• Features of expeditious treatment of gynecologic diseases laparotomic and laparoscopic accesses at women with extragenital pathology

Features of expeditious treatment of gynecologic diseases laparotomic and laparoscopic accesses at women with extragenital pathology

HEALTH OF WOMAN. 2017.4(120):111–114; doi 10.15574/HW.2017.120.111

Kostikov V. V.
National Medical Academy of Postgraduate Education P. L. Shupyk, Kiev

The objective: definition of optimum access of an operative measure at gynecologic patients with extragenital pathology.

Patients and methods. Were included in research of 240 patients who were on treatment inhospital and operated concerning diseases of internal genitalias laparotomic and laparoscopic accesses. All patients had an extragenital pathology. Depending on operation access all patients were divided into two groups. The main group was made by 120 patients operated with laparoscopic access. 120 patients operated with laparotomic access, made group of comparison.

Results. Results of the conducted researches testify that at gynecologic patients with cardiovascular, broncho-pulmonary pathology, an obesity and a diabetes mellitus preferable quick access it is necessary to consider laparoscopy. Operation by laparoscopic access at patients with cardiovascular diseases is accompanied short-term (till 5 minutes) by deterioration of indicators of a hemodynamic at the time of rising of intra abdominal pressure and creation of provision of Trendelenburga. The specified changes quickly are normalized and remain stable throughout operation and in the early postoperative period. Laparotomic access leads to more expressed and long deterioration of hemodynamic indicators at patients with cardiovascular diseases during operation and in the early postoperative period. Laparoscopic operations at patients with extragenital pathology are less enduring, minimum traumatic, are accompanied by small hemorrhage. At the patients operated with laparoscopic access, the pain syndrome, disturbances of function of an intestine is less expressed, a physical activity is quickly restored, terms of stay in hospital and after treatment terms are reduced.

Conclusion. At gynecologic patients with the compensated extragenital pathology can be given preference to laparoscopic access of an operative measure.

Key words: gynecologic operations, laparotomy, laparoscopy.


1. Adamyan LV, Kulakov VI, Askolskaya SI. 2009. Quality of life of women after various types of the hysterectomies executed by laparoscopic, laparotomic and vaginal by accesses. Endoscopy in gynecology: 135-148.

2. Breusenko VG, Kravchuk OS, Evseev AA. 2010. Features of maintaining patients after laparoscopic operations on a uterus. Messenger of the Russian association of obstetricians – gynecologists 2:44-49.

3. Vdovichenko YuP, Gorbunova OV, Voloshin AA. 2015. Complex preoperative preparation and postoperative prophylaxis at laparoscopic operations in gynecology. Health of the woman 4(24):157-158.

4. Ventskovsky BM, Zhegulovich VG, Yarotsky NE. 2012. Modern aspects of laparoscopic surgery in gynecology. International medical magazine 1-2:112-115.

5. Zaporozhan VN, Gladchuk IZ, Rozhkovskaya NN. 2008. Endoscopic surgery in gynecologic clinic. Hospital surgery 4:32-40.

6. Kozub NI. 2011. A laparoscopy in diagnostics and treatment of purulent inflammatory diseases of appendages of a uterus. International medical magazine 3:53-56.

7. Bartos P, Zelenka Z. 2015. Total laparoscopic hysterectomy: current role in gynecology surgery. Ceska Gynekol. 64;4:224-227.

8. Chapron CM, Dubuisson JB, Ansquer Y. 2015. Is total laparoscopic hys­terectomy a safe surgical procedure? Human Reproduction. l:2422-2424.