24.10.2020

Appendectomy by laparoscopy

The Appendix is in the abdominal cavity to remove it, you need to get access on. Used to do quite a large incision in the iliac region on the right. At the same postoperative wound long time to heal, the recovery period was delayed. Now apply minimally invasive (gentle) treatment – appendectomy by laparoscopy.

Through a small hole in the anterior abdominal wall is inserted into a special device. It is equipped with a camera, illumination optics, also there is a surgical tool which made removal of the Appendix.

Key benefits

1. Tissue damage is minimal, which reduces the postoperative period. After only 2 days the patient is discharged home.

2. Surgery usually takes 30 minutes.

3. With a large cut wound heal for a long time, pronounced pain syndrome. In the case of laparoscopy discomfort is minimal.

4. The percentage of complications after appendectomy is low. In this way it is possible to avoid adhesive disease.

5. The presence of the camera in the abdominal cavity allows to assess the condition of adjacent organs: ovaries, uterus, intestines, liver, gallbladder. If identified surgical pathology, it is not necessary to increase access, removal of altered foci is carried out through the existing holes.

6. Postoperative scar in a few months will become invisible from the cosmetic point of view this is a clear advantage.

7. Laparoscopy is a method of not only treatment but also diagnosis. If unconfirmed or questionable appendicitis procedure to confirm the diagnosis.

Inflammation of the Appendix is one of the most frequent surgical pathologies, the main method of treatment – operative. The disease occurs in all age groups, but in children the risk of the largest. Because it is very important to choose the tactics that will minimally injure the surrounding tissue, will not cause complications. Laparoscopy in acute appendicitis has all the advantages, therefore it is a good choice.

What is the procedure?

Preparation for the appendectomy takes less than 2 hours. Held infusion therapy (intravenously infused saline solutions, glucose), treatment of the surgical field. Laparoscopy is done under General anesthesia or local anesthesia. The patient takes a horizontal position, the table is slightly tilted to the left.

Next, make three punctures, which individually depends on the location of appendicitis.

  • Just above the umbilical ring is introduced laparoscope with video equipment, lighting.
  • Under the control of between the navel and the womb is made a second incision for the trocar.
  • The third depends on the location of the Appendix.

Laparoscopy begins with the puncture of the abdomen with a special needle. She passes the skin, fatty tissue, after entering the abdominal cavity, there is introduced air for better visualization of structures. Using the tools in the Appendix stands out from the surrounding tissue, tied off and clipped. Mandatory stage inspection of all organs to exclude complications. If necessary, put a drainage tube. After surgery hole sutured. The intervention lasts no more than an hour.

In the hospital the patient is 2 days. During this period as normal on the 3rd day the person is discharged home. The pain syndrome is in a week. To eat the food is recommended the next day, but must adhere to dieting after removal of appendicitis. Preference is given puréed dishes, so as not to burden the intestines. Exclude cabbage, beans, grapes – the foods that increase flatulence. 3-4 weeks is allowed to return to normal life.

Testimony

1. Acute and chronic appendicitis, confirmed clinically and laboratory (leukocytosis, increased SOY).

2. Suspected inflammation of the Appendix.

3. Patients with obesity are recommended to do a laparoscopy, as it decreases the amount of tissue dissection of the subcutaneous tissue. The risk of septic complications in this case is much lower, the recovery process will be faster.

4. The desire of the patient to remove the Appendix by minimally invasive method when an important cosmetic effect.

Contraindications

1. Laparoscopy is not performed during an acute heart attack, severe heart, respiratory, kidney failure, third trimester of pregnancy.

2. Generalized peritonitis, the presence of abscesses in the abdominal cavity requires a thorough debridement, drainage. Not always through small incisions manage to finish the operation. In dangerous cases, switching to open access.

3. If inflamed, the dome of the cecum, there is a risk of the eruption of the ligature, which was applied to a remote appendectomy. The contents of the intestine may enter the abdominal cavity with the development of fecal peritonitis.

4. Pronounced adhesions is a contraindication to laparoscopy appendicitis.

Possible consequences

Despite the advantages, like any surgery, minimally invasive access has its complications.

1. Failure of equipment may disrupt the integrity of the gut. If the defect is small, it is immediately sutured, the abdominal cavity is rinsed and introduced antiseptics. When significant damage is not excluded the transition to open access.

2. The bone has its own blood supply, the location of vessels in each individual. If the artery is placed in atipicheskim place during the removal of the appendicitis probably bleeding.

3. Failure to comply with the rules of asepsis (sterility) occurs purulent inflammation, peritonitis, abscesses.

4. If the seams were imposed substandard, there is a discrepancy.

5. In place of punctures muscles are weakened, because the risk of hernias is increased.

Laparoscopy is an effective method of treatment of appendicitis with minimal harm to health. Previously it was thought that peritonitis, complicated shapes require intervention. But the surgeons drain the abdomen, injected drugs, and remove nekrotizirovannye areas through small incisions. This reduces the recovery period to return to normal life.

Hospitalization for suspected appendicitis free. The cost of the surgery depends on the type of hospital where delivered to the patient. In public institutions the price is lower than in the private. Laparoscopy is an expensive procedure when compared with open surgery.

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