First after laparoscopy. Main types of complications after laparoscopic operations

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Update: December 2018

Unfortunately, not all women manage to get pregnant “easily and simply”, without delays and problems. Various gynecological diseases become an obstacle to motherhood, and in such cases medicine comes to the rescue. Laparoscopic surgery, which can be performed both for the inability to get pregnant and for the treatment of any gynecological pathology, is one of the methods that helps to become a mother. But on the other hand, patients who have undergone this manipulation have a lot of questions: when can they get pregnant, what is needed for this, whether the operation will cause infertility, and others.

Laparoscopy: what's the point?

Laparoscopy, which means “looking at the womb” in Greek, is the name given to modern surgical method, the essence of which is to perform surgical operations through small holes (up to 1.5 cm) in the amount of three. Laparoscopy is used to operate on the abdominal and pelvic region. Laparoscopy is widely used in gynecology, as it allows you to reach both the appendages (tubes and ovaries) and the uterus.

The main laparoscopic instrument is the laparoscope, which is equipped with lighting and a video camera (everything that happens in the pelvis is displayed on a television screen). Various laparoscopic instruments are inserted through the other 2 openings. To provide surgical space, the abdominal cavity is filled with carbon dioxide. As a result, the abdomen swells, and the anterior abdominal wall rises above the internal organs, forming a dome.

Advantages and disadvantages of the method

First of all, it is worth noting that with a laparoscopic approach, the surgeon sees much wider and more accurately the organs on which he operates due to multiple optical magnification of this area. Other advantages should be noted:

low trauma to organs (they do not come into contact with gloves, air and gauze swabs);
minor blood loss;
short periods of hospital stay (no more than two to three days);
Hardly ever pain(except for a feeling of abdominal distension in the first or second days after surgery, until the gas is absorbed);
absence of rough scars, except for the places where the holes were sutured;
quick rehabilitation period (does not require bed rest);
low probability of formation of postoperative adhesions;
the possibility of simultaneous diagnosis and surgical treatment;

The disadvantages of laparoscopy include:

requires general anesthesia, which is fraught with various complications;
requires specially trained surgeons;
the impossibility of performing some operations laparoscopically (large tumor sizes, operations involving suturing of blood vessels).

Examination before laparoscopy

Before performing laparoscopy, as before any other surgical operation, it is necessary to undergo a certain examination, the list of which includes:

examination of the patient on a gynecological chair;
complete blood count (with platelets and leukocyte count);
general urine analysis;
blood clotting test;
blood chemistry;
blood group and Rh factor;
blood for hepatitis, syphilis and HIV infection;
gynecological smears (from the vagina, cervix and urethra);
ultrasound examination of the pelvic organs;
fluorography and electrocardiography;
spermogram of the husband in case of laparoscopy for infertility.

Laparoscopic surgery is prescribed for the first phase of the cycle, immediately after the end of menstruation (approximately 6–7 days).

Indications for use

Laparoscopy is performed for both planned and emergency indications. Indications for immediate laparoscopic surgery are:

ectopic (ectopic) pregnancy;
rupture of an ovarian cyst;
torsion of the pedicle of an ovarian cyst;
necrosis of the myomatous node or torsion of the subserous node of uterine fibroids;
acute purulent inflammatory diseases of the appendages (tubo-ovarian formation, pyovar, pyosalpinx)

But, as a rule, laparoscopic operations are performed as planned (not all clinics are equipped special equipment). Indications for them are:

Fallopian tube ligation as a method of contraception;
temporary sterilization (clamping of the fallopian tubes with clips);
various tumors and tumor-like formations of the ovaries (cysts);
polycystic ovary syndrome;
genital endometriosis (adenomyosis and ovarian endometriosis);
uterine fibroids (multiple nodes for myomectomy, removal of pedunculated subserous nodes, amputation of the uterus if its size is small);
tubal infertility, intersection of adhesions in the pelvis;
abnormalities of the internal genital organs;
removal of the ovary/ovaries or removal of the uterus (amputation and extirpation);
restoration of patency fallopian tubes;
chronic pelvic pain of unknown etiology;
diagnosis of secondary amenorrhea.

Contraindications

Laparoscopic surgery, like laparotomy, has a number of contraindications. Absolute contraindications are:

diseases of the cardiovascular system in the stage of decompensation;
cerebral hemorrhage;
coagulopathies (hemophilia);
kidney and liver failure;
malignant diseases of the pelvic organs greater than grade 2 plus the presence of metastases;
shock and coma of any etiology.

In addition, laparoscopic surgery is prohibited for its own specific reasons:

incomplete and inadequate examination of spouses in the presence of infertility;
the presence of sexual and general acute and chronic infectious diseases or in case of recovery less than 6 weeks ago;
subacute or chronic salpingoophoritis (surgical treatment is carried out only for acute purulent inflammation of the appendages);
pathological indicators of laboratory and additional examination methods;
3 – 4 degree of vaginal smear purity;
obesity.

Laparoscopy: when can you get pregnant?

And finally, the climax of the article has come: when can you plan a pregnancy or even “get active” after laparoscopic surgery? It is not easy to answer this question unequivocally, since much depends not only on the diagnosis for which the operation was performed, but also on the accompanying gynecological diseases, any difficulties during surgery and in the postoperative period, the woman’s age and the presence/absence of ovulation before surgery.

After tubal obstruction (tubal-peritoneal infertility)

If laparoscopic surgery was performed for obstruction of the fallopian tubes (dissection of adhesions), then doctors, as a rule, allow planning a pregnancy no earlier than 3 months.

What explains this? After laparoscopy of the fallopian tubes and dissection of the adhesions that are tightening them, the tubes themselves are still in a state of edema for some time, and in order to return to normal, they need some time. The swelling subsides after about a month, but the body also needs rest to recover after the operation and to “regulate” the functioning of the ovaries.

It is undeniable that the less time has passed since the separation of adhesions, the higher the chances of conception, but. Against the background of swollen, hyperemic and “in a state of shock” pipes, there is a high probability ectopic pregnancy, that’s why doctors recommend waiting. And so that the wait is not painful, combined oral contraceptives, usually monophasic, are prescribed for a three-month period. Such a prescription of hormonal pills serves not only the purpose of preventing “pregnancy that occurs at the wrong time,” but also to give the ovaries a rest, which, after stopping the pills, will begin to work (ovulate) in an enhanced mode.

After cyst removal

After laparoscopy for an ovarian cyst, pregnancy should also not be rushed. Laparoscopic removal of an ovarian cyst is performed very carefully; only the ovarian cyst itself is removed, leaving healthy tissue behind.

In most cases, ovarian function is restored within a month. And yet, doctors advise to delay the desired pregnancy as at least 3, preferably 6 months.

For this period, oral monophasic contraceptives are usually prescribed, which protect against unplanned conception, allow the ovaries to rest and normalize. If the pregnancy occurs earlier than the agreed upon date, then problems with its course are possible, so you should not delay visiting a doctor and registering.

After polycystic disease

Polycystic ovarian disease is characterized by the presence of many small cysts on the surface of the ovaries. The operation can be performed in three ways:

cauterization - when multiple incisions are made on the ovarian capsule;
wedge resection - excision of part of the ovary along with the capsule;
decortication - removal of part of the compacted ovarian capsule.

After such operations for polycystic disease, the ability to conceive (ovulation) is restored for a short period (maximum one year). Therefore, you should start planning your pregnancy as early as possible (approximately one month after surgery when sexual rest is canceled).

After an ectopic pregnancy

After laparoscopy for ectopic pregnancy, doctors it is strictly forbidden to become pregnant for six months(it does not matter whether a tubectomy or enucleation was performed ovum from the pipe with its preservation). This period necessary to restore hormonal levels after an interrupted pregnancy (as well as after a miscarriage). You should protect yourself for 6 months by taking hormonal pills.

After endometriosis

Laparoscopy of endometriosis consists of either removing the endometrioid cyst or cauterizing endometrioid lesions on the surfaces of organs and peritoneum with simultaneous dissection of adhesions. Pregnancy has a beneficial effect on the course of endometriosis, as it inhibits the process of growth of lesions and the formation of new ones. But in any case, doctors recommend planning pregnancy no earlier than 3 months.

As a rule, laparoscopic surgery is supplemented by the prescription of hormonal therapy, the duration of which can last for six months. IN in this case Pregnancy can be planned after completing a course of hormone therapy.

After uterine fibroids

If a laparoscopic conservative myomectomy was performed (that is, removal of myomatous nodes while preserving the uterus), the uterus needs time to form “good” wealthy scars. In addition, the ovaries also need to “rest” in order to function effectively in the future. Therefore, pregnancy planning is allowed no earlier than 6 – 8 months after operation. During this “rest period”, it is recommended to take oral contraceptives and regular ultrasound examination of the uterus (to check the healing process and the consistency of scars).

Pregnancy that occurs earlier than the agreed term can cause uterine rupture along the scar, which can lead to its removal.

Laparoscopy: chances of pregnancy

There is a chance of pregnancy within a year after laparoscopic surgery in 85% of women. How long after laparoscopy is pregnancy possible (by month):

in 1 month positive test 20% of women report pregnancy;
20% of patients become pregnant within 3–5 months after surgery;
within 6 to 8 months, pregnancy was registered in 30% of patients;
by the end of the year, the desired pregnancy occurred in 15% of women.

However, there are still 15% of women who have undergone laparoscopy and never become pregnant. In such situations, doctors recommend not to delay the wait, but to resort to IVF. After all, the longer the time passes after the operation, the less likely the chances of conceiving a child become.

Rehabilitation after laparoscopy

After laparoscopy, rehabilitation of the body occurs much faster than after laparotomy (an incision in the abdominal wall). By the evening, the woman is allowed to get up and walk, and discharge is carried out after a couple of - three days. You are also allowed to start eating on the day of surgery, but meals should be small and low in calories.

Sutures, if they were applied, are removed on 7–8 days. As a rule, there is no pronounced pain, but in the first days you may be bothered by bursting pain in the abdomen due to the gas introduced into the abdominal cavity. After its absorption, the pain disappears.

Menstrual cycle after laparoscopy

After undergoing laparoscopic surgery, in most cases, menstruation comes on time, which indicates normal functioning ovaries. Immediately after surgery, mild mucous or bloody discharge, which is considered normal, especially if the intervention was performed on the ovaries.

Minor bleeding may continue for three weeks with the transition to menstruation. Sometimes there is a delay in menstruation from 2 - 3 days to 2 - 3 weeks. If the delay is longer, you should consult a doctor.

Menstruation after an ectopic pregnancy, which was removed by laparoscopy, occurs on average within a month, plus or minus a few days. In the first days after laparoscopic removal of an ectopic pregnancy, slight or moderate bleeding appears, which is absolutely normal. This discharge is associated with the rejection of the decidua (where the embryo should have attached, but did not attach) from the uterine cavity.

Preparing for pregnancy after laparoscopy

In order to increase the chances of conception and reduce the risk of possible complications of the desired pregnancy, you first need to undergo examination:

mandatory visit to a gynecologist;
general clinical tests (blood, urine), biochemistry and blood sugar as indicated;
PCR tests for sexually transmitted infections (if detected, mandatory treatment);
smears from the vagina, cervix and urethra;
determination of hormonal status (according to indications) and correction of disorders;
Ultrasound of the reproductive system;
genetic consultation (preferably for all married couples).

It is possible that a more extensive examination will be needed, for example, a colposcopy or ultrasound of the mammary glands, which is decided by the doctor observing the woman.

reception folic acid at least three months before the planned pregnancy;
completely abandon bad habits, including the future father;
lead a healthy and active lifestyle (walking fresh air, moderate physical and sports activities);
review your diet in favor of a healthy and fortified diet;
avoid stressful situations if possible;
calculate or determine the days of ovulation (using a special ovulation test) and “be active” during this period.

How does pregnancy proceed after laparoscopy?

If you follow the terms after which pregnancy is permitted and recommendations during the planning period, pregnancy, as a rule, proceeds without complications. All deviations from the normal course of the gestation period are not associated with the laparoscopic operation performed, but with the reason for which the operation was performed.

For example, when pregnancy occurs after ovarian laparoscopy earlier than 3 months, the risk of early miscarriage increases due to a failure of the hormone-producing function of the ovaries. Therefore, in this situation, the doctor will most likely prescribe progesterone drugs and antispasmodics to prevent miscarriage. The development of other complications of gestation cannot be ruled out:

intrauterine infection due to chronic inflammatory diseases of the genital organs;
polyhydramnios (as a result of infection);
placenta previa (after removal of fibroids);
fetoplacental insufficiency (hormonal dysfunction, infection);
incorrect position and presentation of the fetus (uterine surgery).

Course of labor

The previous laparoscopic operation is not an indication for a planned cesarean section, so the birth is carried out through the natural birth canal. The only exceptions are those operations that were performed on the uterus (removal of fibroid nodes or reconstruction of the uterus due to developmental anomalies), since after them scars remain on the uterus, creating a danger of its rupture during childbirth. Complications of childbirth that are possible are associated with the presence of gynecological pathology for which laparoscopy was performed, and not with the operation:

anomalies of generic forces;
prolonged labor;
early postpartum bleeding;
postpartum subinvolution of the uterus.

Question answer

Question:
Six months ago I had a laparoscopy, but the pregnancy never occurred, does this mean that the operation was ineffective?

Answer: Laparoscopic surgery cannot be ineffective. In any case, for whatever reason it was performed (polycystic ovary syndrome, cyst or ectopic), the surgeon eliminated all pathological formations. Six months, of course, is already a decent period, but pregnancy can occur after 9 or 12 months. The main thing is to follow your doctor's recommendations.

Question:
Why is there no pregnancy after laparoscopic surgery?

Answer: Firstly, it is necessary to clarify how long after the operation pregnancy does not occur. If less than a year has passed, then you should not worry; you may need to undergo an ultrasound of the pelvic organs and take blood tests for hormones (progesterone, estrogens, prolactin, testosterone). In some cases, the doctor prescribes a more detailed examination to clarify the cause of infertility. It is possible that the operation was performed for obstruction of the tubes and patency was restored, but there is also anovulation or some pathology in the husband’s sperm.

Question:
After laparoscopy, the doctor prescribed me hormonal pills. Is it necessary to take them?

Answer: Yes, after laparoscopic surgery, no matter for what reason it was performed, it is mandatory to take hormonal pills. They not only protect against unwanted pregnancy, but also normalize hormonal background and give rest to the ovaries.

Nobody wants to undergo surgery. An operation is always an alarming moment associated with moral and physiological discomfort. However, in many cases, the patient can do with laparoscopy, which is not so traumatic. But this procedure has side effects, including bloating.

What is laparoscopy?

Laparoscopic surgery is an operation performed using a small puncture method in which an optical diagnostic device, gastroscope or laparoscope is inserted into the internal cavity of the body, which allows an examination of the organs from the inside. In medicine, laparoscopy is used for diagnostics and surgical procedures. In the first case, a puncture and insertion of an optical device are used to make a diagnosis. During surgical laparoscopy, the doctor eliminates existing in the patient’s body pathological changes. Another difference is the method of anesthesia: during a diagnostic examination, he is given local anesthesia, and during surgery, general anesthesia is given.

What surgical interventions are performed using laparoscopy?

Removal of ovarian cyst;
Ovariectomy;
Cholecystectomy;
Hysterectomy;
An operation to restore the patency of the fallopian tubes;
Removal of fibroids, ectopic pregnancy, enlarged endometrium, malignant and benign formations in the abdominal cavity.

In general, almost all surgical procedures performed by the laparoscopic method are performed open method. Since laparoscopy involves the most delicate intervention in the body, it is considered the most gentle option.

Benefits of the procedure:

Minimally invasive intervention;
Acceleration of the healing and recovery process;
Accessible and detailed study of the condition of internal organs;
The process is not as traumatic as standard abdominal surgery;
No large scars;
Reducing the likelihood of infection.

Laparoscopy is the most popular diagnostic method in gynecology, but it is also used for endoscopic examinations in gastrology.

Why does my stomach swell after laparoscopy?

Many patients report the appearance of bloating and distension in the abdomen after laparoscopy. Don't panic right away. The procedure itself can give such a symptom. Before introducing an optical device into the abdominal cavity through a trocar (special tube), a small amount is pumped into it. carbon dioxide to create volume and improve visibility. Often, in the first hours after laparoscopy, the remaining gas continues to put pressure on the walls of the internal organs, including the intestines, which causes bloating. The unpleasant symptom should disappear on its own soon. However, it may take about two weeks for the gases to completely leave the body. This process can be accelerated with the help of medication therapy, rehabilitation exercises and traditional medicine recipes.

Attention: If other symptoms, including chills, fever, nausea and vomiting with bloody discharge, are also observed along with bloating, you should seek urgent medical attention. medical care. This may be a symptom of infection or internal trauma caused by the trocar or Veress needle through which the gas was injected.

What to do?

Abdominal bloating after anesthesia and laparoscopy can be eliminated on your own. The main principles of therapy are:

Bed rest and rest on the first day after surgery;
Eating foods that help speed up metabolism;
Maintain moderate physical activity in the following days (approximately 7–10 days after laparoscopy) to reduce the risk of bile stasis.

If the patient is experiencing severe and painful intestinal cramps due to remaining gas in the abdominal cavity, the following medications may be prescribed:

Espumisan;
Polysorb;
Disflatil;
Sub simplex.

It is prohibited to choose your own medication without permission! The wrong choice of medication can cause infection of internal organs or other severe consequences that are a threat to life.

You can help speed up the elimination of gases with light exercise. You should not give the body a strong load, as this will delay the healing process of the wound and internal microtrauma.

Exercises for bloating after laparoscopy:

In the first few days

Squeeze the muscles of the buttocks and the sphincter of the anus rhythmically while lying down (up to 50 times);
Bring your knees together and slightly raise your pelvis. Do not overload the peritoneum!

7 – 10 days after surgery

Place your feet shoulder-width apart, place your hands on your waist, and bend slightly to the sides;
Standing on one leg, bend forward (up to five times on each leg);
Do the “bicycle” exercise in a lying position;
Pull in and relax the peritoneum (up to 10 times in one approach). Performed with straight and bent legs;
Lightly stroke the area around the navel, without pressing on the stomach.

Recovery after laparoscopy is impossible without following a therapeutic diet. Let's look at its main points.

Diet

For the first month and a half after surgery, the patient adheres to a strict diet, which is as close as possible to dietary nutrition. Failure to comply with the regimen can aggravate the condition and delay the healing process. Each patient is notified of possible complications in case of dietary disturbance. He is also informed that he must eat in accordance with diet number 5. Subsequently, the menu can be expanded, but only by the decision of the attending physician. If cholecystectomy has been performed, an extremely strict diet is required. The relaxation is carried out during the period when the function of the removed gallbladder will be taken over by the intrahepatic and extrahepatic ducts. If the patient follows all the instructions, the likelihood of bile stagnation is minimized. After a certain time, he will be able to return to his usual diet, which includes minor restrictions.

On the first day after laparoscopy, no food is taken; it is permissible to drink still water. On the second day, a light snack is allowed, including non-concentrated vegetable broth, chopped or minced boiled chicken fillet, light yogurt and low-fat cottage cheese. The portions are small, meals are taken every 3 hours (up to six times a day).

What should be excluded from the diet during the diet?

Fatty varieties of fish, meat, poultry;
Products containing solid animal fats;
Dishes prepared by frying;
Canned food of any kind, including meat and vegetables;
Marinated, salted, smoked products;
Spicy sauce;
Animal entrails that are difficult to digest (offal, kidneys, stomachs, brain, etc.);
Fresh baked goods;
Confectionery;
Raw vegetables and fruits;
Caffeine;
Cocoa;
Alcoholic drinks.

On the third day after surgery and in the next seven days, the patient begins to adhere to the basic principles treatment table No. 5:

Fractional meals (five to six times a day);
You should try to eat at the same time every day;
Portions should be the same size;
Food is taken only warm;
The products consumed are processed thermally (boiling, stewing, steaming, baking);
Products are crushed, rubbed through a sieve (in a blender) or ground to facilitate digestion.

It is often difficult for a person to adapt to a changed lifestyle, not only physically, but also psychologically. The restrictions seem too strict, so many people break the diet, refusing to acknowledge the temporary decrease in their activity and abilities due to illness. However, the main purpose of the diet is not to infringe on the patient’s pleasures, but to reduce the load on the digestive tract. It should prevent stagnation of bile and the development of constipation. It is necessary to accustom the body to work in a new mode and stimulate intestinal motility.

What can you eat?

Dried bread made from wheat flour;
Fish, meat, poultry of lean varieties (chicken, turkey, rabbit, pike perch, haddock, pollock, hake, etc.);
Cereal porridges cooked in water (legumes are prohibited);
Puree soups and low-fat broths;
Stewed and boiled vegetables;
Berry and fruit jelly, jelly;
White marshmallows without chocolate;
Apple marshmallow;
Soft-boiled chicken eggs (one per day);
Low-fat cottage cheese;
Kefir, yogurt.

If the use of any product causes bloating, bloating and colic, then you should remove it from the diet or significantly reduce the portion.

Folk recipes

Treatment with medications gives a more successful result if combined with the techniques suggested by traditional medicine. When recovering and eliminating bloating after laparoscopy, you can try the following options:

A tablespoon of dried immortelle flowers is poured hot water and boil for five minutes. After cooling and straining, drink one to two tablespoons before each meal;
A decoction of 15 g of birch buds, prepared in 200 ml of water, relieves bloating and eliminates flatulence. 50 ml of liquid is taken before meals about three times a day:
An infusion of fig fruits is useful for eliminating constipation after surgery, which is dangerous by causing stagnation in the bile ducts;
An infusion of chicory root has a laxative and carminative effect. It is also drunk as tea (the raw materials can be purchased at a pharmacy or any grocery store). The main thing is to take pure chicory without additional flavoring additives. The plant contains inulin, which has a general regenerative effect, which is especially effective for recovery in the postoperative period;
Increased gas formation, which worsens the patient’s condition after laparoscopy, can be quickly removed by an infusion of cinquefoil root. Drink 50-100 ml before meals no more than twice a day;
An herbal infusion containing celandine, peppermint, lemon balm and the already mentioned bloodroot will do an excellent job of treating flatulence. Prepared in the proportion “1 tablespoon of phyto-raw materials per 300 ml of boiling water.”

Plant-based choleretic agents have a good effect. They are available without a prescription in every pharmacy. Possible options include:

Biligin;
Flamin;
Turmeric-based preparations;
Rosehip syrup;
Corn silk extract in liquid form;
Choleretic herbal teas.

No one folk recipe not recommended after laparoscopy unless its use is approved by the specialist who performed the operation or who monitors the patient’s condition after it. Uncontrolled use of herbal preparations and herbal infusions can lead to a sharp deterioration in the patient’s condition, so before starting therapy you need to obtain an appropriate medical prescription.

Laparoscopy is a modern minimally invasive method used in surgery for diagnostics and therapeutic interventions on the abdominal organs. If the surgeon is properly qualified, complications after surgery are minimal, and recovery period It proceeds easily and does not require a long hospital stay. In most cases, on the second day the patient can already move independently.

Laparoscopy – modern method surgical intervention

The key advantage of the method is minimal tissue damage, which ensures quick rehabilitation. However, it is impossible to do without the consequences of any intervention, and after laparoscopy, patients often complain of pain that occurs not only in the operation area, but also in the joints, shoulders, chest– they involve the use of gas necessary to inflate the abdominal cavity and provide free access to the internal organs.

Does everyone need gas injection, and how to speed up elimination?

Provide good review surgeon during the operation, as well as relatively free access to the internal organs without filling the abdominal cavity with gas is impossible, therefore harmless in its chemical composition gas is administered to absolutely all patients. This is one of the very first stages of laparoscopy. Already at the moment the gas begins to enter the body, subcutaneous emphysema often occurs, which in most cases resolves on its own within 1-2 days and does not require special treatment.

It is impossible to give an unambiguous answer to the question: “how much gases come out after laparoscopy - much depends on the individual characteristics of the body and the age of the patient. The main part is removed upon completion of the operation, but the remaining part can annoy patients for some time, so there are certain recommendations on how to make the process of removing it from the body faster. To completely leave the body, the gas takes about 2 weeks, during which you need to follow a certain regime.

Follow the diet recommended by your doctor.
Be reasonably active physically.

Following a diet after laparoscopy promotes rapid recovery

The diet is not particularly strict. All foods that are difficult to digest are excluded - fatty meats, rich broths, cabbage and apples, whole milk and cottage cheese. It is better to start your diet with yogurt or fermented milk products, be sure to drink at least 2 liters clean water per day. Carbonated drinks, strong black tea and coffee are undesirable; green tea and dried fruit compotes are allowed. Products such as broccoli, almonds, grapefruit, and, accordingly, the removal of residual gas, stimulate metabolism well. bell pepper. Spices are allowed in moderation.

After the operation, the patient is advised to move a lot. Because gas can be somewhat uncomfortable before gas leaves the abdomen after laparoscopy, especially when moving, many patients find it optimal to remain in bed. This is not at all true, and on the second day a person should start walking. It is optimal if you have the opportunity to take walks in the fresh air. They may be short-lived, but regular. In the postoperative period, any feasible physical activity is useful.

For 3-4 weeks after the laparoscopic intervention is completed, heavy physical work, exercise in gyms, carrying heavy loads. It is worth understanding that any operation is accompanied by damage to internal organs, and thoughtless exercise can cause internal bleeding.

If complications arise

In some cases, the gas introduced during surgery is not removed from the body on its own. One of the common problems is subcutaneous emphysema - the accumulation of air in the subcutaneous tissue. If emphysema appears in the face and neck area and reaches large sizes the surgeon will decide on re-intervention or installation of special drainage. In other cases, active medical action is not required.

Medicine to eliminate bloating

If there is severe bloating after surgery, accompanied by digestive problems, medication may be required. Most often, positive dynamics are observed when taking Espumisan, Simethicotin; in some cases, a sufficient effect is observed from the standard activated carbon. A number of doctors prefer to prescribe Polysorb.

How to speed up gas elimination with exercise?

If gases come out slowly, and against this background unpleasant or painful sensations appear, physical exercise can help. Certain restrictions are present only in the first days after surgery, although more late dates not prevent preliminary consultation doctor The following exercises have proven the most effective.

Tilts of the body in different directions.
Bend the body forward while standing on one leg.
Lying on a flat surface, perform the “bicycle” exercise.
While lying on your back, pull in and “inflate” your stomach - without excessive effort.
Stroke your stomach yourself with light and then stronger pressure.
Squeezing/unclamping the gluteal muscles.

In addition to the fact that accumulations of gases will be eliminated more quickly after such exercises, they contribute to the speedy restoration of stool, which often becomes unstable after surgery.

With your doctor's approval, you can use some folk remedies. The following remedies help restore normal digestion and stimulate the release of gas from the body:

dill seed infusion;
tea, which includes fennel, valerian leaves and mint;
caraway decoction.

As a rule, recovery after laparoscopy does not take much time, but if any symptoms that are uncharacteristic for a person occur after surgery, you should immediately notify the doctor.

The postoperative period for laparoscopy of ovarian cysts generally lasts no more than three months. During this time, the woman’s body is completely restored, damaged tissues are healed. The rehabilitation period can be changed - this is influenced by individual characteristics patient, type and size of cyst to be removed.

Indications for surgery

Laparoscopy is performed when it is impossible to eliminate the pathology with medication. Indications for intervention:

large size of education;
severe symptoms;
rupture of a cyst or ovary;
risk of developing a malignant process;
the likelihood of rupture of the formation or torsion of its legs.

In some cases, before surgery, patients are prescribed a course drug treatment. If there are clear indications for laparoscopy, the intervention is performed immediately.

Most often, surgery is necessary in the presence of epithelial ovarian cysts. These types of formations have the ability to degenerate into cancerous tumors and cannot be eliminated by medications. Functional cysts arising from disorders menstrual cycle, are rarely removed surgically. They usually go away on their own or under the influence of hormonal and other drugs.

Postoperative rehabilitation period

In the process of recovery after laparoscopy of an ovarian cyst, a woman goes through several periods. Early rehabilitation is considered the shortest, lasting no more than 7 days. Subsequent recovery takes place at home.

The first day after surgery

On the first day after ovarian laparoscopy, the patient must be in a hospital setting. At this time she is recovering from anesthesia. The doctor monitors her condition and, if necessary, changes the treatment regimen or performs additional manipulations. This prevents many complications - uterine bleeding, suppuration of sutures, deterioration of health.

Recovery from anesthesia is the most difficult. At this time, the woman feels nausea, weakness, and chills, which go away on their own on the first day.

You need to get out of bed 3-5 hours after waking up. This is often problematic due to severe pain. These symptoms are normal and result from tissue damage during surgery. Rapid restoration of motor activity will improve the patient’s physical and emotional condition. In the postoperative period during laparoscopy to remove an ovarian cyst, activity resumes gradually - on the first day it is enough to simply get out of bed to go to the toilet.

Diet

After surgery, a woman’s usual diet changes. On the first day you are allowed to consume only mineral water, sometimes - light broths. The next day you can eat slimy soups, boiled vegetables, steamed cutlets, jelly and fruit drinks. Such a diet after laparoscopy of an ovarian cyst ensures the normal functioning of the intestines and stomach, weakened after the intervention and medications taken.

Subsequently, the diet becomes more varied. In the first few weeks after surgery, the basis of the diet consists of the following dishes and products:

baked apples;
flax seeds;
cereals – rice, buckwheat, oatmeal, pearl barley;
sauerkraut;
soups made from vegetables or with the addition of lean meat;
hard cheese;
steamed omelettes;
boiled lean meat and fish;
black bread;
fruit juices and fruit drinks;
herbal infusions;
green tea;
tomatoes;
dry biscuits, crackers;
vegetable salads with vegetable oil;
low-fat kefir.

Prohibited products:

Black tea;
coffee;
alcohol;
sugar;
mayonnaise;
fresh wheat bread;
spicy, fried, smoked, salted;
spices;
fresh cabbage, onions, radishes;
pasta;
grapes, pears;
beans and peas;
milk, cream;
bakery;
sweets – candies, chocolate;
nuts.

Diarrhea, constipation, and bloating can increase pain from healing stitches.

General rules of nutrition after laparoscopy of an ovarian cyst:

eating 5-6 times a day in small portions;
drinking water at least one and a half liters per day;
drinking any liquids before or an hour after meals;
dinner - no later than 2-3 hours before bedtime;
refusal to consume permitted foods that cause unpleasant symptoms.

Discharge

Immediately after surgery to remove an ovarian cyst, the patient is bothered by vaginal discharge.
They consist of impurities of blood, clots, and mucus. The total duration of their presence is no more than two weeks. Wherein greatest number blood is observed in the first week, then its concentration decreases. Discharge after laparoscopy of ovarian cysts becomes brown 5-7 days after surgery, then becomes more and more transparent.

Heavy uterine bleeding during any period of rehabilitation is not considered normal and requires urgent medical attention.

Pathological discharge has bad smell, acquire a yellowish, brownish or greenish tint, and may have admixtures of a white curd substance. This indicates the course of a genital tract infection or an inflammatory process. If they appear, you should immediately visit a doctor.

Unpleasant feeling in the stomach

Compliance with nutritional rules is necessary to prevent failure of the digestive process. Symptoms requiring medical attention:

constipation;
diarrhea;
nausea;
bloating;
heartburn.

To prevent the development of unpleasant symptoms, the patient is recommended to undergo an examination of the abdominal organs before the operation - colonoscopy, FGS, ultrasound.

To eliminate these signs, it is necessary to normalize nutrition. If discomfort occurs despite strict adherence to the doctor’s recommendations, you need to increase the amount of the following drinks in your diet:

herbal tea – chamomile is best;
still mineral water;
dill decoction;
drinks with added cinnamon, cardamom, ginger;
kefir.

These products will speed up the digestion process and normalize the functioning of the gastrointestinal tract. For achievement best effect For constipation, kefir should be consumed at night, 2 hours before bedtime. Herbal teas and other similar drinks are taken before meals or directly during tea drinking.

Postoperative pain

During the first 5-7 days after laparoscopy of an ovarian cyst, patients experience pain in the lower abdomen. This condition is considered natural and goes away on its own after the sutures heal. To relieve the symptoms, it is allowed to take painkillers.

At severe pain After laparoscopy of an ovarian cyst, the patient is advised to remain in bed, rest more, and not make sudden movements. If you have aching muscles in your body and back, you need to walk in the fresh air. If pain worsens, activity should be stopped.

When are the stitches removed?

Sutures are removed one and a half weeks after ovarian laparoscopy. During this period, the tissues are almost completely restored and do not require additional support. Before removing the sutures, it is necessary to carry out daily procedures for their treatment. The patient herself or with the help of medical staff must replace sterile dressings and clean wounds with antiseptic solutions.

After the stitches are removed, the scars heal very quickly. The laparoscopy method involves the use of only small tissue punctures during the intervention. Therefore, traces of the surgery are practically invisible, and sometimes they heal without a trace.

Drainage installed for a day after laparoscopy of an ovarian cyst accelerates the healing of sutures and prevents their suppuration.

Length of stay in hospital

After laparoscopy of an ovarian cyst, there is no need to stay in the hospital for a long time. The patient is usually discharged on days 3-5 depending on her well-being. A longer hospital stay is recommended if there are postoperative complications.

Hospital care services after laparoscopy can be waived, which is not recommended by experts, since the responsibility for own health the woman will carry it herself.

Sick leave

A certificate of incapacity for work is issued for the operation and initial period rehabilitation. Sick leave after laparoscopy of an ovarian cyst lasts 1.5-3 weeks. If you feel unwell, severe weakness and in the presence of complications, it can be extended.

Rehabilitation after discharge from hospital

To quickly undergo rehabilitation after laparoscopy of an ovarian cyst, the patient must follow all recommendations postoperative period and at home. Her well-being depends on her lifestyle and the accuracy of following the rules specified by the doctor.

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Home restoration

During the entire period of being on sick leave, the woman does not visit the attending physician. His consultation is necessary only if there are any questions about the current treatment or if the condition worsens. Therefore, she must follow the previously prescribed rules:

daily treatment of seams;
avoidance of active physical activity;
refusal of sex life and sports for 1-1.5 months;
regular ultrasound examination to obtain results on the condition of the ovary on which the cyst was removed;
cessation of activity when pain intensifies;
prohibition on lifting heavy objects;
refusal to treat scars after laparoscopy of ovarian cysts using folk and other means;
washing the body only in the shower;
wearing a bandage immediately after ovarian laparoscopy for 1 month;
avoiding visiting baths, saunas, swimming pools;
prohibition on scratching an itchy seam;
refusal of clothes that compress the lower abdomen;
compliance with the diet established after removal of the ovarian cyst.

Removal of prohibitions is possible only after the permission of the attending physician. Disregarding the rules rehabilitation period after laparoscopy, ovarian cysts are fraught with the development of complications that negatively affect the health of the woman’s reproductive system.

Duration of the postoperative period

The total duration of the recovery period is individual for each woman. On average, full functionality of the ovaries returns after 3 months. The sutures heal in 1-1.5 months. All rehabilitation rules should be followed for 1-2 months or until they are changed by a doctor.

The patient's health returns to normal a few weeks after the operation. At this time, she may feel completely healthy and only occasionally feel pain in the lower abdomen that accompanies the healing of appendage tissue. Weakness after surgery goes away quite quickly.

Start date of menstruation

Menstruation after laparoscopy usually continues as before. The first menstruation occurs according to a set schedule, individual for each woman. Bleeding may be slightly more or less profuse, long or short. This is considered normal and does not require a visit to the doctor.

Heavy and painful bleeding that increases over time and causes deterioration in health is considered pathological and requires urgent medical attention.

Menstruation may be delayed after surgery. This is also considered normal. During surgery, the tissue of the appendage is damaged, which can lead to a temporary disruption of its functionality and, as a result, to hormonal imbalance. Menstruation comes after their work is restored. If they are absent for more than a month and a half, you should undergo diagnostics of the genital organs.

The first 2-3 cycles after treatment may be irregular. Subsequently, menstruation is established and occurs in a certain manner. Usually their schedule coincides with the previously established one that occurred in the woman before the intervention.

The main condition for successful recovery is sexual and physical rest. In the first case, sex immediately after removal of an ovarian cyst can provoke increased pain and slow down the healing of appendage tissue. Unprotected sexual intercourse can lead to inflammation or infections, which can lead to suppuration of the internal sutures. This condition is manifested by acute pain, increased body temperature, and the appearance of pathological vaginal discharge. This requires hospitalization of the patient.

You need to wear a bandage after laparoscopy of an ovarian cyst for preventive purposes. Its use is strictly indicated for women who have an increased risk of complications that may arise after surgery. A corset is also necessary when removing a large tumor or intestinal dysfunction.

Physiotherapy courses after laparoscopy of an ovarian cyst will help speed up recovery - they improve blood flow in the pelvis and promote rapid tissue healing.

Physical activity is strictly limited only in the first week of rehabilitation. Subsequently, the woman is allowed to take short walks. Light exercise is encouraged. With its help, muscles are strengthened and stagnation in tissues is prevented. Increasing pain after performing exercises during a recent laparoscopy of an ovarian cyst indicates that the body is not sufficiently prepared for exercise. In such cases, physical activity should be limited for a few more days.

It is important to take all medications prescribed by your doctor:

antibiotics – prevent suppuration of sutures and the development of infections;
painkillers - improve a woman’s well-being;
anticoagulants – prevent the formation of blood clots;
hormonal – necessary to prevent hormonal imbalance after removal of an ovarian cyst or to correct the menstrual cycle;
immunomodulators – increase immunity;
vitamin complexes - restore the functioning of the appendages, saturate the body with useful substances.

Taking alcoholic beverages after laparoscopy of an ovarian cyst during drug treatment can lead to severe side effects from medications and worsen the patient’s condition.

Antibiotics and painkillers are used only 3-10 days after the intervention. Other types of drugs need to be taken for a longer period of time, which is determined individually.

Modern surgery gradually moves into the category of laparoscopic. It is this type of surgical intervention that is welcomed by the vast majority of surgeons. There are almost no limits to its capabilities.

Today, interventions have been mastered on almost all internal organs, including those located outside the abdominal cavity (retroperitoneal).

These include laparoscopic nephrectomy, herniotomy, prostatectomy, adrenalectomy and others. But the only successful one laparoscopy, postoperative period which was brought to its logical conclusion - the discharge of a practically healthy patient.

Basics of an easy postoperative period

By her own laparoscopic surgery was created to facilitate the postoperative period and rapid recovery of the patient. After all, with this intervention, all the requirements for an ideal operation are met.

And they include careful treatment of tissues, low trauma and aggression towards organs and the entire body as a whole. The less invasive the surgical intervention was, the faster the patient’s recovery in the postoperative period.

Another factor that influences its course is the presence of postoperative complications. Their development depends on many factors. Such conditions can be the result of a layering of several circumstances that do not in themselves cause danger.

But their combination turns out to be extremely dangerous. Postoperative complications can be local in nature, associated directly with defects in the surgical technology of the intervention, and general, associated with decompensation of the patient’s chronic pathology before the procedure. laparoscopy, postoperative period.

Their appearance aggravates the normal course of postoperative recovery, lengthening the rehabilitation period. It indicates possible technical errors or insufficient preoperative preparation. Although, globally, everything depends on the initial condition of the patient. Equally important is the implementation of recommendations on diet and nutrition by the operated patients themselves.

Thromboembolic processes are considered among the most dangerous complications that can arise. They become the main cause of mortality in. Therefore, both during preoperative preparation and after the intervention, prevention of this kind of complications is indicated.

This set of measures includes the administration of anticoagulant drugs in prophylactic doses and elastic bandaging of the legs in individuals at risk (presence of venous pathology, thrombophlebitis or phlebothrombosis in the anamnesis.)

To prevent suppurative processes from the postoperative wound and abdominal cavity, antibiotic prophylaxis is indicated, which is carried out with broad-spectrum antibiotics. Their administration is advisable together with induction anesthesia.

Since this type of operation is accompanied by minor trauma, early activation is recommended for all patients. After minor operations performed in the morning, by evening you can safely walk.

More complex ones require the patient to stay early postoperative period of laparoscopy, in the intensive care unit. This is necessary for careful monitoring of vital parameters. In case of any failures, they are corrected immediately.

The next day, if there are no complications, all patients are transferred to their ward. Already during this period, patients are allowed to sit and stand near the bed. It is very important, even in the absence of this opportunity, to carry out the most basic methods of exercise therapy and breathing exercises in the form of flexion and extension of the limbs, fingers, deep inhalations and exhalations with breath holding and obstruction.

This will prevent the development of congestion in the lungs and thromboembolic complications.

A natural and logical question: when can you eat? Usually the appearance of appetite is this criterion and occurs on 2-3 days. The diet should be very gentle, including only liquid food with mashed potatoes, butter, light varieties meat. Gradually, the diet is expanding, but in the hospital it is strictly forbidden to take fatty, fried foods and smoked foods with spices, citrus fruits and juices based on them.

After 4 days the patient can be discharged with a normal course postoperative period of laparoscopy. The stitches are removed after 7-8 days. After just a month, only small scars remind you of the operation, which completely disappear after 6 months.

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