Planned simultaneous laparoscopic operations in gynecology and surgery

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Actuality. Increase of traumatic effect during performance of simultaneous phases and additional accesses use are presented as a major reason of surgeons’ rejection to perform simultaneous correction of combined diseases with laparoscopic methods. This major reason may become disputable as laparoscopic methods are introduced in contemporary medicine.

Aim of the research. To make comparative estimation of early and late post-operative periods with patients who had isolated and simultaneous laparoscopic surgery as well as to optimize the attitudes for performances of planned simultaneous laparoscopic operations in gynecology.

Materials and methods. From January 2000till August 2005 in the departments of gynecology and surgery of Regional S.V. Ochapovskiy Clinical Hospital № 1, 26 planned simultaneous laparoscopic operations had been performed.

Results of the research. Coagulation and/or removal of nidus of outer genital endometriosis (OGE) was performed in 5 patients (19,3%), total laparoscopic hysterectomy (TLH) was performed in 4 patients (15,4%), conservative myomectomy - in 4 patients (15,4%), cystadenonectomy - in 3 patients (11,5%), salpingolysis-ovariolysis and neosalpingoectomy were performed in 3 patients (11,5%), sub-total hysterectomy (STLH) - in 2 patients (7,7%), tubectomy - in 2 (7,7%) patients and andexectomy - in 1 patient (3,8%). Laparoscopic gynecological operations were combined with laparoscopic hernioplastics for umbilical incarcerated hernia (3), for post-operative ventral small hernias (2) and inguinal hernia (21). The operations for the patients under research, had been started from gynecological phase; hemioplasty with the use of MESH-prosthesis, as a rule, was performed as a last phase. Average duration of an operation was 83,2 ± 8,1 minutes. The longest operations were in cases of relapse hernia, average duration of such operations was 82,8 ± 6,7 minutes, as well as in cases of herniorrhaphy combined with TLH, average duration of such operations was 65,4 ± 8,1 minutes. Average in-hospital stay of patients who had simultaneous herniorrhaphy was 9,5 ± 2,6 days. 3 patients had minimal period of in-hospital stay, it was 5 days, the longest stay in the hospital was 16 days. There were no complications in post-operative period, the cases were typical. There were no lethal outcomes.

Conclusions. Planned simultaneous laparoscopic operations allow to perform simultaneously radical and reconstructive plastic surgical treatment of gynecological and surgical diseases, they do not increase traumatic effect of operations and have excellent cosmetic results.

About the authors

Т. V. Gordeeva

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Krasnodar

А. N. Grigorova

Email: info@eco-vector.com
Russian Federation, Krasnodar

Z. V. Dudka

Email: info@eco-vector.com
Russian Federation, Krasnodar

References

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