Laparoscopy for ectopic pregnancy: features of surgery, consequences

In this article, we suggest that you get acquainted with laparoscopy in ectopic pregnancy, which occurs quite often, at about 5%. Unfortunately, the child can not be saved in any way, the earlier to take measures for interruption, the more chances to save the appendages or even the life of a woman. If you feel the signs of pregnancy, then immediately it is worth to go to the gynecologist. The sooner ultrasound is done, the faster and easier it is to get rid of unpleasant consequences. In addition, ultrasound can help determine the location of implantation of the fetal egg. If the ultrasound revealed that the pregnancy is an ectopic, then it is necessary to act immediately (interrupt). How can this be done? What is a laparoscopy tube for ectopic pregnancy? For all these questions, you will find the answer in this article.

Ectopic pregnancy

First, we will understand how fertilization takes place. It is the fusion of two germ cells (ovum and sperm) in the fallopian tube. After this process, the already fertilized egg passes into the uterine cavity and is fixed to the wall. This is an example of a normal pregnancy, which occurs in ninety-five cases out of a hundred. In other cases, the fertilized egg is retained in the fallopian tube and fixed somewhere outside the uterine cavity. Where the fetus can fix:

• In the fallopian tube;
• In the abdominal cavity;
• In the ovary.

This is the wrong location of a fertilized egg and is called an ectopic pregnancy. Save the child in this case does not work, the doctor necessarily appoints a procedure for its interruption. Laparoscopy for ectopic pregnancy is the most popular and gentle method of treatment. If the time is right to take action, then after the operation after a while you can start planning the birth of a child.

Ectopic or ectopic pregnancy is a pathology in which a fetal egg is implanted outside the uterine cavity. It is worth noting that in recent times the number of cases has only increased.

What are the reasons that provoke this pathology? They include the following:

• Infectious diseases of the uterus;
• Diseased appendages;
• Disorders or inflammatory processes that occur in the bladder;
• Congenital irregular structure of pipes;
• Operations carried out on the fallopian tubes;
• hormonal disbalance;
• Frequent abortions;
• Presence of a spiral (method of contraception);
• Long-term treatment with hormonal drugs;
• Genital endometriosis;
• Swelling of the fallopian tubes and so on.

Laparoscopy of the tube with ectopic pregnancy, which develops in the fallopian tubes, is simply necessary. The sooner this pathology is diagnosed and the operation performed, the more likely it is that the appendages will remain. In addition, you need to find out the reason and do treatment to avoid recurrence.

Types of ectopic pregnancy

One can cite the following classification of ectopic pregnancy (in the place of fixation of the fetal egg):

• Tubular;
• Ovarian;
• Abdominal;
• Cervical.

The first species is the most common (98% of all cases). With tubal ectopic pregnancy, the mucosa is fixed to one of the fallopian tubes. In this case, it is possible to divide the tubular form into several subspecies (because of the location in the fallopian tube):

• Ampullary;
• Istmic;
• Interstitial;
• Fimbrial.

The other three types of these are quite rare cases. When the ovarian ectopic pregnancy occurs, the fixation in the cavity of the follicle occurs, with the abdominal - in the abdominal cavity, with the cervical - in the cervix.

Methods of treatment

It is very important to detect the presence of an ectopic pregnancy in time. Her symptoms will help. First, a woman can feel aching pain, perhaps she will give back. If you do not go to the doctor at this stage, the pain will soon become acute. It should not be taken with pain medication, as this can interfere with the diagnosis of an ectopic pregnancy. Also, a woman can feel strong weakness, dizziness and nausea.

Pay attention to the discharge, they can have a bloody color, this indicates internal bleeding due to damage to the appendages. If the pregnancy test is positive and you notice these symptoms, then go to the gynecologist. Note that loss of consciousness is also a symptom of this pathology.

The doctor must send you to the ultrasound, which will reveal the place of implantation of the fetal egg. After receiving the results, the gynecologist prescribes treatment. Ways to get rid of ectopic pregnancy:

• Laparotomy (surgical intervention, which involves opening the abdominal wall, removing the embryo along with the tube or even the ovary);
• Laparoscopy (with ectopic pregnancy this is the best and less dangerous method, during the operation make a single small puncture);
• Drug treatment.

Now let's talk a little more about each method.

Laparotomy is the removal of the fetal egg, which can lead to the removal of the tube or ovary. This method was used earlier, before the appearance of laparoscopy. However, in some clinics it is practiced to this day. These can be the following cases:

• The necessary modern equipment is not available;
• There is no specialist who can perform a laparoscopy operation;
• A critical condition of a woman, dangerous for her life.

Laparotomy is performed in several ways:

• Milking;
• Tubotomy;
• Tubectomy.

The first method allows you to save and protect from the incision of the fallopian tube. The fetal egg is squeezed out, it is possible if it is near the exit from the tube. After the operation, the woman will be able to become pregnant.

Tubotomy involves cutting or removing part of the tube together with the fetal egg. This method is resorted to, if you can not extract the fetal egg by extrusion. The probability of re-pregnancy in a woman after the operation remains, but significantly reduced.

Tubectomy is the removal of the fallopian tube and, if necessary, the ovary. Of course, the woman does not have a chance to become pregnant, but she will be able to save her life. As a rule, this method is used only in emergency situations, when the account goes for seconds.

Now we turn to the more popular method at the present time, this operation is laparoscopy with an ectopic pregnancy. It is considered less dangerous and sparing. We will devote a lot of time to this method later.

The last way is medical treatment. It is worth noting that doctors do not trust him, preferring surgical intervention. This method is used very rarely and with a very short time. Its essence lies in the introduction of the drug "Methotrexate", which kills and splits the fetus. The probability of getting pregnant after a successful medical treatment is practically not reduced compared to what was before him.

Laparoscopy

As mentioned earlier, laparoscopy for ectopic pregnancy is the best method of treatment. Immediately it can be noted that it is not traumatic. Laparoscopy helps to completely completely painlessly get rid of ectopic pregnancy, that is, one that develops outside the uterus. A woman during an operation can not feel any pain or discomfort, since she is under general anesthesia.

The surgeon must make a small puncture in the abdominal cavity and introduce a special instrument with which he can extract the embryo from the fallopian tube. The whole operation is done under the control of an ultrasound machine.

As it became clear, a child with laparoscopy of an ectopic pregnancy can not survive. But a timely operation helps save a woman's life and health. At the first suspicions on ectopic pregnancy go to the doctor. The sooner measures are taken for the treatment of ectopic pregnancy, the more likely a woman will have children in the future.

Already during the operation the doctor decides whether to keep the pipe or not. All this depends on some factors. The uterine tube is retained if:

• Small gestational age;
• The uterine tube was not severely affected.

If these two important conditions are met, the doctor makes a small incision to remove the fetal egg. After such an operation, a woman quickly goes on to recover and maintains her reproductive health. Otherwise (if the fetus is large enough and severely injures the fallopian tube), the doctor decides to remove part or all of the tube.

Once again, we draw your attention to the fact that the earlier you seek help from a gynecologist, the greater the chance of maintaining your reproductive health. Be attentive and listen to the signals of your body. Summarizing this section, I want to highlight the advantages of a modern operation called laparoscopy:

• Low blood loss;
• Rapid recovery from surgery;
• Rare postoperative complications;
• Absence of scars.

This operation has some more advantages:

• With laparoscopy, the abdominal cavity is washed away from the blood (blood is the cause of the formation of adhesions, the latter, in turn, can lead to a repeat ectopic pregnancy);
• After surgery, the surgeon can assess the condition of the second tube and appendages;
• Possibly reconstructive intervention (dissection of adhesions, restoration of patency of pipes).

The sooner you are assigned a laparoscopy, the more likely you are to conceive a healthy baby in the future.

Saving the pipe

Laparoscopy with ectopic pregnancy with preservation of the tube is carried out under certain rules: the gestation period is small, the tube is not damaged. In other cases, the doctor can not leave the tube, because it can cause a repetition of the pathology, since it will no longer fulfill its direct purpose.

Conducting laparoscopy in ectopic pregnancy with preservation of the tube is possible only with timely treatment in a medical institution. Listen to the signals of your body. The development of ectopic pregnancy is dangerous in that the walls of the uterine tube stretch as the fetal egg grows. As a result, they can not stand and are torn. At this stage it is important not to save the pipe, but the life of the woman.

If you feel the first symptoms of an ectopic pregnancy, then go to the gynecologist. Diagnosis of it is reduced to several items:

• Delivery of a blood test for HG;
• ultrasonography.

With an ectopic pregnancy test, even conducted at home by yourself, will show a positive result. However, ultrasound will not reveal a fetal egg in the uterine cavity. In this case, you need to immediately go for laparoscopic diagnosis. If this is done in time, the chances of saving the pipe and maintaining reproductive health are very high.

Pipe Removal

The operation of laparoscopy of an ectopic pregnancy with the removal of a tube is simply necessary in some cases. You will learn about them in this section of the article.

The operation itself is completely safe and is characterized by a quick recovery period for a woman after it. It is done under general anesthesia. For its carrying out it is necessary to make three punctures (diameter no more than one centimeter) for laparoscopic tubes and a laparoscope. The second is necessary in order to display on the screen a picture, which is necessary for assessing the state of organs.

Laparoscopy has two types:

• Tubotomy (we spoke about it above, the surgeon cuts the uterine tube and extracts the fetal egg, retaining the functions of the tube);
• Tubectomy (removal of the uterine tube).

Laparoscopy of the fallopian tubes in ectopic pregnancy with removal of the tube is needed in emergency and very severe situations (if the preservation of the uterine tube carries a greater risk than its removal). You can save it if there are no structural changes, otherwise it's pointless and dangerous.

So, tubectomy is done if:

• There are irreversible changes in the uterine tube;
• Repeated ectopic pregnancy with implantation in the same tube as before after tubotomy;
• Adhesive process in the pelvis.

In the operation, the mesosalpinx and the isthmic department are excised. The fallopian tube is removed along with the fetal egg. To assess the condition of the "pregnant" pipe helps to inspect the second. After the examination, the surgeon decides: you can leave the sick tube or remove it better.

To maintain reproductive health and the opportunity to become pregnant and give birth to a healthy baby, you should not postpone your visit to a gynecologist. Timely treatment and treatment is the guarantee of your happy future.

Recovery

So, laparoscopy is the removal of an ectopic pregnancy, which, with timely treatment, is more sparing. We have already highlighted the advantages of this operation. One of them is the rapid recovery of a woman after laparoscopy. Removing an ectopic pregnancy using this method consists in piercing small holes to insert special devices. In this regard, the sutures are removed already on the fifth to the seventh day after the operation, provided that there is no inflammatory process.

Recommendations of doctors in the postoperative period:

• Treatment of iodine wounds for two weeks;
• Two weeks to take shower exclusively;
• Not fat and sharp;
• Sex is possible only after the restoration of the menstrual cycle;
• Planning of pregnancy is discussed with the doctor (it is necessary to wait from 1 month to 4).

Bleeding

In this section, we will discuss bleeding after laparoscopy of an ectopic pregnancy. Many women who underwent this operation noticed that after 20-30 days, bleeding opens. They write it off as a side effect of the prescribed treatment. Below is an approximate list of medicines for rehabilitation:

• calcium chloride;
• Metrogil;
• "Actovegin";
• "Cycloferon";
• AGT;
• Diclofenac;
• "Gluconate SA";
• "Voebenzim";
• Rotamycin;
• Viferon.

The course of treatment should begin immediately after surgery, use those drugs that are prescribed by the attending physician. Before the opening of bleeding, clots of blood can leave, it is quite normal phenomenon after laparoscopy. Open bleeding is nothing but a period.

Allocations

Bloody discharge after laparoscopy of ectopic pregnancy indicates the arrival of menstruation. Immediately after surgery, do not panic if the discharge will have an "smearing" character. If the spotting appeared earlier than 25-30 days after the operation, this indicates a bleeding from the uterus. Be sure to consult a doctor.

Also, do not delay the visit to the gynecologist, if there are no discharges for more than a month after the operation. This may indicate that the hormonal balance is broken and a special course of treatment is necessary.

If the body has an infection, the discharge will have an unpleasant smell. In consistency, they resemble porridge. Be sure to go through the examination and treatment.

Monthly after operation

Monthly after laparoscopy of an ectopic pregnancy come no later than thirty days after the operation. Do not worry if you see blood clots.

The absence of a monthly testifies to a hormonal failure after the operation. Contact your doctor. He is obliged to send you to the tests, which will confirm or refute this theory. With any deviation from the norm, go immediately to a consultation with a gynecologist.

Pregnancy after laparoscopy

Pregnancy after laparoscopy of an ectopic pregnancy is quite possible. Please be sure to consult with a gynecologist about this. If there are no contraindications, then you can begin planning pregnancy in the next month.

It is also necessary to take into account the fact that to prevent the recurrence of an ectopic pregnancy, you need to undergo a complete examination and find out the cause of its occurrence. After identifying and fixing the problem, you can safely do another attempt at conception of the baby.

A long-awaited pregnancy after laparoscopy of an ectopic pregnancy may not occur for a long time. In this case, women receive IVF treatment. It is important to mention that in this way, even girls and women who have had a mother tube removed during the operation can become pregnant.

Reviews

Laparoscopy of ectopic pregnancy reviews is exceptionally positive. After all, this method is characterized by rapid rehabilitation and the ability to maintain reproductive health. In addition, the doctor during surgery can eliminate some more problems that prevented a woman from becoming pregnant. These include cutting the adhesions or restoring the patency of the pipes.