The use of the adhesion barrier 4DryField® PH significantly reduces the formation of adhesions, their extension and their severity after endometriosis surgery.
La gynecological laparoscopic surgery, Commonly known as laparoscopyIs a minimally invasive surgical technique since it allows the patient to intervene without having to open the abdomen by making small incisions.
It is currently being used in many pathologies such as cancer or for the extraction of cysts and myomas. Also performed with this technique hysterectomy, surgery of the endometriosis And, in fact, practically any gynecological surgery can be performed using this type of approach. In all cases, during the intervention, general anesthesia is applied to the patient.
Basically the procedure consists of injecting carbon dioxide to raise the abdominal wall and thus create a greater space to work. This makes it easier for the surgeon to visualize and work with the organs.
The laparoscope (a tube with a small television bed at the end) is then inserted so that the organs in the pelvis and abdomen can be examined. Additional small incisions may be needed.
Using carbon dioxide can cause shoulder pain for a few days by irritating the diaphragm, which shares some of the same nerves as the shoulder. Likewise, there may be an increase in the need to urinate, since the gas can put pressure on the bladder.
The main advantages for patients are that the 5 mm incisions are painless, leave very small scars and generate much less adhesion. Postoperative recoveries are much faster than in the case of laparotomy. In many interventions carried out with gynecological laparoscopic surgery the patient is discharged the same day that the intervention is performed
This technique of the laparoscopic surgery was first used in medicine by gynecologists and later it was gaining followers in other specialties, gallbladder extraction being one of the most common.
When video cameras were incorporated in the 80s, the use of this technique increased greatly, seeing the image on a monitor greatly facilitates the intervention and allows the surgeon's team to play an active role. Camera interventions can be recorded for later evaluation. Intensive use also led to the incorporation of new instruments together with the camera that allowed greater precision and made the surgery even less invasive.
When used to study the inside of the uterus, it is called hysteroscopy and allows examination of the endometrium to make an accurate diagnosis of a disease. Hysteroscopy detects polyps and fibroids that can be removed or taken biopsies according to the type of alteration.
Preparing for a gynecological laparoscopic surgery require the patient to be fasting and have ingested a laxative the day before to have an empty bowel and to get a better view of the pelvis. If the patient will undergo surgery where the vagina will be opened as in the case of hysterectomies, then antibiotics must also be used prior to surgery to avoid an ascending infection, that is, that goes from the vagina to the pelvis.
Advances in laparoscopic surgery
This field is constantly evolving and updating. Minimally invasive surgery makes postoperative recovery faster and with fewer complications than other types of surgery. In October 2020 I was able to know the JACK device which will possibly be used in the Hospital Clinic of Barcelona if it is approved, it constitutes an example of the novelties that occur in this field.
These techniques offer advantages for patients, but also for doctors who can operate with more precision and for hospitals that reduce the time of admission and therefore can operate on more patients and reduce waiting lists.
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Dr Francisco Carmona
Women's Medical Director