Laparoscopy is the direct observation of the inside of the abdomen and performance of some operations, if necessary, thanks to the camera and light source placed in the abdomen from the navel level. Technically, open and closed methods can be used. In the closed method, the abdomen is first inflated with approximately 3000 ml of air, and then the instruments are placed. In the open method, a small incision is made in the navel and the camera is inserted through this incision. This method can be preferred to avoid organ injuries (bowel). It can be used for two purposes: identification (diagnostic) and surgery (operative).
For diagnostic purposes;
- To reveal the cause of a sudden onset (acute) or persistent (chronic) lower abdominal pain,
- To investigate the causes of infertility,
- To make the definitive diagnosis of congenital uterine anomalies.
For the purpose of surgery;
- Removal of various cysts in the ovaries,
- Evacuation of pregnancy or removal of the duct in ectopic pregnancy (tubal pregnancy),
- Destruction of foci in endometriosis, opening of adhesions, removal of chocolate cysts,
- Removal of fibroids that have grown out of the uterus,
- Removing the uterus and ovaries,
- For carrying out some female cancer surgeries (cervical and uterine cancer).
What are the advantages of laparoscopy over open surgery?
- There is no large incision in the patient’s abdomen.
- Post-operative pain is less.
- The stay in hospital and return time to work are very short. That is, the patient recovers very quickly.
- Compared to open surgeries, the possibility of adhesion formation in the abdomen after surgery is less.
When should laparoscopy not be performed?
- In bowel obstructions (mechanical or paralytic),
- In the presence of widespread infection in the abdomen (peritonitis),
- Diffuse bleeding into the abdomen,
- Severe heart and respiratory diseases,
- It should not be applied in cases where the membrane separating the abdominal and thoracic cavities has a hole (diaphragmatic hernia). It should be applied very carefully in overweight people, in cases where there are large masses in the abdomen and in the presence of pregnancy.
What kind of damage (complications) can occur in laparoscopy?
- Injury of the great vessels in the abdomen: It can be prevented by following the rules and being very careful while inserting the instruments. It is life threatening.
- Intestinal injuries: can occur both during the introduction of instruments and during the operation. If it is not noticed, it can become life-threatening.
- Urinary tract (ureter) and urinary bladder injury may occur. These can be easily repaired.