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Laparoscopic procedure

Released on May. 19, 2022

With the development of medical technology, at present, laparoscopy has become an indispensable means of examination and treatment of female infertility. Laparoscopic technique is a minimally invasive surgery, which allows doctors to clearly see the tissue and organs in the pelvic cavity and abdominal cavity, make a quick diagnosis, and perform necessary surgical treatment under laparoscopy.

Laparoscopic surgery mostly uses 2 to 4 holes, one of which is opened on the navel of the human body to avoid leaving long scars in the abdominal cavity of the patient. After recovery, only 1 to 3 holes of 0.5 to 1 are left in the abdominal cavity. The linear scar of centimeters can be said to be a small wound and less painful operation, so some people call it "keyhole" surgery. The development of laparoscopic surgery relieves the pain of the patient's surgery and shortens the patient's recovery period. It is a surgical project that has developed rapidly in recent years.

Laparoscopic procedure:

1. Artificial pneumoperitoneum

The skin was incised 1 cm at the lower edge of the umbilical wheel, and a pneumoperitoneum needle was inserted at a 45-degree angle from the incision. After the blood was withdrawn, a needle was inserted. If the normal saline flowed smoothly, the puncture was successful and the needle was in the abdominal cavity. Connect the CO2 inflator, the air intake speed should not exceed 1L/min, and the total amount should be 2-3L. The intra-abdominal pressure does not exceed 2.13KPa (16mmHg).

2, trocar puncture

The laparoscope needs to be inserted into the abdominal cavity from the cannula, so the trocar needs to be inserted first. The laparoscopic sleeve is thicker, and the incision should be 1.5cm. Lift the abdominal wall below the umbilicus, and slowly insert the trocar obliquely and then vertically into the abdominal cavity. When entering the abdominal cavity, there is a sense of breakthrough. Pull out the cannula core, and insert the laparoscope after hearing the gas rushing out of the abdominal cavity, turn on the light source, and adjust the patient. Position your head down to a 15-degree hip-high position and continue to inflate slowly.

3. Laparoscopic observation

The operator held a laparoscope and observed the uterus and various ligaments, ovaries and fallopian tubes, rectum and uterine depression with the eyepiece. During the observation, the assistant can move the uterus lifter to change the position of the uterus to cooperate with the examination. If necessary, suspicious lesions can be sent for pathological examination.

4. Take out the laparoscope

After checking that there is no internal bleeding and organ damage, the laparoscope can be taken out. After the gas in the abdominal cavity is exhausted, the cannula is removed, and the abdominal incision is sutured, covered with sterile gauze, and fixed with adhesive tape.

5. Post-processing of laparoscopy:

(1) Antibiotics should be given to prevent infection;

(2) Although the gas has been exhausted before the abdominal incision is sutured, there may still be residual gas in the abdominal cavity, causing shoulder pain and epigastric discomfort, which are usually not serious and do not require special treatment.

Laparoscopic direct vision can perform tubal drainage, with a large amount of fluid and good dredging effect; at the same time, an ostomy can be performed in the fimbriae of the fallopian tube to eliminate hydrops, adhesions, and pelvic adhesions and separation, and perform ovarian chocolate cyst peeling. Excision surgery and polycystic ovary perforation can minimize various injuries caused by other surgeries, with short hospital stay, safe surgery and quick recovery. In the modern field it is known as "quality of life-saving surgery".