Type of Surgery
Last updated: 11/24/2009
Following laparoscopy, patients are required to remain in a recovery area until the immediate effects of anesthesia subside and until normal voiding is accomplished (especially if a urinary catheter was used during the surgery). Vital signs...
are monitored to ensure that there are no reactions to anesthesia or internal injuries present. There may be some nausea and/or vomiting, which may be reduced by the use of the propofol anesthetic for healthy patients undergoing elective procedures such as tubal ligation, diagnostic laparoscopy, or hernia repair. Laparoscopy is usually an outpatient procedure and patients are discharged from the recovery area within a few hours after the procedure. For elderly patients and those with other medical conditions, recovery may be slower. Patients with more serious medical conditions, or patients undergoing emergency laparoscopy, an overnight hospital stay or a stay of several days may be required.
Discharged patients will receive instructions regarding activity level, medications, postoperative dietary modifications, and possible side effects of the procedure. It may be helpful to have a friend or family member present when these instructions are given, as the aftereffects of anesthesia may cause some temporary confusion. Postoperative instructions may include information on when one might resume normal activities such as bathing, housework, and driving. Depending on the nature of the laparoscopic procedure and the patient's medical condition, daily activity may be restricted for a few days and strenuous during administration of anesthesia may cause some soreness. Additionally, shoulder pain may persist as long as 36 hours after surgery. Pain-relieving medications and antibiotics may be prescribed for several days postoperatively.
Patients will be instructed to watch for signs of a urinary tract infection (UTI) or unusual pain; either may indicate organ injury. It is important to understand the difference between normal discomfort and pain, because pain may indicate a problem. Patients may also experience an elevated temperature, and occasionally "postlaparoscopy syndrome"; this condition is similar in appearance to peritonitis (marked by abdominal pain, constipation, vomiting, and fever) that disappears shortly after surgery without antibiotics. However, any postoperative symptoms that cause concern for the patient should be discussed with the doctor, so that any fears can be alleviated and recovery can be accomplished. Due to the after-effects of anesthesia, patients should not drive themselves home.
It is advisable for someone to stay with the patient for a few hours following the procedure, in case complications arise. Injury to an organ might not be readily apparent for several days after the procedure. The physical signs that should be watched for and reported immediately include:
- fever and chills
- abdominal distension
- difficulty urinating
- sharp and unusual pain in the abdomen or bowel
- redness at the incision site, which indicate infection
- discharge from any places where tubes were inserted or incisions were made
Additional complications may include a urinary tract infection (resulting from catheterization) and minor infection of the incision site. An injury to the ureter may be indicated by abdominal distention or a pain in the flank. Additional testing may be required if a complication is suspected.
This video shows how the large intestine or colon is removed through laparoscopic surgery. The perspective is that of the surgeon performing the colectomy or colon resection. A note to viewers, this video shows surgery on an actual patient. The anatomical landmarks are not labeled, but described by the surgeon narrator.
The surgeon has a choice of incision options for laparoscopy, depending on the needs of the procedure (A). In this abdominal procedure, carbon dioxide is pumped into the cavity to create a condition called pneumoperitoneum, which allows the surgeon easier access to internal structures. The laparoscope is connected to a video monitor, and special forceps are used to carry out any necessary procedure (C and D) (Illustration by GGS Inc.)
Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, keyhole surgery, or pinhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5-1.5cm) as compared to larger incisions needed in traditional surgical procedures. Laparoscopic surgery includes operations within the abdominal or pelvic cavities, whereas keyhole surgery performed on the thoracic or chest cavity is called thoracoscopic surgery. Laparoscopic and thoracoscopic surgery belong to the broader field of endoscopy.
Biliary colic is the presenting symptom in 80% of patients with gallstone disease who seek medical care; however, only 10-20% of all individuals with gallstones experience severe gallstone pain.
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