Laparoskopia represents a form of minimally invasive surgery where Laparoskop access to the internal organs of the body and conduct a variety of operations.
Naim Shabani, Dr.sci.dr.
Gynecologist-oncologist
Pathologist-citolog
Tel: 044677-333
Tel. ++ 49 38 174 38705
The first to start the application of laparoscopy (TSS) as a method of minimally invasive operation are gynecologists; a few decades ago and then this form of surgery, has found application in other areas of medicine.
Laparoskopia has, in fact, a form of minimally invasive surgery with the introduction of the so-called Laparoskop (a stick with a small and light camera) access to the internal organs of the body (LSK diagnosis) and conduct a series of operations (LSK operating) for which previously had to be done to open the abdominal wall.
How done?
To access the Interior of the abdomen, it must first with a special needle abdominal wall bristles. As the most common place for this umbilical region elected. Is 1 cm incision and through a needle as it enters the inside of the abdomen, injected 3-4 liters of gas (CO2). This allows us to the anterior wall of the abdomen to leave the intestines and other organs so as not to come to harm in the case of introduction of a tool (GMD) with a diameter of approximately 10-12 mm. Even this step, as well as the insertion of a needle already done in a blind (i.e., without seeing what happens, what in the abdomen. Through this trocars placed inside a Laparoscopy minikamerë who accompanied original images (color) screen. From this point, any further action is performed in control and the risk of complications is lower.
First become a "walk" with a camera on top of the abdomen to see if liver okay, bile bladder, stomach, spleen, part of the intestine, and then again in the pelvic region, where to see the situation of the uterus and ovary. To notice the female genitalia, the patient is placed in an upside down position (operating tables removed) and 1-3 small incisions (5 mm) in the lower region of the abdomen. Here we introduce a 5 mm trocars and through them can integrate additional tools to remove the intestine and uterus and ovaries.
If women have the abdomen and genital pain above are in place, we get a bacterial smear and then finishes the operation (TSS diagnostikuese-requires 10-15 minutes).
Where conclude, vepërçues ovary syndrome or uterus, can continue to operate TSS.
What operations can be performed in Gynecologic laparoscopy?
Today, through LSK can be performed nearly 90% of all gynecological operations. The prerequisite for this is the operator with experience, team of experts which assists and adequate equipment.
Ekstrauterine pregnancy (ectopic pregnancy), it is capable of locating abroad normal pregnancy (cancer), especially in vepërçues. Here you can come to pëlcitja vepërçuesit with internal bleeding, then is also an acute conditions in gynaecology, which if not diagnosed in time, could endanger the lives of women. Through diagnostic laparoscopy becomes safer and more removing of this pregnancy, either by opening the tube (tubotomi) or when you damage more complete removal of the tube (tubektomi).
Removal of ovarian cysts, ovarian cysts occur in women of reproductive age due to hormonal changes during the menstrual cycle. They in many cases withdrawn automatically and appear again. If ovarian cyst persists (not withdrawn automatically) for a couple of months, or more than 5 cm caliber or causes abdominal pain, should be removed by surgery. This cistes intervention to keep starting organ (ovary), performed flawlessly with laparoscopy (TSS). After inserting laparoskop into the abdomen, cut the outer wall of cistes (taking care not to open the cistes cysts so no fluid released) and gradually the skin cyst that, together with the liquid content put into a bag and then kicked out through one of the holes of the laparoscopy.
25-year-old patient with ovarian Cyst, 5.5 cm right: (. Dr. Saini) operator cistes Kareem LSK with the maintenance of ovary
Complete removal of Adnexeve (ovaries and veperçuesit), and this is done easily with LSK. In cases where the ovary is completely damaged by various illnesses (cancer, etc.) Leave together with the tube in question. Adnexit Same extraction (ovary with pipe) created with the help of a bag.
Ovarian cysts, turn the Adnexit and necrosis (acute). Due to the patient who comes in late, leave everything adnexi (ovary and vepërçuesi-perish due to lack of blood supply). Operator: Dr. B. Shabani
The removal of uterine fibroids, benign tumors such as fibroids, often the size or location in the uterus, causing various problems, such as increased menstrual bleeding, pain or an obstacle to getting pregnant. In cases where the need to preserve the uterus (female wants to have children), avoiding their enukleim called fibroids. This surgery can be performed by LSK. After removing one or more fibroid tumors, like the opening operation (by cutting the wall of the abdomen), the uterus must be woven into places where there was myomas.
The 30-year old patient, secondary infertility, uterine myomatosus. Myomenukleacion op with LSK (operator Dr. n. Saini)
Partial removal of the uterus, removal of the uterus (Hysterektomia-HE) can be done in a form such that only the body of the uterus to save my neck (laparoscopic Hysterektomia). This is done by laparoscopy and is labeled ADL (laparoscopic hysterectomy Suracervical). After inserting minikamerë into the abdomen, uterus, on both sides of the shkolitet camera support and finally, in the neck region, completely separated from the neck. The body of the uterus removed from the abdomen through fragmentation in bark form, as when qërojmë Apple (with the help of an apparatus called the mill-morcellatore).
The complete removal of the uterus: Hysterektomia set can be set with LSK, and therefore is called TLH (Total hysterectomy Laparscopic) LSK partially or in part from the vagina (vaginal lap LAVH-Assisted HE.).
Surgical treatment of Gynecologic Neoplasms:
Recently in Western countries, with the advance of laparoscopic technology and experience with this type of operation, more often and in many centres, applied by TSS operational even gynaecological cancers (are radical operations that last for hours Each). Here it must be said radical operation of cervical cancer known as operation Werthheim. To run an op Werthheim LSK (Radical hysterectomy total = TRLH) as precondition is the experience of the operating team and possession of modern operational tools. As shown in the following illustration, for this we need to open more holes to use multiple tools operating and, in addition to the operator needed a doctor at least two and sometimes three medical assistants. During this operation removed radically the uterus, both ovaries, tubes, and sometimes the pelvis and lymph nodes along the main blood vessels (aorta and vena kava until the veins of the region of the kidney.
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