How should laparoscopic surgery be performed?

The examination and treatment of pelvic and ovarian diseases in female friends often require the use of laparoscopy, and laparoscopic surgery also plays a very important role in the treatment of ovarian diseases. Laparoscopic surgery is also a minimally invasive surgery and causes little harm to patients.

Steps/Methods

1: Artificial pneumoperitoneum: Make a 1 cm skin incision at the lower edge of the umbilicus, insert the pneumoperitoneum needle at 45 degrees through the incision, and connect a needle tube after aspirating no blood. If normal saline flows in smoothly, it means that the puncture is successful and the needle is in the abdominal cavity. Connect to 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 method is shown in the abdominal puncture section of this chapter. The laparoscope cannula is thicker and the incision should be 1.5 cm. Lift the abdominal wall below the navel and slowly insert the trocar into the abdominal cavity first obliquely and then vertically. There will be a breakthrough feeling when entering the abdominal cavity. Pull out the trocar core, insert the laparoscope after hearing the sound of gas rushing out of the abdominal cavity, turn on the light, adjust the patient's position to a 15-degree head-low-hips-high position, and continue to slowly inflate.

3: Laparoscopic observation The surgeon holds the laparoscope and uses the eyepiece to observe the uterus and its ligaments, ovaries and fallopian tubes, and the rectouterine pouch. During observation, the assistant can move the uterine manipulator to change the position of the uterus to cooperate with the examination. If necessary, tissue from suspicious lesions can be taken for pathological examination.

4: The laparoscope can be removed only after examination to confirm that there is no internal bleeding or organ damage. After the gas in the abdominal cavity is discharged, the cannula is removed, the abdominal incision is sutured, covered with sterile gauze, and fixed with adhesive tape.

5: Post-laparoscopic treatment: (1) Antibiotics should be given to prevent infection; (2) Although gas is exhausted before the abdominal incision is sutured, there may still be residual gas in the abdominal cavity, causing shoulder pain and upper abdominal discomfort, which is usually not serious and does not require special treatment.

Precautions

You can eat a small amount of liquid food, such as rice soup, noodle soup, etc. 6 hours after the operation. Do not give patients sweetened milk, soy milk powder or other sugary drinks;

The incision for laparoscopic surgery is only 1 cm, so the abdominal dressing can be removed after one week, and you can take a shower and then gradually resume normal activities. You should still pay attention to proper and light activities a week before the event to help your body recover as soon as possible.