Laparoscopic Surgery

Introduction

Possible Complications

Service Number

Procedure and Course of Treatment

Procedure of Surgery

Recovery Time

Postoperative Care

 


Introduction
1.Advantage of laparoscopic surgery: small wound and less pain, less hospital stay and rapid recovery.
2. Disadvantage of laparoscopic surgery: the equipment required by the surgery and training of the medical personnel are relatively complicated, some operations may be longer; artificial pneumoperitoneal media made of CO2 may cause pain under bladebone for 24-36 hours after surgery.


Possible Complications
Since there is risk during any surgery and anesthesia, laparoscopic surgery may result in following risks and complications, thus the hospital stay may be prolonged, even need to undertake the second surgery.

  1. Hemorrhage due to large blood vessel damage (0.1%)
  2. Urinary ladder injury (1.8%)
  3. Urethra injury (0.3%)
  4. Large and small intestines injury (0.4%)
  5. Delayed fistula formation (0.04%)
  6. Lung embolism (0.2%)
  7. Pelvic hemorrhage
  8. Phlegmon at vagina incision (0.7%)
  9. Urinary tract infection (0.4%)
  10. Respiratory infection (0.3%)
  11. Wound infection (0.1%)
  12. Blood transfusion (1.4%)
  13. Other complications (0.1%)

In case of following cases, it is better to undertake the traditional abdominal surgery:

  1. 1.6% of possibility about adhesion, fatness, matrix hypertrophy or endometriosis in large intestines or hemorrhage occurring during surgery. It should change back into the traditional surgery.
  2. In case of above complications, must remedy it with the traditional abdominal surgery, it may need to make artificial anus for intestine repair. No matter it is abdominal or traditional surgery, a few of patients should stay in the ICU for the disease itself or complication caused by surgery. There is only a few of report on death due to surgery complications.


Service Number

Year

2005

2006

2007

2008

2009

Treated patients

579

939

871

929

711

Cumulative Number of Treated patients

579

1518

2389

3318

4029


Procedure of evaluation and treatment
OPD examination: echo, hysteroscopy, tumor marker
Admission: Pre-OP evaluation (blood biochemistry examination, Chest X ray, EKG)
OPD follow-up


Course of Treatment
Admission for 3~5 days (Examination, Treatment, Observation)


Procedure of Surgery
1. Pre-OP evaluation (blood biochemistry examination, Chest X ray, EKG).
2. NPO. NPO means withhold oral food and fluids from a patient. The reason for NPO instructions is the prevention of aspiration pneumonia, e.g. in those who will undergo general anaesthetic.
3. Skin preparations: The patient should bathe the night before an elective operation. Hair in the operative site should not be removed unless it will interfere with the surgical procedure. Shaving can damage the skin so clipping is better if hair removal is required; it should be done in the operating room. Just before the operation, wash the operation site and the area surrounding it with soap and water. Prepare the skin with antiseptic solution, starting in the centre and moving out to the periphery.
4. Sign the operation permit.
5. Operation.
6. In general, laparoscopic surgery is an outpatient procedure.


Recovery Time
1. You can usually return to work and moderate activities by the third day.
2. You may need 1-3 weeks to return to heavy activities and for full recovery.


Postoperative Care
1. Site Care
(A) Your laparoscopic incisions will be covered with steri-strips or bandaids. Do not peel these off; they will fall off on their own in 7-10 days.
(B) You may shower on the day of discharge.
(C) Do not take tub baths or go in pools or hot tubs until your doctor says it is okay.

2. Activity
(A) Because your stomach muscles are weak after surgery, avoid heavy lifting (greater than 10 lbs.) for 4-6 weeks. This includes any pushing or pulling.
(B) Increase activity as tolerated and continue to walk several times a day.
(C) Your doctor will let you know when it is safe to return to work or school and resume driving.

3. Hydration
(A) Increase your fluid intake after surgery, especially water.
(B) Avoid carbonated beverages that can cause gas.
(C) Using straws will also increase gas.

4. There may be some vaginal staining after the procedure. Sexual intercourse can be resumed after vaginal bleeding has stopped (2 weeks or more).


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