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Diagnostic and surgical laparoscopy

Diagnostic and operative laparoscopy is a minimally invasive surgical technique that allows the visualization of the abdominal cavity and the organs found in it, the observation of possible anomalies in same and in the best of cases, correct them. In the case of female fertility, laparoscopy will allow the doctor to diagnose complications in her reproductive organs.

The goal of a laparoscopy is to diagnose and solve any problem that is detected during the procedure.

The main indications of this technique in gynecology are:

  • The study of infertility
  • The diagnosis of uterine malformations
  • Chronic pelvic pain
  • Tubal ligation and recanalization
  • Endometriosis
  • Ectopic pregnancy
  • Management of ovarian and oophorectomy cysts
  • Handling of tubal and salpingectomy abnormalities
  • Ovarian drilling
  • Myomectomy and hysterectomy

The procedure is usually performed in a hospital or outpatient surgical center using general anesthesia. The procedure is carried out as follows:

  • The surgeon makes an incision at the navel.
  • A needle is inserted into the incision. Carbon dioxide is then passed into the abdomen through the needle or the probe. The gas helps expand the area, giving the surgeon more room to work and helping the physician see the organs more clearly.
  • A tube is placed through the incision in the abdomen. A camcorder is passed (laparoscopy camera) and the abdominal cavity and pelvis are observed. More small incisions can be made in different locations that allow for better visualization and manipulation of the affected organs. In the case of gynecology, these incisions are usually on the side of the abdomen, both on the right and left side.
  • If a gynecological laparoscopy or fertility study is performed, a dye can be injected through the cervix to identify the Fallopian tubes and their permeability.
  • After the study, the gas, laparoscopy equipment and instruments are extracted, and the incisions are closed.
  • Before the procedure, it is important to fast 8 hours with no food or drink.
  • It may be necessary to suspend any medication prior to the procedure such as the use of aspirin or anticoagulants, as well as medications to be ingested on the day of surgery. The treating physician and anesthesiologist will inform the patient which of these should be suspended.
  • The doctor may make other recommendations such as no smoking or drinking alcohol, following a special diet days before surgery, etc.

There is a risk of infection. For this reason, a prophylactic antibiotic (prevention) is used 30 minutes prior to the procedure, which will be administered intravenously and thus prevent complication.

There is a risk of organ injury. This may mean damage to the bladder, intestines, or a blood vessel that may require immediate change of procedure to surgery (laparotomy). It depends to a great extent on the surgeon’s experience, the history of previous surgeries and the diagnosis for which the procedure is performed. However, this type of complication is not frequent and occurs in about 1 in every 500 to 5000 surgeries, depending on the complication.

A diagnostic laparoscopy may not be possible if the bowel is swollen or has fluid in the abdomen (ascites), or if the patient has had surgery in the past.

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