Is it necessary to do a gastroscopy before surgery? Necessary tests for laparoscopy and preparatory procedures. Application of the laparoscopic method

No complex preparation is required for laparoscopy. Before the operation, the doctor must check the patient's condition to ensure that there is no possible risk of complications. The patient needs to undergo tests, for which the doctor gives directions. Without them, the patient will not receive admission.

Basic tests before laparoscopy, the results of which are needed for admission to surgery:

Complete blood count (CBC).
Biochemical analysis.
General urinalysis (UCA).
General smear on the flora.
Coagulogram.
Test for HIV, hepatitis B and C.
Wasserman reaction (test for syphilis).
Oncocytology.
Electrocardiogram.
Blood type, Rh factor (to eliminate errors and be safe during laparoscopy).

Depending on the presence of other diseases or the purpose of laparoscopic surgery, the doctor decides what additional tests and studies need to be performed.

Preoperative preparation may include visits to other specialists to evaluate contraindications. For diseases of the cardiovascular, respiratory, endocrine and gastrointestinal systems, the patient is first sent to see other doctors to confirm or refute contraindications.

Additional research:

Fluorography.
Examination of stool for the presence of helminths.

Each general test (blood, urine, smear) is valid for 2 weeks. After the expiration of the period, the patient must be tested again. A smear for oncocytology and stool for helminths are valid for a year. The Wasserman reaction, blood test for HIV and hepatitis are valid for 3 months. The validity period of an ECG is 1 month, fluorography is 11 months.

Particular attention is paid to the number of platelets and the content of prothrombin, fibrinogen, bilirubin, urea, glucose, and total protein in the blood.

General blood analysis

Clinical analysis (CBC) is a diagnostic method in which blood is taken from the ring finger. The goal is to identify anemia or inflammatory disease.

The main indicators that pay close attention before laparoscopy (including diagnostic):

leukocytes. A decrease in indicators indicates leukopenia, an increase indicates any inflammatory disease in the body.
hemoglobin. A decrease in indicators indicates insufficient oxygen supply to the body, an increase indicates heart defects, smoking and dehydration.
red blood cells. A decrease indicates pregnancy, anemia, blood loss, destruction of red blood cells, and an increase is observed with neoplasms, polycystic disease, and hormonal disorders.
platelets. A decrease in indicators indicates a diseased liver, bacterial infections, anemia, hemolytic disease, immune and hormonal diseases. An increase is observed after operations, with cancer, benign tumors, and inflammation.
ESR. A decrease in indicators indicates an increase in albumin (a group of proteins), bile acids, and circulatory failure. An increase is observed with a decrease in albumin, red blood cells, an increase in fibrinogen, as well as in infectious and inflammatory diseases, liver and kidney damage, fractures, postoperative periods, and endocrine disorders. If a woman is found to have an increase in ESR, it is necessary to undergo a gynecological examination and check the gastrointestinal tract system.
hematocrit Low levels indicate a deterioration in blood viscosity and anemia. An increase is observed with dehydration, lack of oxygen, and congenital heart defects.

The doctor evaluates all indicators and discrepancies from the norm. For example, if leukocytes, red blood cells, ESR and platelets are elevated, and other indicators are within normal limits, then we will talk about the presence of an inflammatory process and neoplasms, due to which laparoscopic treatment methods are planned. If red blood cells, platelets, and hematocrit are low, and other indicators are within normal limits, then the patient most likely has anemia.

Interpretation of biochemical blood test. Click to enlarge

Blood chemistry

This diagnostic method before laparoscopy allows us to judge the functioning of all organs. The main goal is to check the condition of the heart, endocrine system, liver and kidneys. It reveals:

Total protein. A decrease indicates starvation, liver disease and serious bleeding of an acute and chronic nature. Increase – about dehydration, oncology, acute infections.
Bilirubin. A decrease indicates the use of certain groups of drugs, alcohol and coffee, and coronary heart disease. Increase – about hepatitis, acute infections and viruses, tumors and cirrhosis of the liver, anemia, inflammatory diseases.
Urea. A decrease indicates fasting or strict vegetarianism, pregnancy, poisoning with toxic substances, and impaired liver function. Increased – kidney disease, cardiovascular failure, severe blood loss, excess protein intake.
Fibrinogen. A decrease indicates the formation of microthrombi, toxicosis, hypovitaminosis, poisoning, and liver cirrhosis. Increase – about pregnancy, heart attack, diabetes, pneumonia, tuberculosis, oncology and infectious diseases.
Glucose. A decrease indicates poor nutrition, starvation, excessive stress, bad habits, malignant tumors, excessive consumption of baked goods, fast food and sweets. An increase occurs with diabetes mellitus, pancreatitis, cancerous tumors, diseases of the endocrine system, and metal poisoning.

Analysis of biochemistry results provides an almost accurate picture of the patient’s body condition.

General urine analysis

Normal urinalysis results. Click to enlarge

OAM is the simplest and most painless diagnostic method before laparoscopy, with the help of which acute and chronic pathologies of the genitourinary system and other inflammatory diseases are determined. Together with blood tests, the overall picture will allow you to better understand the functionality of the body.

The main values of TAM, which are given attention before performing a laparoscopy operation:

Amount of urine. A decrease is observed in the initial stages of acute renal failure and chronic kidney disease. Increased in diabetes mellitus, acute renal failure, heavy drinking.
Color. A specific color change, depending on the shades, is caused by urolithiasis, tumor decay, red blood cells in the urine, liver disease and consumption of coloring foods.
Transparency. Cloudy urine is characteristic of cystitis and pyelonephritis.
Smell. Harshness or a specific odor is observed with hereditary diseases, increased acidity or diabetes.
Reaction. High acidity indicates previous infectious diseases.
Protein. An increase in the amount is observed with inflammation and kidney disease.
Glucose. Presence in urine indicates diabetes mellitus.
Leukocytes. Indicate an inflammatory process in the body.

A general urine test is necessary to assess the functioning of the genitourinary system and kidneys.

General smear

A flora smear is a method for diagnosing diseases and assessing the state of the microflora of the vagina, urethra and cervical canal. The goal is to identify infections and inflammations. Analysis shows:

Leukocytes. Enlargement is a sign of inflammation or pregnancy.
Lactobacilli. A decrease in their number is a symptom of bacterial vaginosis.
Yeast. A high rate indicates thrush.
Key cells. Enlargement is a sign of gardnerellosis.
Leptothrix. Occurs when mixing infections: bacterial vaginosis, candidiasis, chlamydia and trichomoniasis.
Mobiluncus. The appearance in the results is a sign of candidiasis or bacterial vaginosis.
Trichomonas. The appearance is a symptom of inflammatory diseases of the genitourinary system.
Gonococci. The appearance is a sign of gonorrhea.
Escherichia coli. An increase in the number indicates the onset of bacterial vaginosis, neglect of intimate hygiene, and stool getting into the smear.
Staphylococci, streptococci, enterococci. Enlargement is a sign of infection.

A flora smear assesses the general condition of the reproductive organs.

Decoding the coagulogram. Click to enlarge

Coagulogram

This test before laparoscopy examines the blood clotting system, regulated by the endocrine and nervous systems. The goal is to determine how the operation will go, whether the surgeon will be able to stop the bleeding and save the patient in an unforeseen situation. Particular attention before the operation is paid to the following indicators:

PT and INR. A decrease in readings may be a sign of thrombosis. Increased – liver diseases, intestinal dysbiosis, amyloidosis, nephrotic syndrome, etc.
APTT. Shortening the value is a sign of increased coagulability. Lengthening – insufficient coagulation, severe liver disease, etc.
PTI. A decrease is observed with increased coagulability during pregnancy, thrombosis, cirrhosis, and hepatitis. Increased – deficiency of blood factors, vitamin K, etc.
Fibrinogen. A reduced amount is a symptom of congenital deficiency, liver disease, bone marrow damage, prostate cancer, etc. An increased amount is observed during infections, injuries, stress, menstruation, heart attacks, pregnancy, lung cancer, and also in the postoperative period.
RFMK. An increase occurs with sepsis, thrombosis, shock, complicated pregnancy, etc.

Not all doctors are able to decipher this analysis.

Cytological smear analysis

Oncocytology is a method for diagnosing oncology in the reproductive organs. The goal is to detect the presence of cancer cells or other viral diseases.

Abnormalities in the analysis do not always imply the presence of cancer. A positive result may be a consequence of pathologies:

chlamydia;
trichomoniasis;
gonorrhea;
fungal diseases.

If infections are found, therapy is prescribed, after which the test is repeated to monitor the dynamics.

Electrocardiogram and ultrasound

An ECG is prescribed to study the heart's function in order to assess the patient's readiness for laparoscopy. Contraindications to laparoscopic surgery are diseases of the heart, respiratory system, liver and kidneys.

No matter how many studies the doctor prescribes, they are carried out as soon as possible. CBC, coagulogram, Wasserman reaction, analysis for Rh factor, blood group, HIV and hepatitis - the material is taken from a vein once, checked for all the necessary indicators, and this already means that half of the tests have been passed.

Content

Modern gynecology regularly performs laparoscopic operations, which are considered simple and common. Many patients, on the advice of doctors, undergo this procedure because it is safe for them - the absence of an open process reduces risks, increases the speed of healing and return to normal.

What is laparoscopy

During the procedure for removing polycystic cysts, the surgeon makes 3 holes in the abdominal cavity, where he inserts instruments, and sees the direction using a camera. Due to the lack of opening, laparoscopic removal of an ovarian cyst is considered gentle compared to open surgery. The following types of techniques in gynecology are distinguished:

Diagnostic laparoscopy - the purpose of the method is to examine the abdominal organs without making incisions along the wall. To increase the field of view after punctures, gas is injected into them and a laparoscope instrument is inserted, which looks like a thin tube with a lens and an eyepiece. Instead of an eyepiece, a video camera can be used: the image obtained from it can be viewed on the monitor. A manipulator is inserted into the second puncture, and the doctor examines the organs with it.
Operative laparoscopy always follows diagnostic laparoscopy. If the doctor finds indications for surgery, then miniature instruments are inserted into the puncture, which are controlled in midair using the same camera. Surgical laparoscopy of an ovarian cyst involves anesthesia, during which an intravenous and urinary catheter is inserted, and then a silicone drainage tube. The advantages of laparoscopy are rapid tissue healing, absence of scars, and the possibility of emergency intervention. Due to the minimal size of the instruments, the organs are not severely injured, which preserves their functionality to the maximum. There are no serious complications, so laparoscopy can be performed even during pregnancy.

The success of the operation will depend on diagnostic success and preparation for laparoscopy of the ovarian cyst. If this is a planned procedure, then patients need to follow a special diet, undergo the necessary tests, and come for an examination with a doctor to identify the peculiarities. Directly during laparoscopy itself, special measures also need to be taken. Doctors will tell you in detail about the preparation of the woman and the uterus during the removal of polycystic disease.

On what day of the cycle is laparoscopy performed?

Before you find out what tests are taken before the operation, you need to take care of choosing the day for it, which depends on the menstrual cycle. It is prohibited to perform the procedure during menstruation and in the period 1-3 days before it. It would be best to choose a day in the first days of the cycle, as soon as your period ends. It is best to conduct a study for polycystic disease after ovulation - approximately on the 15-25th day of a cycle of 28.

How to prepare for laparoscopy of an ovarian cyst

In order for the operation in the clinic to be successful, you should know information about its preparation. It includes tests before laparoscopy, a set of ECG studies, X-rays, and ultrasound. During the examination, you should inform the doctor about the medications you are taking, and start preparing in terms of diet a week in advance. Treatment with Aspirin, Ibuprofen and similar medications should be stopped a week before. On the day of surgery, you take a shower, plus you need to shave the hair on the entire lower abdomen and perineum.

Doctors recommend starting to take sedatives for psycho-emotional preparation a couple of days before surgery. Only herbal sedatives are suitable - tincture of valerian, motherwort, Persen. When a cycle suitable for surgery arrives, it is recommended to refrain from taking oral contraceptives so as not to disrupt hormonal levels.

Necessary examinations and tests before surgery

In addition to conducting a set of examinations, the patient should know what tests need to be taken before surgery. Their results will help the attending doctor perform the operation safely and without pain. Mandatory tests that must be taken:

general blood, urine, stool tests;
blood type with Rh factor;
ECG, fluorography;
biochemical data: glucose, protein, bilirubin levels;
determination of HIV, hepatitis B, C, syphilis;
smear for microflora, oncocytology;
on the degree of blood clotting.

Taking laxatives or a cleansing enema before surgery

Preparation for laparoscopy of an ovarian cyst necessarily includes several cleansing enemas with a volume of up to 2 liters the night before. Another enema of water with chamomile decoction or the addition of glycerin is performed in the morning, strictly on the day of the operation. If bowel cleansing is neglected, the surgeon will be forced to insert a probe to drain feces, which is an unpleasant procedure. Instead of an enema, you can take the following laxatives to prepare.

You are about to undergo a planned operation, and then, along with various tests, the doctor sends you for... gastroscopy of the stomach.

And why should I do this gastroscopy before surgery? - you think, - there is enough hassle and nerves of all sorts here without it. My stomach doesn't seem to hurt...

Well, a lot of things don’t hurt until they catch on :) And this does not mean that there are no changes or neoplasms in the organs and you won’t have to wait for surprises during the operation.

Gastroscopy before surgery is necessary for a number of reasons:

1. During abdominal operations, as a rule, a probe is inserted into the stomach.

And if in the walls of the esophagus or stomach there are neoplasms, ulcers, congenital or developed during life protrusion of the organ wall(diverticulum), then you can damage its integrity.

2. If in the stomach or esophagus there is a neoplasm of a malignant nature, That surgical intervention leads to an exacerbation of the process. After surgery, the body devotes all its energy to the healing and restoration process, metabolism is activated, which leads to tumor growth.

And here it is very important to know that in the early stages, cancer does not manifest itself in any way and does not hurt. And the lesion may be small.

It’s better to take care of yourself in advance and make sure that everything is in order with this matter.

3. B postoperative period often occur exacerbation of erosions and ulcers(if they are not cured before surgery). This is fraught with massive bleeding, which are difficult to stop due to the weakening of the body and inevitable blood loss during the operation itself.

If endoscopically - during therapeutic gastroscopy - it is not possible to stop the bleeding, then the patient has to be taken back to the operating table on an emergency basis. Repeated surgery in a short time is a serious blow to the body and is fraught with a long and dangerous postoperative period.

We talk openly with you about the possible consequences so that you are aware of the risks you are taking when considering whether or not to have a gastroscopy before surgery.

Laparoscopy is a therapeutic and diagnostic procedure that is performed to identify and eliminate diseases of the internal organs without a scalpel. What is the preparation for laparoscopy in gynecology, what should the patient do on the eve of the procedure? We will consider these questions in detail in the article.

Features of laparoscopy

The procedure is performed under general anesthesia in a hospital setting and is a seamless type of surgery. A laparoscope and additional medical instruments with lighting and a video camera are inserted into the abdominal cavity. An image of the cavity structures appears on the monitor, and the surgeon can examine the condition of the internal organs with a laparoscopic instrument.

To obtain a three-dimensional image of the abdominal organs, air or a gaseous substance is introduced into the patient’s body using pneumoperitoneum. Carrying out a laparoscopic examination requires preliminary careful preparation of the patient at home. It is necessary to follow a number of rules and recommendations of the gynecologist.

Indications for laparoscopy

suspicion of the presence of neoplasms of various nature;
menstrual irregularities;
endometrial diseases;
adhesive formations;
polycystic ovary syndrome;
ovarian cyst;
uterine fibroids;
infertility.

Laparoscopy is also performed for diseases of the appendages, ectopic pregnancy and for diseases that are not cured by conservative therapy. In some cases, examination with a laparoscope is prescribed in the first months of pregnancy.

How to prepare for surgery

What do you need to know before laparoscopy, and how to prepare correctly? The list of requirements necessary to prepare for the examination includes:

positive attitude of the patient;
ultrasound examination;
collection of necessary tests;
compiling a medical history;
taking prescribed medications;
compliance with diet and food regimen;
procedure for removing hair from the pubic area.

A positive attitude is necessary to form the correct idea about the upcoming procedure. The patient should learn in advance about all the details of this examination, about possible risks and their prevention, as well as about ways to quickly recover in the postoperative period.

An ultrasound examination must be completed in advance. In addition to ultrasound diagnostics, the gynecologist may recommend magnetic resonance imaging or computed tomography. The decision is made depending on the clinical picture of the disease.

The collection of biomaterial for laboratory testing is mandatory. Tests are taken for both biochemical and antiviral studies. The laboratory may also require the donation of blood from relatives for an unforeseen event during laparoscopic diagnosis.

Before the operation, a detailed medical history of the woman is compiled, which includes a list of previous diseases, abdominal and other operations, organ injuries, and drug intolerance. This is necessary for successful examination using a laparoscope.

Diet

Why stick to a diet? Two weeks before laparoscopy, the patient should change her diet. Firstly, this is due to the delivery of biomaterial to the laboratory. Secondly, it is necessary to eliminate the processes of gas formation in the intestines. Therefore, women are recommended to exclude from the menu:

smoked and fatty foods;
foods high in carbohydrates.

This is especially true in the last three to four days before laparoscopy. Every day the amount of food eaten should gradually decrease. In the last two days, you can take laxatives and give an enema to completely cleanse the intestines. An enema must be done, otherwise, when anesthesia is administered, the intestines will clear spontaneously.

List of prohibited products:

milk and black bread;
fatty meat and potatoes;
apples and plums;
all legume products;
fresh and salted cabbage;
eggs and black bread.

What foods can you eat? It is advisable to consume low-fat fermented milk products, cereals, fish and broths.

To reduce bloating, take activated charcoal for 5 days in a row, 6 tablets per day (in three doses). To calm the nervous system, preparations of valerian, motherwort or other sedatives of plant origin are used. If necessary, they also take sleeping pills.

Personal hygiene

To prepare for laparoscopy, you must thoroughly wash your entire body using antibacterial agents. It is recommended to treat the peri-umbilical area with medical alcohol, and the groin area is completely shaved.

Doctors also require that a woman shave her umbilical area if there is hair on it. When is the best time to shave? It is better for a woman to shave directly on the day of surgery - then the stubble will not have time to appear.

Laparoscopy for colds

An important issue remains the presence of a cold on the eve of surgery. Can anesthesia be used for cold symptoms? Cough and runny nose must be cured. Inserting a tube into the trachea while coughing can cause respiratory failure and oxygen starvation of internal organs. With a prolonged lack of oxygen in the brain, the patient may not recover from anesthesia.

If the nasal passages are clogged with mucus, this will also interfere with anesthesia. For mild nasal congestion, vasoconstrictor drops should be used. To avoid getting sick before surgery, take care of your health. You can take medications to increase immune defense and strengthen the body's status.

Bottom line

Laparoscopy is considered a serious abdominal operation that requires preparation. Careful implementation of all recommendations will reduce the risk of complications during and after the operation. Dress according to the season to avoid getting rhinitis or another form of cold: a cough and runny nose will complicate the use of anesthesia.