Laparoscopy is a method of visual examination of the abdominal and pelvic organs using a miniature video camera-laparoscope, which is inserted inside through a small puncture of soft tissue.
Our expert in this field:
Allahverdyan Alexander Sergeevich
Surgeon-oncologist, professor, MD. Head of the ROH expert group. International expert
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Diagnostic laparoscopy is a minimally invasive examination method. At the same time, it provides significant advantages, since the doctor can visually examine the internal organs and examine them in detail.
In some cases, visual examination of organs through laparoscopy provides more valuable information than x-rays, ultrasound, CT or MRI. The laparoscope video camera has a high resolution; the image from it is transmitted to the monitor and can be enlarged many times. This makes it possible to detect tumors of the smallest size at an early stage of the development of cancer.
What organs can be examined by laparoscopy?
Diagnostic laparoscopy is used to examine the abdominal organs, as well as in gynecology, to examine the pelvic organs and female reproductive system.
In recent decades, the use of this method has become increasingly widespread. Doctors are fully appreciating its benefits and are using it more and more often.
At the international clinic Medica24, laparoscopy is used to examine:
- liver,
- gallbladder,
- stomach,
- spleen,
- intestinal loops,
- greater omentum,
- diaphragm,
- Bladder,
- fallopian tubes,
- uterus,
- ovaries.
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However, the possibilities of operative laparoscopy are limited. Performing major reconstructive operations is possible only during transection. The effectiveness of infertility treatment after such operations is very low.
Advantages
Diagnostic laparoscopy is actively used in the international clinic Medica24 due to its advantages:
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During laparoscopy, the doctor can not only examine the internal organs in detail, but also take a tissue sample from a suspicious area or tumor.
The procedure for collecting a tissue sample is called a biopsy, and the tissue sample itself is called a biopsy. After receiving the biopsy, it is sent for histological examination. In the laboratory of the international clinic Medica24, a doctor examines the cellular structure of tissue under a microscope.
This allows us to make an unambiguous conclusion about the benign or malignant nature of the neoplasm.
In the second case, histological examination shows the degree of malignancy of the tumor (differentiation of cancer cells), its type. This is invaluable for choosing treatment tactics for cancer.
During a histological examination of a biopsy obtained during pelvic laparoscopy, the doctor examines the sensitivity of the tumor to hormones (estrogens, progesterone), as well as the presence of HER2 protein receptors. Sensitivity to various chemotherapy drugs is studied. The tactics of chemotherapy, immunotherapy, targeted therapy, and the decision to use certain drugs depend on this.
The risk of relapse after removal of the tumor, and therefore the extent of surgical intervention, depends on the degree of malignancy of the tumor (differentiation of tumor cells).
Thus, diagnostic laparoscopy is not only a visual examination of the internal organs of the abdominal cavity and pelvis, but also a way of taking tissue samples (biopsies), examining them and obtaining information that cannot be obtained by any other means.
Minimal invasiveness
The laparoscope and biopsy instruments are inserted into the abdominal cavity or pelvic area through small punctures. The procedure does not require incisions like open surgery. After it there are no scars left, there is no need for stitches.
The traumatic effect on soft tissues during diagnostic laparoscopy is minimal. Therefore, it does not produce side effects, complications and is highly safe.
Fast rehabilitation
After laparoscopy, a long rehabilitation period is not required, which also distinguishes it favorably from open surgical interventions.
In general, laparoscopy helps the doctor obtain maximum diagnostic information with minimal surgical intervention. This determines its widespread use in the diagnosis of cancer and other diseases.
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Possible consequences
The likelihood of complications with minimally invasive interventions is extremely low - 1-3 per 1000 cases. The risk group consists of women with a high body mass index, concomitant diseases, and a history of surgery on the pelvic organs.
Most often, intervention leads to the following consequences:
- allergic reaction to painkillers;
- re-development of the underlying disease;
- damage to nearby organs;
- bleeding;
- thromboembolism.
During the recovery period, infection and poor healing of wounds, divergence of postoperative sutures are possible. To minimize the likelihood of complications, you need to strictly follow your doctor’s recommendations. In Moscow, in paid clinics, such a minimally invasive intervention for diagnostic purposes can be done for 40,000 - 60,000 rubles. As complexity increases, the cost increases.
Indications
Diagnostic laparoscopy at the international clinic Medica24 is performed for:
- suspected internal bleeding in the abdominal cavity or pelvic area,
- ascites,
- benign or malignant neoplasms of the abdominal cavity and pelvic organs,
- jaundice of unknown cause,
- pain in the abdomen, pelvic area, when their cause is unknown,
- infertility, obstruction of the fallopian tubes,
- endometriosis,
- ectopic pregnancy or suspicion of it,
- adnexitis, oophoritis,
- uterine fibroids,
- ovarian cysts,
- pancreatitis,
- suspected appendicitis, peritonitis,
- closed abdominal injuries.
What does the doctor see during laparoscopy?
Using a visual examination with a video camera, the doctor can:
- detect the presence of fluid in the abdominal cavity and find out the cause of its accumulation,
- examine defects in the walls of hollow organs,
- detect even the smallest tumors at the initial stage of formation,
- find out the cause of fallopian tube obstruction, infertility,
- detect rupture, torsion of the ovarian cyst and other acute conditions requiring emergency intervention,
- investigate inflammatory processes in the pelvic area and abdominal cavity, differentiate them from tumor diseases.
The capabilities of visual examination in some cases significantly exceed the capabilities of ultrasound and other hardware diagnostic methods (CT, MRI).
Progress of the operation
A woman may undergo surgery to remove adhesions in the fallopian tubes or dissection of adhesions in the area of the uterus, ovaries, and rectum. Before the intervention begins, the woman is given endotracheal general anesthesia. After the patient has fallen asleep, three incisions up to 2 cm long are made in the navel and bikini area. Through these holes, the doctor inserts instruments to manipulate the camera, air supply, and lighting. An inert gas is injected into the lumen of the pelvic cavity to lift the anterior abdominal wall and make work more comfortable. The surgeon examines the cavity, determines the presence of adhesions, grabs them with an instrument under the control of a video camera and carries out dissection and removal. Vessels damaged during the operation are cauterized with an electrocoagulator. After cutting the adhesions, the devices are removed from the punctures, sutures are placed on the incisions, processed and covered with a bandage.
How is the procedure performed?
Diagnostic laparoscopy at the international clinic Medica24 is performed under local anesthesia in combination with sedation or general anesthesia.
When examining the abdominal cavity, a small puncture is made in the navel area, through which a cannula is inserted and carbon dioxide or nitrous oxide is injected. The gas lifts and expands the walls, filling the abdominal cavity for a better visual overview.
After this, a miniature video camera with illumination on a flexible fiber-optic cable is inserted into the abdominal cavity. With its help, the doctor examines the internal organs in detail.
If it is necessary to take samples of tumor tissue, additional punctures are made through which instruments are inserted. With their help, the doctor performs a biopsy.
As a rule, the procedure takes no more than 40 minutes. Upon completion, the gas is removed from the abdominal cavity, and a bandage is applied to the punctures.
Laparoscopy of the pelvic area for gynecological diseases is not fundamentally different from the examination of the abdominal organs.
Laparoscopic hysterectomy: price in Moscow
Our clinic’s specialists have more than 18 years of successful experience in performing operations of this type. Thanks to highly qualified surgeons and many years of practice, we help our patients cure even the most complex and advanced stages of gynecological diseases.
The price of laparoscopic hysterectomy depends on the specific individual case. To find out the current cost of surgical treatment in our clinic, visit the “Prices and Promotions” section of the website or call.
Preparation
Diagnostic laparoscopy is a minimally traumatic examination method. And yet, it requires short-term hospitalization in the hospital of the international clinic Medica24, where all conditions have been created to ensure that the stay is as comfortable as possible.
During laparoscopy, large incisions are not made as in open surgical interventions, however, before it is carried out, a mandatory set of examinations is performed:
- General blood analysis.
- Blood test for coagulation (coagulogram).
- Tests for HIV, syphilis, hepatitis B, C.
- General urine analysis.
- Ultrasound of the pelvis.
- ECG (electrocardiography).
- Fluorography (x-ray of the lungs).
Laparoscopy is performed on an empty stomach. For 8 - 10 hours you need to stop eating and smoking. If you are taking blood thinning medications, you should stop taking them 2 weeks before the procedure.
In 2 - 3 days you need to go on a diet, eliminate the consumption of foods that provoke gas formation (legumes, yeast bread, cabbage, raw vegetables and fruits, etc.).
If laparoscopy is scheduled for the morning, a light dinner is allowed the night before. You can't have breakfast. Before the procedure, as a rule, a cleansing enema is performed.
Postoperative period
The recovery period after the intervention is not long. If there are no complications or complaints, the patient goes home the next day; pain and discomfort in the abdominal area disappear within 3-4 days after the intervention. Full recovery takes up to 4-6 weeks. During this time, a diet is needed to prevent gas formation and intestinal overload, limiting exercise, a temporary ban on intimate life, visiting a sauna, bathhouse.
After surgery, the sutures are treated with antiseptics for 6-7 days, then they are completely tightened. As they recover, they become almost invisible.
After the procedure
Laparoscopy is a minimally invasive diagnostic procedure. After the anesthesia or anesthesia wears off, within a few hours you can get up and walk, and you are allowed to eat.
For the first day or two days, it is advisable to stay in the hospital of the international clinic Medica24, where impeccable medical care and medical supervision will be provided.
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Contraindications
Diagnostic laparoscopy is not performed for:
- the presence of adhesions in the abdominal cavity,
- extensive blood loss and hemorrhagic shock,
- liver or kidney failure,
- decompensated conditions in cardiovascular diseases,
- acute respiratory failure,
- intestinal colic,
- bloating,
- diffuse peritonitis,
- large fibroids,
- acute infectious diseases,
- obesity 4 degrees,
- as well as in the 2nd - 3rd trimesters of pregnancy (for periods greater than 16 weeks).
The material was prepared by oncologist, chief surgeon of the international clinic Medica24, Konstantin Yuryevich Ryabov.
