Tuesday, March 19, 2013

Laparoscopy

Laparoscopy is a way of performing a surgery. Instead of making a large incision(or cut) for certain operations, surgeons make tiny incisions and insert tiny instruments and a camera into a site, such as into the abdomen, to view the internal organs and repair or remove tissue. 
Laparoscopy operations performed for :

Prior to the Surgery
Do not eat or drink anything after 12:00 midnight the night before surgery.
Do not smoke or chew gum after 12:00 midnight.
If you are currently taking medication, ask you doctor if you should stop taking it.
You may be asked to use an enema several hours before or the day before the surgery to empty your colon.
Patient must shower or bathe the night prior to surgery.
Nail polish, make-up and jewelry should be removed the night before surgery.
Remove your glasses, contacts, and dentures or a removable bridge before the laparoscopy.
Arrange for someone to drive you home after the laparoscopy.
Wear loose-fitting clothes to prevent any unnecessary pressure on the umbilicus on the day of surgery.

During the surgery
General anesthesia is generally used, but other types of anesthesia, such as spinal anesthesia, may be used. Talk with your doctor about what choice is best for you.
About an hour before the surgery, you will empty your bladder. You will get fluids and medicine through an intravenous (IV) in a vein in your arm. You may get a medicine (sedative) to help you relax.
Several procedures may be done after you get your anesthesia and are relaxed or asleep.
  • An airway will be placed in your throat to help you breathe if you get general anesthesia.
  • A thin flexible tube (urinary catheter) may be put through your urethra into the bladder.
  • Some of your pubic hair may be shaved.
  • Your belly and pelvic area will be washed with a special soap.
  • For women, your doctor may do a pelvic exam before putting a thin tube (cannula) through your vagina into the uterus. The cannula lets your doctor move your uterus and ovaries to get a better look at the belly organs.
During laparoscopy, a small incision is made in the belly. More than one incision may be made if other tools will be used during the surgery. A hollow needle is put through the first incision and gas (carbon dioxide or nitrous oxide) is slowly put through the needle to inflate the belly. The gas lifts the abdominal wall away from the organs inside so your doctor can see clearly.
A thin, lighted tube (laparoscope) is then put through the incision to look at the organs. Other tools can be used to take tissue samples, fix damage, or drain cysts. A laser may be attached to the laparoscope to help with the surgery.
After the surgery, all the tools will be removed and the gas will be released. The incisions will be closed with stitches and covered with a bandage.  Very small incisions may not require stitches, just small strips of sterile tape.The scar will be very small and will fade over time.
Laparoscopy takes 30 to 90 minutes, depending on what is done, but can take longer if a condition (such as endometriosis) is found and treated. After the laparoscopy, you will go to the recovery room for 2 to 4 hours. 
After the surgery
  • Some pain or throbbing is possible where the small cuts were made. The doctor may recommend a prescription or over-the-counter pain reliever.
  • If stitches were used, a follow-up appointment for removal of stitches may be scheduled in a week or two as directed.
  • Sometimes the carbon dioxide gas can trigger shoulder pain after the procedure. Some of the same nerves that reach the shoulder are present in the abdomen. The pain goes away over time.
  • Pressure from the gas may cause a sensation of needing to urinate more often and more urgently. This sensation goes away over time.
  • The doctor will determine when eating and drinking can be resumed.
  •  Do not drink carbonated beverages for 1 to 2 days after the laparoscopy to lower your chance of gas pains and vomiting.
  • You will be encouraged to get out of bed and walk, starting the first day after the operation. The more you move the less chance for complications such as pneumonia or the formation of blood clots in your leg veins.
  • You may experience a sore throat. This is caused by irritation from a tube placed in your throat (trachea) during anesthesia. It usually lasts for just a few days and can sometimes be helped by throat lozenges.
After you are able to empty your bladder, you will be allowed to go home. Someone else should drive.If additional medications are required, you will be given prescriptions to take with you. If you are unable to empty your bladder or nausea is severe, a 23 hour hospital stay over night may be considered.

Care After Your Surgery At Home
You may have drainage from the incisions for a day or two. It will be watery and pink-tinged. You may go without dressings 48 hours after surgery if you so desire. You may want to cover your incisions with a light dressing to protect your clothes or to prevent your clothing from rubbing on your incisions. If you have had a microlaparoscopy no sutures will be used and bandaids can be removed the next morning.
Diet
 In general, you must consume only clear liquids (juices, Jello, or both) until you pass gas from you rectum or have a bowel movement. At this time, you may begin to advance your diet. Eat light, easily digested food for a few days.
Activity
You will be encouraged to steadily increase your activity once you are home. Walking is great exercise! Walking will help your general recovery by strengthening your muscles, keeping your blood circulating to prevent blood clots, and helping your lungs stay clear.
Gas Pains
You may experience some gas pains from residual carbon dioxide that may remain in your abdomen following the procedure. This pain usually presents as shoulder pain or sharp pain underneath your diaphragm. The pain is usually transient and will disappear in a day or two. It helps if you get up and move around while you are having this pain, and also if you drink either hot water or hot tea with fresh lemon. Heat, massage and exercise can also help to alleviate this pain.
Infection
If you note increasing redness, swelling, pain or unusual drainage from your incisions, please call our office. If you experience frequent urination, burning with urination, or spasmodic pain in the lower abdomen above the pubic bone, you may have a bladder infection. Please notify our office if you have any of these symptoms.
Sexual activity
Sexual activity may be resumed approximately two to three days following surgery unless you are told otherwise. However, if you have any pain, vaginal bleeding, or discharge, please do not resume sexual intercourse until these symptoms have subsided.

Advantages
  • Reduced hemorrhaging, which reduces the chance of needing a blood transfusion.
  • Smaller incision, which reduces pain and shortens recovery time, as well as resulting in less post-operative scarring.
  • Less pain, leading to less pain medication needed.
  • Although procedure times are usually slightly longer, hospital stay is less, and often with a same day discharge which leads to a faster return to everyday living.
  • Reduced exposure of internal organs to possible external contaminants thereby reduced risk of acquiring infections.
Risks
Bleeding in the abdomen is also possible. Scars may develop. Anesthesia during surgery can cause heart attackstroke, and pneumonia, but these consequences are rare.
During laparoscopy, the following risks exist:
  • The surgeon may puncture an organ. This could cause bleeding. If the colon is ruptured, its contents may spill into the abdomen.
  • Scar tissue from previous operations could present a problem for the trocars to be inserted into the abdomen. Scar tissue could prevent the gas from expanding the abdomen.
If complications develop or are found, the surgeon may decide to proceed with a larger incision and a standard surgery rather than laparoscopy. This is a decision made with a patient's safety in mind.



For more informations,check these links
http://www.webmd.com/digestive-disorders/laparoscopy-16156
http://www.emedicinehealth.com/laparoscopy/article_em.htm
http://www.ivf.com/laprscpy.html