Laparoscopy surgery for fallopian tubes

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

Diagnostic laparoscopy of the fallopian tubes

The main reason for diagnostic laparoscopic examination of the fallopian tubes is considered to be infertility of unknown origin. Laparoscopy helps to find out the cause of infertility and make a more accurate diagnosis.

Sometimes, a previously planned diagnostic laparoscopy can become a diagnostic and therapeutic procedure during the course of the surgical intervention: the surgeon assesses the situation and, if possible, solves the problem immediately.

Diagnostic laparoscopy is often performed on a planned basis: the procedure can be supplemented by hysteroscopy or vaginal intervention.

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Indications for the procedure

Laparoscopy of the fallopian tubes may be prescribed for diagnostic purposes, for therapeutic and diagnostic purposes, or exclusively for emergency treatment - for example, in case of an ectopic pregnancy.

• Laparoscopy of fallopian tube adhesions is one of the options for electrocoagulation. After excision of adhesions, in many cases it is possible to solve the problem of infertility. The adhesion process can be a consequence of inflammatory diseases, sexually transmitted diseases, or previous surgical interventions on the pelvic organs (for example, after appendectomy).
• Laparoscopy for tubal obstruction / restoration of tubal patency: laparoscopy in this context allows not only to determine the cause of obstruction, but also to eliminate it: the surgeon excises adhesions, cauterizes endometriotic areas, straightens the tubes. In advance, in order to examine the degree of obstruction, the doctor introduces a special liquid, which passes through the tubes into the abdominal cavity.
• Laparoscopy of fallopian tube cysts is performed for large dermoid or endometrioid cysts, with a high risk of rupture or disruption of the ovary shape, with progressive growth of the cyst, or with a high risk of transformation of the cyst into a cancerous tumor.
• Laparoscopy of the fallopian tubes in case of ectopic pregnancy can be performed in two ways: with removal of the affected tube, or with partial resection of the tube. Unfortunately, the first option is the most common, since there is no guarantee that problems will not arise in the same tube again during the next pregnancy.
• Laparoscopy of the fallopian tubes in case of hydrosalpinx – accumulation of fluid in the tubal cavity – allows to eliminate this problem. However, in most such cases it is not possible to save the tube: it is removed to avoid repeated episodes of hydrosalpinx.

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Preparation

You cannot count on a quality laparoscopy of the fallopian tubes if the appropriate preliminary preparation is not carried out. The risk of complications and negative consequences depends largely on this preparation.

Before undergoing a laparoscopic procedure, the patient must undergo a full examination - first of all, for the presence of contraindications, and also undergo treatment for all existing diseases, including chronic ones.

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

Tests and examinations for tubal laparoscopy include:

• general urine and blood tests;
• blood test for HIV infection;
• blood clotting test;
• blood test to determine blood group and Rh factor;
• X-ray or fluorography;
• cardiography.

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

If the patient suffers from extragenital pathologies - for example, diabetes, thyroid disease, hypertension or asthma, then it is necessary to obtain a conclusion from a specialist doctor who will indicate the possibility of performing surgery in this particular case.

At the preparatory stage for laparoscopy of the fallopian tubes, it is necessary to inform the doctor about all medications that the patient has recently taken or is currently taking. Special control is required for drugs that affect blood clotting processes (including aspirin), as well as drugs that lower blood pressure.

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

An enema before laparoscopy of the fallopian tubes is usually performed twice: in the evening before the operation and in the morning.

The day before laparoscopy, you should exclude from your diet foods that are difficult to digest, as well as beans and cabbage. You should not have dinner the day before laparoscopy, as well as drink any liquid. On the day of the operation, you should neither drink nor eat.

In the morning before the operation, you need to take a shower and shave the pubic area.

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Technique laparoscopy of the fallopian tubes

Laparoscopy of the fallopian tubes is performed using general anesthesia. The doctor makes three punctures (incisions), approximately 10-20 mm each: special sterile instruments are inserted into them, depending on the type of laparoscopy.

One of the incisions will be made in the navel area: carbon dioxide will be introduced into the abdominal cavity through it, which will allow the walls of the organs and abdomen to be straightened out so that they can be examined more easily. The other two incisions are necessary for the introduction of instruments and a mini-camera.

After completing all laparoscopic manipulations (diagnostic or therapeutic), the doctor will remove all instruments and the mini-camera, after which he will apply stitches.

How long does a tubal laparoscopy take?

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

Laparoscopy of the fallopian tubes under general anesthesia

Laparoscopy is always performed under general anesthesia.

General anesthesia involves complete suppression of neuronal impulses in the brain and spinal cord: during laparoscopy, the patient loses the response to all kinds of external and painful stimuli. The anesthesiologist monitors blood pressure, pulse rate, and other values using special sensors.

General anesthesia can be administered intravenously or by inhalation.

With intravenous anesthesia, special drugs are injected directly into the bloodstream, after which the patient falls into a state of sleep within the first seconds.

Inhalation anesthesia is performed using a mask or an intubation tube. The anesthesiologist decides which anesthesia to use.

Laparoscopic removal of the fallopian tube

Removal of one or two tubes is also performed 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 a patient has one tube removed and subsequently wants to have children, then planning a pregnancy is allowed no earlier than 6 months after laparoscopy. Some women are advised to wait a longer period - one or two years. Removal of the fallopian tube is a serious operation, after which the entire neuroendocrine system is rebuilt. Therefore, the body needs much more time to recover and stabilize.

Contraindications to the procedure

When prescribing laparoscopy, the doctor takes into account the absence of contraindications, which may include:

• oncology of the pelvic organs;
• acute renal or hepatic failure;
• severe coronary or respiratory pathologies;
• diaphragmatic or epigastric hernias;
• coma;
• a state of severe exhaustion;
• impaired blood clotting.

Relative contraindications are:

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

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Consequences after the procedure

The risk of negative consequences after laparoscopy of the fallopian tubes is minimal, but it cannot be completely excluded. For example, a woman should definitely consult a doctor if she has:

• the edges of the wound turned red;
• blood or pus is released from postoperative wounds;
• stomach ache;
• the temperature rises;
• breathing becomes difficult and wheezing occurs.

There is no need to worry if we are talking about physiological consequences after laparoscopy, for example, about a disruption of the menstrual cycle or the appearance of discharge from the genital tract.

• Menstruation after laparoscopy of the fallopian tubes most often occurs at the appointed time, which indicates the normal functioning of the ovaries. Immediately after laparoscopy, mucous or bloody discharge from the genital slit may appear - as a rule, such "smearing" continues for 2-3 weeks, after which it turns into a 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 is longer, then you must definitely visit a doctor.
• Discharge after laparoscopy of the fallopian tubes / bloody discharge after laparoscopy of the fallopian tubes usually bothers until the next menstrual cycle. Such discharge is moderate, not abundant, and is mucous or bloody in nature - this is normal, especially if the ovaries were affected during laparoscopy.

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Complications after the procedure

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

1. Injuries to nearby tissues and organs.
2. Internal bleeding.
3. Postoperative inflammatory processes associated with untreated chronic infections.
4. Complications from anesthesia (stroke, pneumonia, heart attack).

• Adhesions after laparoscopy of the fallopian tubes may appear only in extreme cases - for example, with poor sterility of the laparoscope or instruments, with internal tissue trauma during the procedure. Such a complication is subsequently resolved in several ways: repeated surgical intervention, or enzyme therapy (most often Longidaza, Trypsin, etc. are prescribed).
• Obstruction of the fallopian tubes after laparoscopy is an unusual variant of complications. This can happen with an inflammatory process in the tubes or adjacent organs, or with damage to the tissues of the uterus or tubes, with functional disorders in the ovaries. To eliminate the obstruction, it is necessary to perform a repeat laparoscopy.
• Pain after laparoscopy of the fallopian tubes happens to everyone, as after any surgical operation. Pain can be felt in the area of the wounds, in the lower abdomen, in the chest. It is considered normal if the pain goes away during the first or second week after laparoscopy.
• Bleeding after laparoscopy of the fallopian tubes is a rare occurrence. You can suspect bleeding if a lot of blood is released from the genital tract - in clots or large volumes. Normally, a small amount of blood can be released with vaginal discharge: usually they are moderate, spotting. If heavy discharge appears, you must urgently visit a doctor.
• The temperature after laparoscopy of the fallopian tubes should return to normal on the second day. If the temperature readings exceed the norm, this may mean that an infection has entered the body. This situation requires urgent intervention by a specialist: most likely, anti-inflammatory and antibacterial therapy will be prescribed.

Care after the procedure

The peculiarities of the postoperative period after laparoscopy of the fallopian tubes are that it is desirable for a woman to start physical activity as soon as possible: for example, eight hours after the procedure, doctors advise getting up little by little, walking - but without excessive load. On the second day after laparoscopy, the range of activity can be somewhat expanded.

The first day of nutrition should be liquid - soups, porridges, jelly. On the second day, normal healthy food is allowed, but in small portions.

Laparoscopy of the fallopian tubes is a low-trauma intervention. Full incisions, as in abdominal surgeries, are not performed here: the doctor makes only a few punctures through which he inserts special instruments and a mini-camera. This significantly reduces the risk of complications and speeds up recovery.

No special care is required after the laparoscopy procedure. To ensure rapid healing of the wounds, they are periodically treated, and the stitches are removed after about a week. If necessary, the doctor may additionally prescribe antibiotics, vitamins, and 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 laparoscopy, carbon dioxide was introduced into the abdominal cavity - so that it would be possible to better examine the organs. Due to the creation of high pressure, women may experience pain in the chest in the rib area, as well as the liver and neck. After 1-2 days, the condition normalizes, and the pain goes away on its own.

As a rule, all tissues heal completely 20-40 days after laparoscopy. To speed up the healing process, it is necessary to follow certain rules:

• Avoid sexual intercourse for 4 weeks.
• Avoid strenuous physical activity for 4 weeks after laparoscopy.
• Do not lift heavy objects (more than 3 kg) for 5-6 months.
• For 4 weeks, do not visit a bathhouse or sauna, do not take a bath, do not swim in a pool. The sun beach and solarium are also prohibited.

After laparoscopy, most patients experience vaginal discharge similar to menstruation: this is considered normal.

Your monthly cycle may change slightly, but this happens rarely: you should definitely inform your doctor about any changes.

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Nutrition and diet after laparoscopy of the fallopian tubes

After laparoscopy, doctors advise patients to make some changes to their diet:

• During the first day after surgery, it is essential to drink plenty of water;
• it is advisable to consume boiled or stewed foods;
• the amount of food in a serving should be reduced, but the number of meals, on the contrary, should be increased;
• The ratio of fats, proteins and carbohydrates must be shifted towards increasing the percentage of protein and complex carbohydrate foods.

Animal fat, sweets and cocoa, beans, cabbage, alcoholic drinks, soda, and coffee should be excluded from the diet.

What can you eat after laparoscopy of the fallopian tubes?

• Stewed and boiled vegetables, baked fruits and compotes made from them.
• Soups, broths.
• Boiled meat and fish.
• Rice porridge, buckwheat porridge, casseroles made from them.
• Bran bread.
• Weak tea, plain water, jelly, compote, juice.

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

Immediately after laparoscopy you must not:

• live a sexual life;
• exercise;
• lift weights;
• make sudden movements with the body;
• run, jump;
• eat heavy foods (lard, fatty meat, nuts) and foods that increase gas formation (beans, white cabbage, sweets, soda).

Alcohol is also prohibited after laparoscopy of the fallopian tubes, as it can cause complications, in particular, bleeding. Alcohol consumption will be possible no earlier than 4-6 weeks after the procedure. If a woman plans to become pregnant after laparoscopy, she should completely give up alcohol.

Physiotherapy after laparoscopy of the fallopian tubes

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

If laparoscopy was performed due to obstruction of the fallopian tubes, then ozokerite and paraffin in the form of compresses are most often used to consolidate the results. In addition, electrophoresis procedures with zinc, magnesium or calcium are indicated.

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

The use of laser therapy and radon baths is not excluded.

Sports after laparoscopy of 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: at a moderate pace, without excessive intensity, preferably in the fresh air, for example, in a park. Active sports exercises are allowed to begin after about 4-5 weeks, and the first sessions should be relatively easy and not exhausting.

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

Sex after laparoscopy of fallopian tubes

Returning to sexual intercourse after laparoscopy of the fallopian tubes is possible no earlier than 4-5 weeks later. Sexual intercourse can be compared to physical activity - any active actions during the first month after laparoscopy are best postponed. The body must fully recover. In addition, with ongoing sexual intercourse, there is a high probability of infection in the genital tract, which is extremely undesirable, especially after laparoscopy.

After a month, when the body has rested, you can begin to have sex.

Conception after laparoscopy of fallopian tubes

Many patients are surprised that the monthly cycle often remains the same or is restored within the first month. The ovaries, despite laparoscopy, work in the same biorhythm. If there were ovarian dysfunctions before laparoscopy, then, as a rule, these functions are restored in full.

Pregnancy after laparoscopy of the fallopian tubes can 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 smaller the chances of successful conception.

If a woman wants to get pregnant after laparoscopy of the fallopian tubes, she needs to track ovulation monthly so as not to miss the most optimal period for conception. In addition, to increase the likelihood of pregnancy, the doctor can prescribe hormonal treatment - if there are appropriate indications.

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Sick leave after laparoscopy of fallopian tubes

Standard "sick leave" for patients after laparoscopy of the fallopian tubes is issued for 7-10 working days. Indeed, this period is enough for a woman to be able to return to work without problems. There is only one "but": the profession should not be associated with heavy physical exertion. For example, office workers can easily start working on the 5th-6th day after being discharged from the hospital.

In some cases, the period of validity of the "sick leave" is extended: for example, if complications develop, or if the patient's general condition is unsatisfactory. The decision to extend the "sick leave" is made by the attending physician.

Reviews after laparoscopy of the fallopian tubes

Most of the reviews about laparoscopy of the fallopian tubes are positive: many patients get rid of problems in the sexual sphere. The monthly cycle is established, pain disappears, and often the long-awaited pregnancy occurs. Laparoscopy of the fallopian tubes is considered a very popular procedure today - both among patients and practicing surgeons. This operation allows you to solve most problems with minimal tissue damage and minimal impairment of work capacity.

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 limited to isolated cases.