Fistulas that do not close
Long-term fistulas after operations are supported by a cause that external fistulography does not always show: ligature, mesh, desealing of the stump, microabscess. Laparoscopy combines diagnosis and treatment: contrast dye is injected into the external opening, the course is traced from the inside, the source is eliminated and the tract is excised. Patients get rid of months of dressings and recurrent suppurations. The volume is determined by the finds; in case of intestinal fistulas, expansion to resection with anastomosis is possible (discussed in advance).
Indications
- the need for histological verification of formations and lymph nodes of the abdominal cavity;
- staging of tumors before choosing treatment (operability, carcinomatosis);
- pancreatic tumors inaccessible to puncture - direct biopsy;
- complex fistulas of the abdominal cavity - inspection and contrasting from the inside.
Diagnosis under visual control
When puncture under ultrasound/CT is impossible or uninformative, laparoscopy gives the surgeon direct access: examination of all parts of the abdomen with magnification, targeted removal of a sufficient volume of tissue, urgent histology if necessary and simultaneous assessment of the extent of the process (small disseminates in the peritoneum are visible only with the eye). This changes treatment in 15–20% of cancer patients, eliminating unnecessary major operations or, conversely, confirming operability. Hospitalization 1–2 days; The material is used for histology and IHC.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
