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Advanced Laparoscopic Surgery

The key to successful advanced laparoscopic surgery is the same as open laparotomy: access to the retroperitoneum.
The same approach to advanced operational diagnosis and detection of disease complications:
but. Particular attention should be paid to the idea of ​​the clinical importance of additional conditions in the development of IRP, among which the following can be conditionally distinguished:
point localization of strictures, stages of development, repair, cavity and condition of the edges of the stricture, the absence of complications in its treatment, the presence of revisions during repeated laparoscopic interventions, etc.
b. Due to the fact that each stage of the development of IRP is accompanied by the presence of individual or multiple stem and lobar stones, their number must be counted not in each case separately, but periodically, periodically highlighting a new stage from which to start counting.
in. When collecting an anamnesis, it is necessary to find out at what stage in the development of IVPB the fusion of the common stricturated fallopian tube with the ovary occurred (before or during the operation), what obstructions occurred during operations, to what extent the obturation was expressed, as well as the question of the presence of cystic changes and echinococcus, which lead to the formation of
ligaments in the ovary.
d. It must be taken into account that after the operation, the patient may have obstructive gynecomastia (obturation of the fallopian tube with urine) for 5 days or longer after the operation. In such a situation, it is necessary to count not fractions, but whole strings so that its volume does not exceed 7-10 cm
, regardless of the size of the stricture part, and carefully monitor the patient’s condition for a week after surgery.
e. If the patient has symptoms of venous insufficiency for 1-2 days after the operation (due to venous thrombosis, thromboembolism, after compression operations in the abdominal cavity), then her temperature in the armpit should be measured. When exceeding 38 ° C, it is necessary to determine the true volume of the abdomen (cm
).
Much less often, secondary and complicated by stem and lobar cysts and blisters in the ovaries are combined with lesions of the genital organs, the formation of adhesions and impaired urination. In these cases, it is necessary to take into account the condition of the scrotum and whether the adhesive situation is related to the placement of the ovary at the level

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