Laparoscopic surgery (commonly known as "drilling") involves making 3-4 small incisions (diameter 1CM and 0.5CM) on the abdominal wall, placing the cannula into the abdominal cavity, and establishing a channel between the abdominal cavity and the outside world. Using these channels, special laparoscopic instruments can go deep into the abdominal cavity, and the camera can clearly display the images in the abdominal cavity on the monitoring screen, and the surgeon can look directly at the screen to complete various surgical operations.
What should patients pay attention to in gynecological laparoscopic surgery?
Today, with the development of minimally invasive surgery, laparoscopic technology has been widely used in clinical departments, and its application scope in gynecology is also expanding day by day. Among them are ectopic pregnancy, hysteromyoma, teratoma, polycystic ovary syndrome and other diseases. This technique has the advantages of no laparotomy, less trauma, quick recovery and less postoperative pain. In addition, it also shortens the hospitalization days, does not leave earthworm scars on the abdomen, and has a cosmetic effect. However, laparoscopic surgery is a kind of surgery after all, and patients who do this kind of surgery should pay attention to some problems before and after the operation, so that this "non-surgical operation" can achieve satisfactory results.
After being diagnosed as the indication of laparoscopic surgery by gynecologists, we should pay attention to personal hygiene, clean the umbilical region with warm water, and it is best to dip a cotton swab in soapy water or vegetable oil to remove the dirt in the umbilical hole. In terms of diet, the day before operation is mainly light and digestible food to avoid big fish and big meat and prevent flatulence after operation. At the same time, we should be mentally prepared, adjust our mental state and ensure adequate sleep. Take sedatives orally according to the doctor's advice if necessary.
Laparoscopic surgery should pay attention to consolidate the surgical effect, restore physical strength as soon as possible, and do the following:
First, within 6 hours after operation, take off the pillow and tilt your head to one side to prevent vomit from being inhaled into the trachea;
Second, because most patients have no pain after operation, don't neglect to massage the patient's waist and legs, and turn over for the patient every half hour to promote blood circulation and prevent bedsores;
Third, the catheter can be pulled out after transfusion on the same day to encourage patients to get out of bed;
Four, six hours after surgery, patients can eat a small amount of liquid diet, such as thin rice soup, noodle soup and so on. Do not give patients sweet milk, soy milk powder and other sugary drinks;
Five, laparoscopic surgery incision is only 1 cm, so after a week, you can remove the abdominal dressing, you can take a bath, and then you can gradually return to normal activities. A week ago, you should pay attention to proper light activities to make your body recover as soon as possible.
Questions and answers of gynecological laparoscopic minimally invasive surgery
1. What diseases can gynecological abdominal minimally invasive surgery treat?
Diagnose various difficult diseases, such as acute abdominal pain, chronic pelvic pain, uterine perforation, infertility, dysmenorrhea, etc.
Treatment: various types of ectopic pregnancy, conservative treatment of ectopic pregnancy (tubal reservation), pelvic adhesion, endometriosis, ovarian endometriosis cyst, ovarian benign teratoma, ovarian cyst, hysteromyoma, various pelvic tumors, tubal sterilization and tubal recanalization.
Second, can one operation treat gynecological diseases and gallstones at the same time?
If the patient has gynecological diseases (such as hysteromyoma, ovarian cyst, ectopic pregnancy, etc. ) and also suffering from cholecystolithiasis and cholecystitis, the traditional surgery is cholecystectomy and hospitalization for 7~ 10 days, followed by gynecological surgery for 2~3 months, hospitalization for 10~ 15 days, two hospitalizations, two anesthesia and two operations. If you do laparoscopic minimally invasive gynecological and surgical operations, you only need to stay in hospital once, for about 3-5 days, and anesthetize once, so you can remove gallbladder and gynecological pelvic tumors at the same time. You can move to the field within 24 hours, eat early, and recover quickly after operation.
Third, can the operation of "drilling" be thorough?
Some patients worry that "drilling" surgery is not as intuitive and reliable as open surgery, but this is not the case. Laparoscopic surgery is more convenient and reliable by improving surgical methods and instruments. Laparoscopic surgery has clearer vision, more detailed operation and less possibility of complications. At present, the United States, Singapore and other countries have enacted laws, and it is considered illegal for doctors not to use "drilling" surgery first, which increases the pain of patients.
4. Can obese patients do laparoscopic surgery to treat gynecological diseases?
Obese patients are more suitable for laparoscopic surgery. Obese patients undergoing open surgery, because the incision is large and deep, subcutaneous fat is easy to liquefy, so it is easy to cause postoperative incision infection, incision hernia and so on. In addition, the respiratory function of obese patients is significantly lower than that of normal weight patients, and postoperative complications such as pulmonary infection and atelectasis are also significantly higher than that of normal weight patients. If laparoscopic surgery is performed, there is no difference between obese patients and normal weight people in wound size, operation time, physical injury and postoperative complications. The incidence of complications such as incision infection and lung infection in laparoscopic surgery is lower than that in open surgery. Therefore, obese patients are more suitable for laparoscopic surgery.
5. How to take out larger pelvic tumors (such as hysteromyoma and intra-column cyst) from the small mouth?
Some patients asked: How to take out gynecological tumors, such as hysteromyoma and ovarian cyst, from the small incision of abdominal wall? If you see ectopic pregnancy, remove the fallopian tube, which can be easily taken out directly from the small mouth when you remove it. If you see ovarian cystic tumor, you can use a slender puncture needle to suck out the fluid in the cyst to shrink the tumor and take it out from the small opening of the abdominal wall. If it is a large solid tumor, such as hysteromyoma, the tumor can be cut into strips with special equipment first, and then taken out through a small incision in the abdominal wall. All the above specimens should be put into the specimen bag in advance and taken out from the small opening of the abdominal wall. The whole tumor can also be removed from the vagina. When the large tumor was removed, there was no big scar on the abdominal wall, only 3-4 small openings (0.5~ 1cm), and there was no surgical trace after healing.
6. Can laparoscopic treatment of ectopic pregnancy preserve fallopian tubes?
For tubal pregnancy, the diameter of the pregnancy mass
7. Can I get pregnant again after laparoscopic surgery with fallopian tubes preserved?
Yes Many data prove that there is no difference in pregnancy rate between tubal plastic surgery and salpingectomy without other infertility factors.
Eight, laparoscopic ovarian cyst resection can preserve the ovulation function of the affected ovary?
Yes Patients with ovarian cyst can peel off the cyst according to the condition and keep some normal ovaries. Preserve the endocrine function of ovary, and do not affect ovulation.
9. Can patients with polycystic ovary syndrome be treated by laparoscopy?
Yes Polycystic ovary syndrome is a complex syndrome caused by abnormal hormone secretion and regulation among hypothalamus, pituitary and ovary. Its characteristic is that the patient's ovary does not ovulate. Clinically, there are symptoms such as menstrual disorder, obesity, hirsutism and bilateral ovarian enlargement. Traditional surgical treatments are open surgery and wedge ovariectomy. Laparoscopic treatment of polycystic ovary syndrome can restore ovulation function in 90% patients, and the pregnancy rate after operation can reach 70%, and the operation is simple with less pelvic adhesion after operation. At present, laparoscopic treatment of polycystic ovary syndrome has replaced open ovarian wedge resection.
X can laparoscopy treat pelvic inflammatory disease and pelvic abscess?
Yes In the surgical exploration of laparotomy for pelvic inflammatory disease, most people think that inflammatory tissue is edema, tissue fragility is increased, tissue is easy to tear, tissue is congested, capillaries are easy to bleed, hemostasis is not ideal, and blood transfusion is often needed during operation. Because of infection spread and incision infection after operation, the dosage of antibiotics is large. However, laparoscopy is minimally invasive, does not require blood transfusion, and uses less drugs after operation. It is a method with little injury and good diagnosis and treatment effect, and can be used for the diagnosis and treatment of pelvic inflammatory disease and pelvic mass.
XI。 What kind of patients can laparoscopy treat?
No serious cardiovascular disease, no cardiopulmonary insufficiency, no middle and late pregnancy, no coagulation dysfunction and blood diseases can all be treated by laparoscopy.
Laparoscopic ovarian cyst resection is less painful and faster to recover. Its main purpose is to replace abdominal ovarian cyst resection as far as possible in a safe range, and to help overcome the shortcomings of open surgery. As a new type of operation, laparoscopic surgery is not clear to some people. Medical staff should introduce its advantages to patients in order to eliminate their fears and better cooperate with the operation.
3. 1 before operation, it is particularly important to do a good job of skin preparation and clean the navel. Wipe off the dirt on the navel, and move lightly to prevent skin damage and infection on the navel.
3.2 Before bowel preparation, eat liquid food at night, take 250ml of 20% mannitol orally, and enema with fasting water and soapy water 65438 0 times in the morning of operation.
3.3 General nursing patients lie flat for 6 hours after returning to the ward after operation, take routine oxygen inhalation, closely observe vital signs, measure vital signs 1 ~ 2 hours, and pay attention to whether there is blood leakage at the puncture site.
3.4 Diet management: After 6 hours of operation, you can eat liquid food, but don't eat foods that are easy to produce gas, such as milk and beans. The next day, you can change to semi-liquid food and go to the fields for activities, and then change to general food after the intestinal function is fully restored.
3.5 Nursing of Vomiting Some patients vomited after returning to the ward, which may be caused by stomach discomfort caused by anesthesia and fasting. Take a deep breath if it is light, and give metoclopramide intramuscular injection if it is heavy.
3.6 Nursing of urinary catheter Observe whether the urinary catheter is unobstructed, the color and quantity of urine, do a good job in perineal care and keep the vulva clean.
3.7 Care of Pain There is slight pain at the puncture site after operation, and there is no need to use analgesic. However, some patients complained of shoulder pain and discomfort, which was caused by the stimulation of diaphragm by residual carbon dioxide gas in carbon dioxide pneumoperitoneum during laparoscopic surgery. By promoting the absorption of carbon dioxide through oxygen inhalation, the symptoms will gradually disappear, so the patient is very clear and does not need special treatment.
For patients, physical weakness, whether major or minor surgery, will greatly damage the vitality of the body. People after operation want to recover quickly