Laparoscopic Repair of Pelvic Floor

In traditional repair of pelvic floor surgery, incisions are made through the vaginal skins and the torn or damaged connective tissues is plicated using absorbable suture materials. In laparoscopic pelvic floor repair, surgeons reattach the prolapsed pelvic organs to the pelvic floor muscles or bony landmarks using non-absorbable / permanent suture or mesh materials. The repair is based on the concept that pelvic organs prolapse mainly as a result shearing forces which damage the connective tissues that attach the pelvic organs to the pelvic floor. Laparoscopic surgery is suitable for correction of detachment types of pelvic floor defects which form cystocoele, rectocoele, uterine and post-hysterectomy vault prolapse. Risks associated with laparoscopic pelvic floor repair are uncommon. They include risks associated anaesthesia, laparoscopic surgery and vaginal repair. The latter may include rare injury to bladder, bowel, blood vessels and nerves of the pelvis.

Prolapse is a condition in which the body that are normally supported by pelvic floor or bladder, intestines and uterus, hernia or protrudes into the vagina. This happens as a result of damage to the muscles and ligaments that make up the support of the pelvic floor. For many women, prolapse may involve lowering the uterus, vagina, bladder and / or rectum consequences of feeling "buldging" in the vagina. In some cases there can be free screenings of these organs. Pelvic organ prolapse can lead to symptoms such as urinary incontinence, constipation, and difficulty in sex.

Laparoscopic colposuspension is a minimally invasive surgical technique that ensures a safe and sustainable way for the reconstruction of the pelvic floor and its contents, without the need for a large incision in the abdomen.

Pre Operatively

During the preoperative consultation surgeon will examine your medical history and perform a physical examination. What to expect before surgery and most insurance companies will not allow patients to be admitted to the hospital the day before surgery to test done, you should arrange for preoperative tests in the office of their primary care physician within 1 month prior to surgery. After the set date of the operation, a letter will be faxed to your primary care physician requires the following postoperative check:

General Medical examination

ECG (electrocardiogram)

CBC (complete blood count)

PT / PTT (coagulation profile)

Complete metabolic panel

Urinalysis

Operation

Laparoscopic colposuspension is performed using laparoscopic instruments inserted through the incisions through the center of the abdomen. This is in contrast to conventional open abdominal colposuspension where necessary line abdominal incision of annenstiel medium or low. In the case of pelvic organ prolapse, vaginal relaxation there is support causes protrusion of pelvic organs. The aim of laparoscopic colposuspension again suspend the vagina and pelvic organs are connected through keyhole incisions. In certain circumstances, at the same time a hysterectomy, bladder suspension or rectocele repair may be necessary, which can be achieved through a vaginal approach. Laparoscopic colposuspension is well established in the medical center and the process is carried out with the help of laparoscopic surgical teams experienced and dedicated staff, including nurses, anesthesiologists and operating room technicians, many of you cater to day operations.

Laparoscopic colposuspension is performed four small keyhole (0.5-1 cm) cuts through the center of the abdomen. Through these small incisions, laparoscopic fine instruments are inserted to dissect and suture. Excellent viewing the pelvic organs was prepared using a telescopic lens high power device is connected to the camera; that is inserted into the incision. The bodies of the vagina and pelvic re-suspended in combination stitches and supporting networks or graft belt). If necessary, the suspension of the bladder, vaginal hysterectomy and rectocele repair can be carried out simultaneously through the vaginal incision. A Foley catheter (ie catheter bladder) located drain the bladder. Vaginal gauze at the end of the process. The length of the operating time for laparoscopic colposuspension can significantly (3-5 hours) will vary from patient to patient depending on the internal anatomy of the shape of the font, the patient weight and the presence of scars due to pelvic inflammation or infection, or pelvic / abdominal surgery before.

Blood loss during laparoscopic colposuspension is always lower than the 200 cc and transfusions are rarely needed.

What to expect after Surgery

Immediately after surgery, you will be taken to the recovery room, and then transferred to his hospital room, after fully awake and your vital signs are stable. Post-Operative pain: Pain medication can be controlled and delivered to the patient through the pump patient-controlled analgesia (PCA) or intravenous (pain injection), which carried out by a nurse. You may notice a slight pain in his shoulder passable (1-2 days) in relation to the carbon dioxide gas used to inflate the abdomen during laparoscopic surgery.

Spasms of the bladder: Bladder spasms are commonly known as a mild cramping sensation in the bladder or lower abdomen and is common after colposuspension. These cramps are usually transient and usually diminish over time. If severe, medication can be prescribed by doctors to reduce episodes of these spasms

Nausea: You may have transient nausea during the first 24 hours following surgery, which can be related to the anesthesia. There are medications to treat persistent nausea.

Urinary catheter: You can expect to have a urinary catheter (Foley) empty the bladder (placed in the operating room under anesthesia) about 1-2 days after surgery. It is not uncommon to have blood stained urine for several days after surgery. Vaginal Packing: A plug of gauze vaginal always at the end of the surgery, while the patient is under anesthesia. This package will be removed usually the next day.

Diet: You can expect to have an intravenous in 1-2 days. Most patients are able to tolerate clear liquids the day after surgery and normal diet the next day. Once in a typical diet, medication pain than oral or intravenous injection.

Fatigue: Fatigue is a common and should begin to disappear in a few weeks.

Incentive Spirometry: It is to do some simple breathing exercises to prevent respiratory infections by stimulating spirometry device (such exercises are explained during his stay in the hospital). Coughing and deep breathing is an important part of your recovery and helps prevent pneumonia and other pulmonary complications.

Ambulation: The day after surgery, it is very important to get out of bed and start walking with the supervision of a nurse or family member to help prevent blood clots in the legs. You can expect to have Sequential Compression Devices (SCD) with white sock legs adapted to prevent the formation of clots in the legs as he lay in bed.

Hospital Stays: Length of hospital stay for most patients is 1-2 days Constipation: Maybe sluggish bowels for several days to a week after surgery. Suppositories and stool softeners can give to this problem. Take a teaspoon of mineral oil and home milk magnesium and prevent constipation.

What to expect after discharge from hospital

Pain Control: You can expect to have some discomfort cut that may require pain medication for a few days after the launch, a result of Tylenol should be enough to control the pain. Showering: You can take a shower at home. Your incision site can get wet, but must be filled to dry after a shower. Whirlpool can soak cuts and is not recommended in the first 2 weeks after surgery. Do you have duct tape around the cuts? Or will fall on its own or can be downloaded in about 5-7 days. Sutures dissolve under the skin in 4-6 weeks. Physical Activity: Make a daily walk is recommended after surgery. Prolonged sitting or lying on the bed should be avoided and may increase the risk of blood clots in the legs, as well as developing pneumonia. Climbing stairs is possible, but should be limited. Driving should be avoided for at least two weeks after surgery. Absolutely no heavy (more than 20 pounds) or exercise (running, swimming, treadmill, biking) for six weeks or until the doctor's instructions. Most patients return to full activity an average of 3 weeks after surgery.

Sexual Activity: If you need a vaginal incision during surgery, the patient may feel pain during sexual intercourse. Therefore, the patient must abstain from sex for 4-6 weeks after surgery.

Diet: No restrictions. Drink plenty of fluids.

Medication: You can continue your regular medication after surgery, except aspirin or other blood thinners, which can increase the risk of bleeding.

Follow-up Appointment: You will need to quickly call upon release schedule a follow-up visit two weeks after the surgery with your doctor.