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Laparoscopic Management Of Stress Incontinence Lecture By Dr R K Mishra
For Gynecologist / Aug 26th, 2020 7:41 am     A+ | a-


This video Dr R K Mishra delivering lecture on Laparoscopic Management of Stress Incontinence at World Laparoscopy Hospital. a condition (found chiefly in women) in which there is involuntary emission of urine when pressure within the abdomen increases suddenly, as in coughing or jumping. it can be corrcted by burch suspension.
 

Laparoscopic management of stress incontinence is a minimally invasive surgical procedure that aims to improve urinary incontinence caused by weakened pelvic muscles. This procedure involves the use of a laparoscope, which is a thin, lighted tube with a camera that allows the surgeon to view the internal organs. Here is an overview of the laparoscopic management of stress incontinence:

  1. Anesthesia: The patient is placed under general anesthesia, which means that they are unconscious during the procedure.

  2. Incisions: The surgeon makes several small incisions in the lower abdomen to allow access for the laparoscope and other surgical instruments.

  3. Laparoscope insertion: The laparoscope is inserted into one of the incisions, allowing the surgeon to view the internal organs on a monitor.

  4. Placement of sling: The surgeon inserts a small sling under the urethra to provide support and prevent involuntary leakage of urine. The sling is made of synthetic material and acts like a hammock to support the urethra.

  5. Closure: The incisions are closed with sutures or surgical glue, and the patient is transferred to the recovery room.

Laparoscopic management of stress incontinence offers several advantages over traditional open surgery. It is less invasive, which means less pain and scarring, and it typically has a shorter recovery time. Additionally, the use of laparoscopic techniques allows for better visualization and precision during the surgery.

However, laparoscopic management of stress incontinence also has some potential risks and complications. These may include bleeding, infection, injury to nearby organs, or urinary tract infection. As with any surgery, the risks and benefits should be discussed with the patient prior to the procedure.

In summary, laparoscopic management of stress incontinence is a minimally invasive surgical technique that aims to improve urinary incontinence caused by weakened pelvic muscles. This procedure involves small incisions, a laparoscope, and the placement of a synthetic sling to support the urethra. While it offers several advantages over traditional open surgery, it also has potential risks and complications. The decision to undergo laparoscopic management of stress incontinence should be made after a thorough discussion with the patient's healthcare provider.



Laparoscopic management of stress incontinence is generally considered safe, but like any surgery, it can be associated with some potential risks and complications. Here are some of the possible complications:

  1. Bleeding: Laparoscopic surgery may result in bleeding, which can occur during or after the procedure. The surgeon will take appropriate measures to control bleeding during the procedure, but there may be a need for a blood transfusion in rare cases.

  2. Infection: Infection is a risk associated with any surgical procedure, including laparoscopic management of stress incontinence. The risk of infection is generally low and can be reduced by taking appropriate precautions, such as administering antibiotics and maintaining proper hygiene during and after the procedure.

  3. Injury to nearby organs: Laparoscopic surgery may result in injury to nearby organs, such as the bladder, uterus, or intestines. This risk is generally low, but the surgeon will take appropriate measures to minimize the risk of organ injury during the procedure.

  4. Urinary retention or obstruction: The sling used to support the urethra may cause difficulty urinating or urinary retention. This is usually temporary and resolves within a few days or weeks, but in rare cases, it may require additional intervention.

  5. Sling complications: The sling used to support the urethra may migrate, erode, or become infected. This may require additional surgery or removal of the sling.

  6. Recurrent incontinence: In some cases, stress incontinence may recur after the procedure, requiring additional intervention.

It is important to note that the risk of complications is generally low with laparoscopic management of stress incontinence. The surgeon will take appropriate measures to minimize the risk of complications and will discuss the potential risks and benefits of the procedure with the patient prior to the surgery.

Stress incontinence is a type of urinary incontinence that occurs when the pelvic muscles that support the bladder and urethra weaken or become damaged, leading to involuntary urine leakage during physical activities such as coughing, sneezing, laughing, or exercising. Laparoscopic management of stress incontinence is a minimally invasive surgical procedure that aims to restore the normal function of the pelvic muscles and improve urinary continence.

The laparoscopic approach involves making small incisions in the abdomen through which a laparoscope and surgical instruments are inserted to perform the surgery. Compared to traditional open surgery, laparoscopic surgery offers several benefits for the management of stress incontinence, including:

  1. Reduced pain and scarring: Laparoscopic surgery is minimally invasive and involves smaller incisions than traditional open surgery. This results in less postoperative pain and scarring, and a quicker recovery time.

  2. Improved urinary continence: Laparoscopic surgery can improve the strength and function of the pelvic muscles, which can lead to improved urinary continence and a reduced risk of urinary incontinence recurrence.

  3. Shorter hospital stay: Laparoscopic surgery is typically performed as an outpatient procedure, which means that patients can go home on the same day as the surgery.

  4. Faster return to normal activities: Because laparoscopic surgery involves less tissue damage and a shorter recovery time, patients can return to their normal activities and work sooner than with traditional open surgery.

  5. Reduced risk of complications: Laparoscopic surgery has a lower risk of complications, such as infection and bleeding, than traditional open surgery.

    The success rate of laparoscopic management of stress incontinence varies depending on the severity and cause of the condition. However, studies have shown that laparoscopic surgery can significantly improve urinary incontinence symptoms and quality of life for many patients.

    During the procedure, the surgeon may use a variety of techniques to repair or support the pelvic muscles, such as using mesh implants, sutures, or slings to support the urethra and bladder. The specific technique used will depend on the individual patient's condition and the surgeon's experience and preference.

    As with any surgery, there are potential risks and complications associated with laparoscopic management of stress incontinence, including bleeding, infection, bladder or urethral injury, and urinary retention. However, the overall risk of complications is low and can be minimized by choosing a skilled and experienced surgeon.

    After the surgery, patients may experience some discomfort, swelling, and bruising, but these typically resolve within a few days to a week. Most patients can resume normal activities within a few weeks and may experience a significant improvement in urinary continence within a few months.

    In summary, laparoscopic management of stress incontinence offers several benefits over traditional open surgery, including reduced pain and scarring, improved urinary continence, and faster recovery time. It is a safe and effective surgical option for many patients with stress urinary incontinence, but it is important to consult with a skilled and experienced surgeon to determine the most appropriate treatment plan based on individual needs and circumstances.

    Like any surgical procedure, laparoscopic management of stress incontinence can have potential complications. However, the risks of complications are generally low, and many people experience successful outcomes with few or no complications. Some potential complications of laparoscopic management of stress incontinence include:

    Infection: Infection is a possible complication of any surgery. Laparoscopic surgery carries a lower risk of infection than open surgery, but it is still possible. Symptoms of infection may include fever, redness, swelling, pain, or drainage at the incision site.

    Bleeding: Laparoscopic surgery involves making small incisions, which can minimize the risk of bleeding. However, in rare cases, excessive bleeding may occur, which may require blood transfusions or further surgery.

    Injury to nearby organs: Laparoscopic surgery is typically safe, but it is possible to accidentally damage nearby organs, such as the bladder or urethra.

    Urinary retention: After the surgery, some people may experience temporary difficulty emptying their bladder. This is usually temporary and resolves within a few days to weeks after the procedure.

    Urinary tract injury: Rarely, laparoscopic surgery may cause injury to the urinary tract, which can lead to complications such as urinary incontinence, urethral stricture, or bladder perforation.

    Mesh-related complications: If mesh is used during the surgery, there is a risk of mesh-related complications, such as mesh erosion, infection, or pain.It is important to discuss the potential risks and complications of laparoscopic management of stress incontinence with a skilled and experienced surgeon before undergoing the procedure. A qualified surgeon can help determine the best treatment options based on individual needs and circumstances and can help minimize the risks of complications.

2 COMMENTS
Dr. Hitesh
#2
Nov 5th, 2023 7:35 am
Dr. R.K. Mishra's lecture on Laparoscopic Management of Stress Incontinence at World Laparoscopy Hospital highlights a significant condition predominantly affecting women. Stress incontinence, characterized by involuntary urine leakage during abrupt abdominal pressure surges (e.g., coughing or jumping), can be successfully addressed through Burch suspension, a minimally invasive surgical technique. Dr. Mishra's comprehensive explanation sheds light on the laparoscopic approach, involving the use of a specialized camera-equipped tube to visualize and treat weakened pelvic muscles, providing valuable insights into effective stress incontinence management.




Dr. Shashank Shekhar
#1
Aug 26th, 2020 11:22 am
This is an amazing and very inspiring lecture video of Laparoscopic Management Of Stress Incontinence. I think I need to watch it at least once a day or certainly at those times that it all just seems impossible. Thank you!
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