FAQ

What are the contraindications for laparoscopic surgical instruments?

Contraindications for laparoscopic surgical instruments include the following:

Severe organ dysfunction: such as severe heart, lung, liver, and kidney dysfunction, these patients cannot tolerate the risks of surgery and anesthesia.

Huge masses: There are huge masses in the pelvis and abdominal cavity, especially when the upper limit of the mass exceeds the level of the umbilicus or the gestational uterus is greater than 16 weeks of gestation, and the volume of uterine fibroids exceeds 4 months of pregnancy, which will limit the surgical operation space and may cause the mass to rupture.

Diffuse peritonitis with intestinal obstruction: Due to the obvious expansion of the intestinal tract, intestinal perforation is easy to occur during puncture.

Severe abdominal and pelvic adhesions: such as a history of acute and chronic pelvic inflammatory disease, fibroids larger than the size of a fist, and ovarian tumors, etc., these conditions will increase the difficulty and risk of surgery.

Inexperienced surgeons: Laparoscopic surgery is not recommended if the surgeon's skills and experience are insufficient.

Severe complications: such as acute cholecystitis with severe complications (such as gallbladder abscess, gangrene, perforation, etc.), obstructive jaundice, gallbladder cancer, gallbladder protrusion lesions suspected of cancer, portal hypertension of liver cirrhosis, mid-to-late pregnancy, etc.

Other special circumstances: such as acute attack of calculous cholecystitis, chronic atrophic calculous cholecystitis, history of upper abdominal surgery, extraperitoneal hernia, etc.

These contraindications need to be carefully evaluated before surgery to ensure the safety of the patient and the success of the operation.

Which specific diseases are laparoscopic surgical instruments most effective in treating?

Laparoscopic surgical instruments have shown significant advantages in the treatment of a variety of specific diseases. The following are some of the main application areas:

Hepatobiliary surgery: Laparoscopic surgery has gradually replaced open surgery in the field of hepatobiliary surgery and has become the main treatment method. For example, single-port laparoscopic cholecystectomy has been successfully implemented and has the advantages of less trauma and no visible scars.

Digestive tract diseases: Laparoscopic technology has also been widely used in the treatment of digestive tract diseases. For example, the successful laparoscopic removal of benign gastric GIST (gastric stromal tumor) and the successful implementation of total laparoscopic whole liver transplantation have demonstrated its important role in minimally invasive surgery.

Gynecological diseases: Laparoscopic surgery is also widely used in the field of gynecology, especially in the treatment of diseases such as ectopic pregnancy and ovarian cysts. The application of single-port laparoscopic technology in the field of gynecology has also made significant progress.

Colorectal diseases: Single-port laparoscopic colorectal surgery has also shown its advantages in the treatment of colorectal diseases, such as the reduction of surgical incisions and fast recovery.

Urology: Laparoscopic technology has also been widely used in the field of urology, from simple organ resection to complex preservation and reconstruction surgery, laparoscopic technology has made significant progress.

Weight loss surgery: Laparoscopic weight loss surgery is also gradually being promoted, especially for patients with severe obesity. This surgical method is not only less invasive, but also can recover quickly.

How to evaluate the relationship between the risks of laparoscopic surgery and the overall health of patients?

The relationship between the risk of laparoscopic surgery and the patient's overall health status requires comprehensive consideration of multiple factors, including the patient's age, underlying diseases, type of surgery, and postoperative complications. The following is a detailed evaluation method:

Elderly patients may have reduced safety when undergoing laparoscopic surgery. For example, elderly patients have a higher risk of postoperative admission to the intensive care unit (ICU) when undergoing laparoscopic pancreaticoduodenectomy (LPD). Therefore, special attention should be paid to the patient's age during the evaluation, and a comprehensive judgment should be made in combination with other relevant indicators.

The patient's underlying disease has a significant impact on the safety of the operation. For example, patients with chronic liver disease or renal insufficiency may not be able to bear the additional burden of surgery, thereby increasing the risk of surgery. Therefore, during the evaluation process, it is necessary to understand the patient's underlying disease in detail and adjust the surgical plan according to the specific situation.

Different types of surgery and technical requirements have different effects on the patient's health status. For example, laparoscopic cholecystectomy requires certain surgical skills and experience, otherwise it may increase the risk of surgery. In addition, laparoscopic gastric cancer surgery has the same safety as open surgery in some cases, but it still needs to be performed by experienced surgeons.

Postoperative complications are an important indicator for evaluating surgical risks. For example, the incidence of complications after laparoscopic pancreaticoduodenectomy is high, among which the incidence of pancreatic fistula is 17.0%. In addition, postoperative shoulder pain is also a common complication, and its risk factors include residual gas under the diaphragm, prolonged operation time, female, and low BMI.

Laparoscopic surgery may affect the body's immune function, such as changes in T lymphocyte subsets, decreased CD4/CD8 ratio, and increased CRP, IL6, and TNFα levels. These changes may affect the patient's overall health and recovery after surgery.

Evaluating the relationship between the risk of laparoscopic surgery and the patient's overall health requires a comprehensive analysis from multiple perspectives, including the patient's age, underlying diseases, type of surgery and technical requirements, postoperative complications, and the body's immune function.

In laparoscopic surgery, which complications are emergency situations that require immediate discontinuation of medication or cancellation of surgery?

In laparoscopic surgery, the following complications are emergency situations that require immediate discontinuation of medication or cancellation of surgery:

Rupture of large blood vessels: This is a serious complication in gynecological laparoscopic surgery. Once it occurs, the patient will suffer from hemorrhagic shock and lose his life in a short period of time, so emergency treatment is particularly important.

Gas embolism: When using carbon dioxide for abdominal insufflation, acidosis may lead to gas embolism, which may be fatal.

Severe incision infection: If severe incision infection occurs after surgery, such as fever, redness and swelling around the incision, abnormal exudation, etc., immediate treatment may be required to prevent further complications.

Pulmonary infection: Since laparoscopic surgery requires general anesthesia and endotracheal intubation to assist breathing, irritation to the throat may cause increased secretions. If it cannot be discharged in time, aspiration pneumonia may occur, which is also an emergency.

Bleeding: Damage to blood vessels during laparoscopic surgery can cause bleeding, which is one of the main causes of death in patients. If a large amount of bleeding is found during surgery, measures should be taken immediately.

Before laparoscopic surgery, what specific preparation and assessment procedures are there to ensure patient safety?

Before laparoscopic surgery, the specific preparation and assessment procedures to ensure patient safety include the following aspects:

Routine preparation:

Skin cleaning: The abdominal skin needs to be thoroughly cleaned before surgery, especially the navel, because the navel will be punctured during surgery.
Bathing and changing clothes: Bathing and changing clothes are performed the day before surgery to ensure that the skin is clean and reduce the risk of infection.

Bowel preparation:

Dietary adjustment: Start a semi-liquid diet the day before surgery. Generally, adults should fast for 12 hours before surgery to reduce intestinal contents.
Enema: For larger surgeries, such as malignant tumors, uterine adenocarcinoma or ovarian cancer, bowel preparation and enema are required.
Case establishment and examination:

Gynecological examination: The doctor will establish a case for the patient, perform a gynecological examination, complete laboratory tests, and determine the date of surgery.

Disease assessment and safety assessment:

Disease suitability assessment: First complete the patient's "disease assessment (whether it is suitable for laparoscopic surgery)" - "safety assessment" - "patient education" - "informed consent" process management.
Perioperative health education: Closely observe the patient's health status to ensure that the patient performs the surgery safely and effectively.

Article preparation:

Laparoscopic instrument preparation: Prepare necessary laparoscopic instruments, fixation belts, shoulder supports, wet saline gauze, etc.

Other assessment contents:

Lifestyle, drug management, personal preparation, multicultural assessment and safety assessment: These are all part of the admission preparation assessment, which helps doctors fully understand the patient's condition and ensure the smooth progress of the operation.

For patients with major lifestyle changes (such as diet and exercise), what special precautions or suggestions are there for laparoscopic surgery?

For patients with major lifestyle changes (such as diet and exercise), there are several special precautions or suggestions after laparoscopic surgery:

Dietary adjustment: After surgery, you should choose foods rich in protein and vitamins, such as eggs, lean meat, milk, apples and oranges, to help your body recover. Generally, there is no need to fast after surgery. Those who are under general anesthesia can eat after waking up, and gradually transition from liquid food to normal food.

Exercise arrangement: The time and intensity of postoperative exercise need to be determined according to the type of surgery and personal physical condition. It is generally recommended to start running exercise one month after surgery. At the beginning, it is recommended to jog, and then gradually increase the amount of exercise according to your own situation. However, it is also recommended that you can do some light exercise 2-3 days after surgery to avoid nausea, fatigue and other discomfort symptoms. Specific to different types of surgery, such as laparoscopic cholecystectomy and appendectomy, you can do moderate exercise about a week after surgery, while it is recommended to start exercise half a month after liver, pancreas, spleen surgery or gastrointestinal surgery.

Wound care: It is very important to keep the wound clean and dry, because the incision of laparoscopic surgery is small. Once infection occurs, recovery will be affected.

Lifestyle: After surgery, you should get enough sleep, develop good living habits, avoid staying up late, don't be picky about food, and try to eat nutritious food.

Activity and rest: 1-2 days after surgery, due to the influence of anesthesia and trauma, the patient's body is relatively weak. At this time, it is recommended to walk less and rest in bed more. However, patients are also encouraged to get out of bed as soon as possible to promote the recovery of gastrointestinal motility, and at the same time avoid strenuous activities.

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