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Laparoscopy, Here's What You Need to Know

Laparoscopy or keyhole surgery is a minimally invasive surgical procedure performed by making a small incision in the abdominal wall. Laparoscopy is done with the help of a thin tube-shaped device called a laparoscope. This tool is equipped with a camera and light on the end. Laparoscopic procedures are performed for diagnostic or treatment purposes. Through this method, the doctor will be able to see a number of abnormalities, such as infections, cysts, fibroids, and adhesions, in the abdominal or pelvic organs. In addition, this procedure can also be applied for the purpose of tissue sampling in a biopsy examination.

Laparoscopic Indications

The doctor will consider laparoscopy with the aim of including:
  • Examine or treat tumor growth in the abdomen or pelvis.
  • Treating endometriosis, ectopic pregnancy, or pelvic inflammatory disease.
  • Look for the cause of the appearance of pain in the pelvis.
  • Taking tissue samples for biopsy examination.
  • Perform tubal ligation (surgery on the fallopian tube).
  • Treating hiatal hernias or inguinal hernias.
  • Check for possible cysts, adhesions, fibroids, or infections in the reproductive organs that make a woman difficult to get pregnant.
  • Removing problematic organs such as the uterus, spleen, gallbladder, ovaries, or appendicitis.

Laparoscopic Warning

Before undergoing laparoscopic surgery, the doctor will ask about your medical history and examine the patient's physical condition. Patients are advised to tell their doctor if they have a drug allergy, have bleeding problems, are taking blood-thinning medications (such as aspirin and warfarin), or are pregnant. Laparoscopy is not recommended if the patient has cancer or a hernia in the abdomen, or has had surgery in that section, because it is very risky. Patients are obliged to follow instructions given by the doctor regarding when to fast before the laparoscopy, as well as medication consumption schedule.

Laparoscopy preparation

Laparoscopy is performed by a surgeon with the help of an anesthetist. One hour before surgery, the patient will be asked to urinate to empty the bladder. Fluid intake and sedatives (sedatives) will be given through an IV that is injected into a vein in the arm. The doctor will take the patient's blood as a sample. Some other tests may be done, such as an electrocardiogram (EKG), X-ray images, examination of lung function, and others. The type of test performed will be adjusted to the patient's age and health condition when he will be operated on. Anesthetist will anesthetize the patient with an injection to fall asleep. There are several procedures performed by the doctor after the patient is anesthetized, including:
  • Trim pubic hair.
  • Clean the abdomen with a special antisepic solution.
  • Installing breathing apparatus through the throat.
  • The catheter may also be inserted into the bladder through the urethra (urethra).
  • In female patients, the doctor will first perform a pelvic examination before inserting a thin tube called a cannula into the uterus through the vagina. The cannula is used to move or shift the uterus and bladder, so as not to obstruct the field of view into the abdominal cavity at the time of examination.

Laparoscopic Procedure

Laparoscopic surgery begins by making a small incision (about 5-10 mm) in the abdominal wall as a way to enter the laparoscope. The doctor can make more than one incision to insert another instrument into the stomach. This procedure generally lasts for 30-90 minutes, depending on the patient's condition. After the incision is made, the doctor will insert gas into the stomach with the help of a medical device such as a needle that has a cavity in the middle. This gas is used to pump the abdominal wall up and away from the organs in it, so the doctor can see the contents of the stomach clearly. After that, the doctor will use the laparoscope and some other medical equipment to repair the damage, take a tissue sample, or to remove the tumor and cyst. Sometimes, the laser is also often attached with a laparoscope to support surgery. After the operation is complete, the laparoscopic device is pulled out and the gas that was pumped will be removed from the stomach. The incision made at the beginning of the procedure will also be closed with stitches, then wrapped in a bandage. This incision leaves very small marks, and will disappear by itself over time.

After Laparoscopy

After surgery, patients will undergo a short recovery period in the ward for two to four hours. The doctor will check the patient's blood pressure, body temperature, oxygen levels, and heart rhythm. If the condition is stable and safe, the patient is allowed to go home and move as before. To speed up wound healing, patients are advised to avoid strenuous activities for a week after surgery.

Laparoscopic Side Effects

Although laparoscopy is relatively safe, this procedure still has side effects. About 1-2 percent of patients who undergo laparoscopy experience minor complications such as infection, nausea, vomiting and bruising. In addition, there are also several other complications that can occur after undergoing laparoscopic surgery:
  • Damage to large arteries.
  • Serious allergic reaction due to anesthesia.
  • Clots in blood vessels.
  • Damage to organs, such as the intestine or bladder.
  • The entry of carbon dioxide into blood vessels as a side effect of the use of gas.

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