Obstetrical laparoscopy is a procedure to diagnose and treat abnormalities or disorders of the female reproductive system. This procedure is usually performed on patients who have problems with the uterus or ovaries.
Obstetrical laparoscopy is performed using a laparoscope, which is a thin and long tube equipped with a camera and a light at the end. This device allows the doctor to obtain images of the inside of the abdominal and pelvic cavities, without having to make a wide incision in the patient's skin.
Obstetrical laparoscopy can also be performed to perform certain procedures, such as removal of the uterus (hysterectomy) or removal of ovarian cysts. This procedure is an alternative to open (conventional) surgery.
Indications for Gynecological Laparoscopy
Obstetrical laparoscopy is used to detect or treat a disease. Some of the conditions that can be diagnosed or treated with obstetrical laparoscopy are:
- Endometriosis
- Chronic or acute pelvic pain
- Ectopic pregnancy
- Myoma (benign tumors that grow in the uterus)
- Ovarian tumor or cyst
- Pelvic inflammation
- Abscess (collection of pus) in the pelvic cavity
- Cancer of the reproductive organs
- Go down
- Infertility (infertility)
Obstetrical Laparoscopy Warning
There are several things that must be known before planning to undergo obstetrical laparoscopy, namely:
- Tell your doctor if you are pregnant.
- Tell your doctor if you have a history of allergies to any of the ingredients in the anesthetic (anesthesia).
- Tell your doctor if you have had abdominal surgery or suffer from intestinal obstruction, as this may increase the risk of perforation of the intestine.
- Tell your doctor if you have a history of heart disease or lung disease.
- Tell your doctor if you are taking nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, vitamin K, and herbal products and supplements.
- Tell your doctor if you have a smoking habit.
Before Gynecological Laparoscopy
Before the patient undergoes obstetrical laparoscopy, there are several things that the doctor will do, namely:
- Examine the patient's medical history thoroughly, including the results of previous medical examinations if any
- Perform supporting examinations, such as blood tests, urine tests, ultrasound, CT scan, MRI, or EKG
The doctor will also advise the patient to do the following before undergoing obstetrical laparoscopy:
- Fasting for about 8 hours
- Quit smoking, at least 1 week before surgery
- Don't wear jewelry, and don't wear make-up and nail polish
- Wear clothes that are not too tight, and wear comfortable sandals or shoes
- Asking family or friends to take you home, because the patient's condition does not allow him to drive a vehicle due to the effects of the anesthetic
Before entering the operating room, the doctor or nurse will put in an IV to deliver drugs and fluids during the obstetrical laparoscopy. After the doctor confirms the patient's condition is stable, the patient will be taken to the operating room.
Gynecological Laparoscopic Procedure
Obstetrical laparoscopy is performed in an operating room equipped with a monitor. This procedure generally takes approximately 1 hour. The following are the steps taken by doctors in the obstetrical laparoscopic procedure:
- Lying the patient on the operating table with the legs slightly elevated and supported with supports
- Inject general anesthesia through the IV tube, so that the patient will fall asleep during the procedure
- Inserting a catheter into the bladder to drain urine
- Inserting a small needle to deliver carbon dioxide gas into the patient's stomach so that the patient's stomach is inflated and easy to examine
- Making a small incision near the patient's navel to insert the laparoscope
- Examine the organs in the abdomen through the monitor connected to the camera in the laparoscope
If the patient requires further action, the doctor will make another incision in the patient's abdomen and insert a laparoscope through this incision. After that, the doctor will perform treatment actions using a laparoscope as a guide.
There are several types of surgery that can be performed with the help of obstetrical laparoscopy, namely:
- Hysterectomy, which is a procedure to remove the uterus
- Oophorectomy, which is a procedure to remove the ovaries
- Myomectomy, which is a procedure to remove myomas
- Ovarian cystectomy, which is a procedure to remove cysts from the ovaries
- Tubectomy, which is a female sterilization procedure
- Salpingectomy is a procedure to treat an ectopic pregnancy
- Procedures to treat endometriosis
After the procedure is complete, the doctor will remove the laparoscope and other supporting tools, then the incision is closed with stitches and bandages.
Obstetric laparoscopy can also be done using a robot. Robotic technology in this procedure is more stable and able to perform more detailed and detailed movements, such as complex cuts and special stitches that are difficult to do manually.
After Gynecological Laparoscopy
After the obstetrical laparoscopy is completed, the patient will be placed in the recovery room until the anesthetic wears off. During the recovery period, the doctor or nurse will monitor the patient's vital signs, such as heart rate and breathing rate.
During recovery, the patient may experience pain in the area of the incision, nausea, and bloating. Gas remaining in the abdominal cavity can also cause discomfort in the stomach, chest, and shoulders. However, these complaints will disappear in a few days.
The length of recovery time generally depends on the type of obstetrical laparoscopic procedure performed and the overall condition of the patient. Patients may be allowed to go home a few hours after the procedure, or be advised to stay in the hospital for one or more nights.
Before the patient goes home, the doctor will explain how to treat the incision scar and relieve the side effects that may appear. Doctors can also prescribe pain medication or antibiotics to prevent infection of the surgical site.
During recovery at home, the doctor will advise the patient to rest for a few days or weeks. Some patients may take 1 month before being able to return to normal activities.
To speed up the recovery process, there are several things that patients can do, namely:
- Rest more
- Try light activities as soon as possible, such as walking, to prevent the risk of blood clots
- Take painkillers given by the doctor, if you still feel pain
- Wearing clothes that are not too tight
Gynecological Laparoscopy Risks
Obstetrical laparoscopy is a safe procedure, but it is not without risks. Common side effects after this procedure are skin irritation, pain at the injection site, and bladder infections.
In some cases, there is a risk of other complications that can occur, including:
- Allergic reaction
- Difficult to urinate
- Blood clotting
- Adhesions of internal organs
- Nerve damage
- Damage to blood vessels in the abdominal area, bladder, intestines, uterus, or pelvic structures
In addition to the above risks, carbon dioxide gas used in this procedure can also cause complications, if it gets into the blood vessels.
Immediately consult a doctor if you experience the following complaints after undergoing obstetrical laparoscopy:
- Severe stomach pain
- Nausea and vomiting constantly
- Fever with a temperature of 38oC or more
- There is pus or bleeding in the area of the incision
- Pain when urinating or defecating
