Operation of laparoscopy of the fallopian tubes

Pipes of the uterus are an important element of the female reproductive system, without which a childbearing function would be impossible. Unfortunately, the fallopian tubes, like any other organ, can also "get sick" - for example, they may be threatened with tubal obstruction, adhesions, endometriosis, tubal pregnancy, inflammatory processes, etc. To cure any of these problems, the doctor can prescribe therapeutic and diagnostic procedure, like laparoscopy of the fallopian tubes - is a minimally invasive operation that allows to eliminate the problem and simultaneously assess the overall condition of the pelvic organs.

Diagnostic laparoscopy of the fallopian tubes

The main reason for diagnostic laparoscopic examination of the fallopian tubes is infertility of unknown origin. Laparoscopy helps to find out the cause of infertility and to provide a refined diagnosis.

Sometimes the previously planned diagnostic laparoscopy in the course of surgery can become therapeutic and diagnostic: the surgeon assesses the situation and, if possible, solves the problem at one and the same time.

Diagnostic laparoscopy is more often performed in a planned manner: the procedure can be supplemented with hysteroscopy or vaginal intervention.

[1], [2], [3], [4], [5]

Indications for the procedure

Laparoscopy of the fallopian tubes can be prescribed for diagnostic purposes, for therapeutic and diagnostic purposes, or exclusively for emergency treatment - for example, with ectopic pregnancy.

• Laparoscopy of the adhesions of the fallopian tubes is one of the variants of electrocoagulation. After excision of adhesions in many cases it is possible to solve the problem of infertility. Adhesive process can be a consequence of inflammatory diseases, diseases that are transmitted sexually, or previous surgical interventions on the pelvic organs (for example, after removal of appendicitis).
• Laparoscopy in the obstruction of the fallopian tubes / restoration of patency of the fallopian tubes: laparoscopy in this context allows not only to determine the cause of obstruction, but also to eliminate it: the surgeon dissects spikes, cauterizes endometriosis sites, spreads the tubes. In advance, to investigate the degree of obstruction, the doctor introduces a special fluid that passes through the tubes into the abdominal cavity.
• Laparoscopy of the cyst of the fallopian tube is carried out with large dermoid or endometrioid cysts, with a high risk of rupturing or disturbing the shape of the ovary, with progressive growth of the cyst, or at a high risk of transformation of the cyst into a cancerous tumor.
• Laparoscopy of the fallopian tubes in ectopic pregnancy can be carried out in two ways: with the removal of the affected tube, or with partial resection of the tube. Unfortunately, the most common is the first option, as there is no guarantee that the next pregnancy will not again cause problems in the same tube.
• Laparoscopy of the fallopian tubes with hydrosalpinx - accumulation of fluid in the tubular cavity - allows to eliminate this problem. However, it is not possible to keep the tube in most of these cases: it is removed to avoid repeated episodes of hydrosalpinx.

[6], [7], [8], [9], [10], [11]

Preparation

It is impossible to count on a quality laparoscopy of the fallopian tubes, unless proper preliminary training is carried out. In many respects from this preparation the danger of development of complications and negative consequences depends.

Before going to the laparoscopic procedure, the patient should be fully examined - first of all, for the presence of contraindications, and also to treat all existing diseases, including chronic ones.

Preparation for laparoscopy is aimed at preventing further unpleasant consequences. In addition, it must be taken into account that anesthesia will be used during the operation, the use of which may also have contraindications.

Studies and analyzes for laparoscopy of the fallopian tubes include:

• general tests of urine and blood;
• blood test for HIV infection;
• blood clotting study;
• a blood test to clarify the group and rhesus attachment;
• X-ray or fluorography;
• cardiography.

In addition to the generally accepted list of studies, it is necessary to undergo an examination on the gynecological chair. The doctor will take a smear on the microflora, will conduct a cytological examination.

If the patient suffers from extragenital pathologies - for example, diabetes mellitus, thyroid disease, hypertension or asthma, it is necessary to get a doctor's opinion of a narrow specialization that will indicate the possibility of carrying out the operation in this particular case.

At the preparatory stage for laparoscopy of the fallopian tubes, the doctor should be informed of all medications the patient has taken recently, or is taking it at the moment. Special control is required for drugs that affect the processes of blood clotting (including aspirin), as well as drugs that lower blood pressure.

Preparation is usually performed immediately before laparoscopy, but not earlier than two weeks before the operation.

Enema before laparoscopy of the fallopian tubes, as a rule, is carried out twice: the evening before the operation, and in the morning.

One day before laparoscopy, it is necessary to exclude from the diet heavy for assimilation products, as well as beans, cabbage. Supper on the eve of laparoscopy should not, as well as drink any liquid. On the day of surgery, you can neither drink nor eat.

In the morning before the operation you need to go to the shower and shave the pubic area.

[12], [13], [14], [15], [16]

Technique of the laparoscopy of Fallopian tubes

Laparoscopy of the fallopian tubes is done using general anesthesia. The doctor spends three punctures (cut), approximately 10-20 mm each: they introduce special sterile instruments, depending on the type of laparoscopy.

One of the incisions will be made in the navel: through it, carbon dioxide will be introduced into the abdominal cavity, which will allow the walls of the organs and abdomen to expand to be convenient for viewing. The other two sections are necessary for the introduction of instrumentation and mini-cameras.

After the completion of all laparoscopic manipulations (diagnostic or therapeutic), the doctor will take out all the instruments and the mini-camera, and then apply seams.

How long does the laparoscopy of the fallopian tubes last?

Laparoscopic surgery does not always run the same amount of time: in light cases, laparoscopy can last about half an hour, on average - 40-50 minutes. In complex cases, the intervention can last one and a half and even two to three hours.

Laparoscopy of the fallopian tubes for anesthesia

Laparoscopy is always performed with general anesthesia.

General anesthesia implies complete inhibition of neuronal impulses in the brain and spinal cord: during laparoscopy, the patient loses reaction to all kinds of external and painful stimuli. Anesthesiologist controls blood pressure, pulse rate and other values by means of special sensors.

General anesthesia can be performed intravenously or by inhalation.

With intravenous anesthesia, special drugs are injected directly into the bloodstream, after which the patient is already in the first seconds immersed in sleep.

Inhalation anesthesia is performed using a mask or an intubation tube. What kind of anesthesia to apply, the anesthesiologist decides.

Removal of the uterine tube in laparoscopy

The removal of one or two tubes is also carried out using laparoscopy. Indications for such an operation are:

• ectopic pregnancy;
• chronic recurrent salpingitis or adnexitis;
• purulent inflammatory process ( pyosalpinx );
• hydrosalpinx;
• pronounced adhesion process;
• malignant tumors, myomatosis.

If the patient is removed one tube, and subsequently she still wants to have children, then the pregnancy can not be planned until 6 months after laparoscopy. Some women are recommended to withstand a longer period - one or two years. Removal of the uterine tube is a serious operation, after which the entire neuroendocrine system is reconstructed. Therefore, the body needs much more time to recover and stabilize.

Contraindications to the procedure

Assigning laparoscopy, the doctor takes into account the absence of contraindications, which can be:

• Oncology of the pelvic organs;
• acute failure of kidney or liver function;
• severe coronary or respiratory pathologies;
• hernia of diaphragm or epigastrium;
• coma;
• a state of severe exhaustion;
• impaired blood clotting.

Relative contraindications are:

• severe obesity;
• diabetes;
• the first days of menstruation;
• high blood pressure;
• the state of a viral or catarrhal disease.

[17], [18], [19], [20], [21]

Consequences after the procedure

The risk of negative consequences after laparoscopy of the fallopian tubes is minimal, but it can not be excluded altogether. For example, a woman should always consult a doctor if she:

• red edges of the wound;
• blood from the postoperative wounds or pus;
• I have a stomachache;
• the temperature rises;
• difficulty breathing, wheezing.

Do not worry if it comes to the physiological consequences after laparoscopy, for example, the violation of the monthly cycle or the appearance of secretions from the genital tract.

• Monthly after laparoscopy fallopian tubes most often occur in due time, which indicates normal performance of the ovaries. Immediately after laparoscopy, the appearance of mucous or bloody discharge from the genital cleft is possible - as a rule, such "smearing" continues for 2-3 weeks, after which it passes into full-fledged menstruation.
• Delay after laparoscopy of the fallopian tubes is allowed: from two to three days to two to three weeks. If the delay turned out to be longer, then it is necessary to visit a doctor.
• Allocations after laparoscopy of the fallopian tubes / spotting after laparoscopy of the fallopian tubes are usually worried until the next menstrual cycle. Such discharges are mild, ungrowth, and are mucous or bloody in nature - this is normal, especially if laparoscopy affected the ovaries.

[22], [23]

Complications after the procedure

Difficulties after laparoscopy of the fallopian tubes are relatively rare. Among them may be:

1. Injuries next to located tissues and organs.
2. Internal bleeding.
3. Postoperative inflammatory processes associated with untreated chronic infections.
4. Complications of anesthesia (stroke, pneumonia, infarction).

• Spikes after laparoscopy of the fallopian tubes can appear only in extreme cases - for example, with poor sterility of the laparoscope or instrumentation, with internal traumatization of the tissues during the procedure. Such complication is further solved in several ways: by repeated surgical intervention, or by fermentotherapy (more often this is prescribed by Longidaz, Trypsin, etc.).
• Obstruction of the fallopian tubes after laparoscopy is an extraordinary variant of the development of complications. This can happen in the inflammatory process in the tubes or neighboring organs, or in damage to the tissues of the uterus or tubes, with functional abnormalities in the ovaries. To eliminate obstruction, there is a need for a repeat laparoscopy.
• Pain after laparoscopy of the fallopian tubes occurs in everyone, as well as after any surgical operation. Pain can be felt in the area of wounds, in the lower abdomen, in the chest. It is considered normal if the pain passes during the first or second week after laparoscopy.
• Bleeding after laparoscopy of the fallopian tubes is a rare phenomenon. It is possible to suspect bleeding if a lot of blood is released from the genital tract - clots, or large volumes. Normally, a small amount of blood can be released with vaginal secretions: they are usually mild, smearing. When there are abundant secretions, it is urgent to visit a doctor.
• The temperature after laparoscopy of the fallopian tubes should be normalized on the second day. If the temperature values exceed the norm, this may mean that an infection has entered the body. This situation requires urgent intervention of a specialist: most likely, anti-inflammatory and antibacterial therapy will be prescribed.

[24], [25], [26], [27], [28]

Care after the procedure

Peculiarities of the postoperative period after laparoscopy of the fallopian tubes are that it is desirable for a woman to start physical activity as early as possible: for example, after eight hours after the procedure, doctors are advised to gradually get up, walk - but without excessive load. On the second day after laparoscopy, the spectrum of activity can be somewhat expanded.

Meal in the first day should be liquid - it's soups, cereals, kissels. On the second day, normal healthy food is allowed, but in small portions.

Laparoscopy of the fallopian tubes refers to interventions with a low degree of trauma. Complete sections, as in cavitary operations, are not carried out here: the doctor makes only a few punctures, through which he introduces a special instrument and a mini-camera. This significantly reduces the risk of complications and accelerates recovery.

Special care after laparoscopy is not required. For the early healing of wounds, they are periodically treated, and after about a week they remove the stitches. If necessary, the doctor can additionally prescribe antibiotics, vitamins, physiotherapy.

Rehabilitation and recovery after laparoscopy of the fallopian tubes

During the first and second days after laparoscopy, patients may experience discomfort in the chest: this is due to the fact that during the laparoscopy, carbon dioxide was injected inside the abdominal cavity - in order to better examine the organs. Because of the creation of high blood pressure in women, the rib cage may be aching for a while, as well as the liver and neck. After 1-2 days the condition is normalized, and the pains pass independently.

As a rule, completely all tissues heal, after 20-40 days after laparoscopy. To heal faster, it is necessary to adhere to certain rules:

• Do not have sexual intercourse for 4 weeks.
• Do not engage in intensive physical labor for 4 weeks after laparoscopy.
• For 5-6 months, do not lift weights (more than 3 kg).
• During 4 weeks not to visit the sauna or sauna, do not take a bath, do not swim in the pool. Under the ban is also a sunny beach and a solarium.

After laparoscopy, the majority of patients develop vaginal discharge as monthly: this is considered a normal indicator.

The monthly cycle can change a little, but it happens seldom: it is necessary to inform your doctor about any changes.

[29], [30], [31], [32]

Nutrition and diet after laparoscopy of the fallopian tubes

After laparoscopy, doctors advise patients to make some changes in the principles of nutrition:

• during the first day after the operation, you must drink plenty of water;
• it is advisable to eat boiled or stewed foods;
• The amount of food in the portion should be reduced, but the amount of meals, on the contrary, increase;
• the ratio of fats, proteins and carbohydrates should be shifted towards increasing the percentage of protein and carbohydrate foods.

From the diet, you need to exclude animal fat, sweets and cocoa, beans, cabbage, spirits, soda, coffee.

What can you eat after laparoscopy of the fallopian tubes?

• Stewed and boiled vegetables, baked fruit and compotes of them.
• Soups, broths.
• Boiled meat and fish.
• Rice porridge, buckwheat porridge, casseroles from them.
• Chopped bread.
• Incomplete tea, plain water, jelly, compote, juice.

What can not be done after the laparoscopy of the fallopian tubes?

Immediately after laparoscopy, it is impossible:

• to live a sexual life;
• do sport;
• to lift weights;
• do sharp movements in the hull;
• run, jump;
• eat heavy food (fat, fatty meat, nuts) and foods that promote increased gas production (beans, cabbage, sweets, soda).

Alcohol after laparoscopy of the fallopian tubes is also prohibited, as it can cause the development of complications - in particular, the appearance of bleeding. The use of alcohol will be possible no earlier than 4-6 weeks after the procedure. If a woman after laparoscopy is planning a pregnancy, then it should be and completely give up alcohol.

Physiotherapy after laparoscopy of the fallopian tubes

The appointment of physiotherapy is appropriate after the therapeutic laparoscopy: after diagnostic laparoscopy of the fallopian tubes, such procedures are not necessary.

If laparoscopy was carried out regarding the obstruction of the fallopian tubes, then ozocerite and paraffin in the form of compresses are most often used to fix the results. In addition, procedures for electrophoresis with zinc, magnesium or calcium are shown.

Electrophoresis and galvanization are also shown after laparoscopy for ovarian cysts. In addition, the doctor can prescribe ultraphonophoresis, ultrasound therapy, magnetotherapy - such procedures have a pronounced anti-inflammatory effect.

Do not exclude the use of laser therapy, radon baths.

Sports after laparoscopy of the fallopian tubes

The ban on active sports after laparoscopy of the fallopian tubes lasts at least a month. For 4-5 weeks it is forbidden to carry heavy objects, run, jump.

It is recommended to walk a lot: in moderate steps, without excessive intensity, preferably in the fresh air, for example - in the park. Active sports exercises are allowed to start in about 4-5 weeks, and the first classes should be relatively light and not debilitating.

Lifting weights (more than 3-5 kg) is allowed only after six months.

Sex after laparoscopy of the fallopian tubes

Return to sexual relations after laparoscopy of the fallopian tubes is possible not earlier than in 4-5 weeks. Sexual contact can be compared with physical activity - any active actions during the first month after laparoscopy is better to postpone. The body must fully recover. In addition, with existing sexual contacts, there is a high probability of infection in the genital tract, which is highly undesirable, especially after laparoscopy.

In a month, when the body rests, you can begin to live sexually.

Conception after laparoscopy of the fallopian tubes

Many patients are surprised that the monthly cycle often remains the same, or is restored within the first month. Ovaries, in spite of laparoscopy, work in the same biorhythm. If laparoscopy had abnormalities of the ovaries, then, as a rule, these functions are restored in full.

Pregnancy after laparoscopy of the fallopian tubes can begin to be planned already in the first months: it is believed that the first six months after the procedure are the most successful for conception. The longer the period after laparoscopy, the less likely are the chances of successful conception.

If a woman wants to become pregnant after laparoscopy of the fallopian tubes, then she needs to monitor ovulation on a monthly basis in order not to miss the most optimal period for conception. In addition, to increase the likelihood of pregnancy, a doctor can prescribe hormonal treatment - if there is a corresponding indication.

[33], [34], [35], [36]

Hospital after laparoscopy of the fallopian tubes

Standard "sick leaves" for patients after laparoscopy of the fallopian tubes are given for 7-10 working days. Indeed, this period is enough for a woman to go to work without problems. There is only one "but": the profession should not be associated with heavy physical exertion. For example, office employees can quite start to work on 5-6 days from the day of discharge from the hospital.

In some cases, the period of validity of the "sick leave" is extended: for example, with the development of complications, or with the general unsatisfactory state of the patient. The decision on the extension of the "hospital" is taken by the attending doctor.

Reviews after laparoscopy of the fallopian tubes

Most of the reviews on laparoscopy of the fallopian tubes are positive: many patients get rid of problems in the genital area. A monthly cycle is established, pains disappear, and often a long-awaited pregnancy sets in. Laparoscopy of the fallopian tubes is today considered a very popular procedure - both in patients and in practicing surgeons. This operation allows you to solve most problems with minimal tissue damage and minimal disability.

Laparoscopy of the fallopian tubes is a wonderful alternative to conventional laparotomy. Recovery of the body after laparoscopy is relatively fast, and the incidence of complications is reduced to single cases.