complications after laparoscopy in gynecology, the gall bladder. These are the most common operations. Often, this method removes hernias.
Approximately 90% of gynecological operations are performed using laparoscopy. Often it is necessary for a detailed diagnosis of the patient. Often, despite the risk of complications after laparoscopy of the ovary, it is the diagnosis with this method that allows those who have lost hope of motherhood to eventually have children.
The main indication for such an intervention is an emergency gynecological condition. These include: rupture of the cyst, ectopic pregnancy and some other dangerous cases. Also, the issue of complications after laparoscopy of an ovarian cyst can also worry women suffering from chronic pain in the pelvis, as this is one of the main indications for this kind of intervention for this disease. The operation is also carried out with abnormalities of the uterus.
Laparoscopy is recommended for women suffering from endometriosis, ovarian pathologies, and tumors. Usually, the question of how likely it is to encounter complications after laparoscopy of a cyst worries women who want to become pregnant later, as well as before IVF. In this case, surgery is mandatory. The frequency of laparoscopy is explained by the fact that this is the most organ-preserving operation.
Endosurgical complications
Although much less common than after conventional operations, complications after laparoscopy of the cyst still occur. Sometimes they can threaten not only the health, but also the life of the patient. In the United States, a patient’s hospital stay after such surgery for more than a day is considered a complication. In Germany, only injuries and injuries are considered complications. In France, complications are divided into small, large, potentially fatal. Complications after laparoscopy in gynecology are not uncommon.
Contraindications
Like any surgical intervention, laparoscopy has a number of contraindications. They are divided into relative and absolute. The first include severe cardiopulmonary pathologies, exhaustion of the body, acute liver failure, coma, shock, asthma, severe hypertension, oncology, inability to accept the Trendelenburg position, hernia in a number of organs.
Relative contraindications include pregnancy later than 16 weeks, peritonitis, allergies, pelvic adhesions, fibroids for more than 16 weeks, poor blood and urine tests, acute respiratory viral infections, and a month after the end of the disease. The risks of complications after laparoscopy of a hernia and any internal organs increase if an operation is performed for people with the listed contraindications.
Preparation for laparoscopy
Many of the consequences of this surgical intervention in the body are due to improper preparation for its implementation. An operation is performed either planned or on an emergency basis. In the second case, preparation time is short, the risk of complications after laparoscopy of the gallbladder and other internal organs increases. But at the same time, the paramount task is pursued - saving the patient's life.
Preparation for surgery consists of conducting blood tests for dangerous diseases, urine, vaginal swabs, fluorography, ultrasound and ECG.
Before the intervention, it is important to first determine how the body will cope with anesthesia. The anesthesiologist needs to find out if the patient has allergic reactions to the components of anesthesia. If necessary, light tranquilizers are used before surgery. Most often, it is necessary that the patient does not eat for 6 to 12 hours before surgery.
The essence of laparoscopy
In the absence of complications after laparoscopy of the gallbladder and other internal organs of the patient, they are discharged on the same day or the next. In addition to a laparoscope with a camera and a light source, other instruments are also introduced into the body through incisions. For example, during an operation on the uterus, a manipulator can be used to move the internal organ in the desired direction. After the operation is over, sutures and dressings are applied.
Postoperative period
In order to notice in time the complications after laparoscopy of the gallbladder or other internal organs, you need to know what condition is considered normal after surgery. So, in the area of ​​incisions, pain is not uncommon, a sore throat may appear from the fact that a tube was used for endotracheal anesthesia.
As a rule, unpleasant sensations pass by themselves in a fairly short time. Women may be bothered by bleeding from the vagina, but soon it also disappears. As a rule, well-being returns on the fifth - seventh day.
Causes of complications
As a rule, in order to avoid complications after the operation, the surgeon is trained for 5 to 7 years before proceeding with the manipulations. The practice is important - about 4 - 5 laparoscopy per week.
Complications usually arise due to the fact that the patient himself violates medical recommendations either before or after surgery. Sometimes their cause may be a medical error. So, the rules of sanitation of the abdominal cavity may be violated. Inflammatory processes may begin, problems associated with anesthesia may appear.
A certain proportion of risk in laparoscopy is associated with the fact that in fact the surgeon does not completely see the internal organs, as with open surgery.
Problems may begin due to the technical complexity of the operation. And if at least one device fails in the process, the result can be incorrect doctor actions. And in this case, an already open operation will be necessary. Also, a laparoscope can narrow the field of view of a specialist, and he simply will not see the whole picture. In addition, this type of intervention does not imply a tactile sensation by which the surgeon is able to isolate pathologies in the altered tissues. The picture may appear with errors due to the fact that the surgeon receives the image not three-dimensional, but two-dimensional.
Varieties of complications
Among the most common consequences of laparoscopy are problems with the respiratory and cardiovascular systems. This happens due to the fact that the movement of the lungs in this case is difficult, carbon dioxide negatively affects the myocardium on the level of pressure in the body. In addition, breathing can become depressed. As a result, the operation increases the risk that a person will suffer from a heart attack, respiratory arrest.
The main prevention of such disorders is the competent work of the resuscitator and anesthetist. They should monitor the level of pressure, pulse, monitor the ECG before and after the operation. In cases where the operation lasts longer than 1 hour, a chest x-ray is performed to detect the presence of complications in the lungs.
There is also the occurrence of blood clots in the body. Sometimes it can be dangerous. Most often, this disorder after surgery is encountered by elderly women, patients suffering from cardiovascular pathology. We are talking about heart defects, hypertension, atherosclerosis, obesity, varicose veins, heart attacks.
The factors affecting the appearance of this group of complications are the patient’s acceptance of an incorrect position on the operating table and the duration of the operation.
As a prophylaxis, heparin is administered to the patient, elastic bandages are applied to the limbs.
Pneumoperitoneum is the introduction of gases into the abdominal region, which always accompanies laparoscopy and sometimes leads to the development of complications. Gas can directly cause harm, and mechanical damage to internal organs can also occur during its introduction. As a result, the gas may be in the subcutaneous tissue, omentum, and patient’s liver. Most dangerous is the penetration of gas into the venous system. In this case, they immediately stop injecting gas into the body, turn the patient on the left side, raise the end of the table, and carry out resuscitation in order to remove the substance.
Sometimes a series of mechanical damage to internal organs occurs during this surgical intervention. Such a complication of laparoscopy occurs only in 2% of cases. This happens when the surgeon is forced to inject tools into the body "blindly." Burns can also occur for the same reason, as well as due to defects in the tools. If the burn goes unnoticed, this leads to tissue necrosis, peritonitis.
Sometimes vessels get damaged. So, this does not pose a threat to life, but in the end it can lead to a hematoma and the risk of suppuration. If the largest vessels are injured, this already poses a threat to life and requires immediate medical attention. This can happen when a scalpel, trocar, Veress needle and a number of other surgical instruments are used.
Prevention of these complications is extremely important, as they often lead to death. For this reason, before laparoscopy, the abdominal cavity is examined without fail, in difficult cases an open surgery is used. To eliminate the problem, right in the process of laparoscopy they go to an open surgery. Special protective caps for surgical instruments are also used.
Sometimes there are complications after laparoscopy of a different kind. These include suppuration around the wounds. This occurs if the patient has a reduced immunity, or due to a violation of medical recommendations. To exclude such consequences, you need to observe bed rest, carefully handle the catheters in the wounds, to prevent cases of their loss. If this happens, the chances of the wound becoming infected will increase.
In addition, metastases may appear in the area of ​​trocar openings. This happens when a malignant tumor is removed during laparoscopy. For this reason, the maximum amount of information is collected before laparoscopy to exclude the likelihood of oncological diseases in the body. In addition, during manipulations with a diseased organ, special sealed containers are used, where the removed organs are placed. Their main disadvantage is their high cost.
Another complication after laparoscopy can be a hernia. To avoid this, the doctor necessarily sews up the holes after surgery, the size of which is more than 1 cm. Then the surgeon palpates to detect invisible wounds.
Conclusion
Like any surgery, laparoscopy carries a risk of complications. And yet it is significantly lower compared to another kind of surgical intervention. Reducing risks allows for strict adherence to instructions and recommendations.