Contraindications

Russian gynecologist do Ott in 1901. first performed inspection of the abdominal cavity through kolpotomnoe hole. For this he used headlamp reflector and the lamp, placing the patient in deep Trendelenburg position. Laparoscopy in terms of pneumoperitoneum using cystoscope was first implemented G. Kelling in 1901 in an experiment on dogs. Since 1911.

there are publications on new methods of laparoscopic surgery, creating a pneumoperitoneum needle, development of new optical devices. Contribute to the development of laparoscopy have Yakobeus, Birmingham, Rosenthal. Enormous contribution to the development of laparoscopy has made X. Calculator. Tracing a modified laparoscope is used in the present time.

Places of trocar become classics – the point of tracing paper. Widespread use of diagnostic laparoscopy was through the work of R. Palmer in France (4050 years) and D. Frangeymera in the U.S. (60 years). In 1962. R. Palmer completed coagulation of the fallopian tubes – the first laparoscopic sterilization operations. Revolutionary changes in operative laparoscopy in gynecology carried the head of gynecological clinic in the city of Kiel, Professor Kurt Zemm. In 1975. He has published a guide which outlined a number of laparoscopic surgery for uterine appendages. Virtually all known laparoscopic instruments designed K. Zemmom. He also developed techniques endoshva. Many apparatus for Endosurgery also developed and implemented in practice Zemmom K. (termokoagulyator, mechanical and manual lithotriptors, , etc.). In 1983, K. Zemm first laparoscopic appendectomy. With the introduction of the practice of endoscopic cameras, laparoscopy has become an indispensable diagnostic and therapeutic operative method. More than 90% of operations in gynecology performed laparoscopic access. Currently, worldwide accumulated vast experience in performing laparoscopic surgery, which showed that laparoscopic surgery is low-impact, safe and economically beneficial. The indications for emergency laparoscopy 1. Impossibility exclude acute surgical diseases (acute appendicitis, necrosis of fat suspension, Crohn's disease). 2. Suspected purulent salpingitis, perforation piosalpinksa, tubovarialnogo education inflammatory etiology. 3. Suspicion of ovarian apoplexy. 4. Suspicion of perforation of the ovarian cyst. 5. Suspicion of torsion legs cyst or tumor of the ovary. 6. Acute trophic disorders in myoma nodes (swelling, necrosis of myoma node, torsion legs myomatous node). 7. Suspected tubal pregnancy, especially advanced or impaired by type of tubal abortion. 8. Suspicion of perforation of the uterus. 9. Suspicion of nonpenetrating uterine rupture after childbirth. 10. Lack of the effect of conservative treatment of complex patients with acute inflammation of the uterus within 12-48 hours, or growth of local and general symptoms of inflammation. Contraindications Contraindications to emergency laparoscopy are always relative. laparoscopy is not indicated in cases where the diagnosis can not change the tactics of the patient, and treatment remains conservative. Absolute contraindications 1. Hemorrhagic shock 2. Acute Myocardial infarction 3. Acute cerebrovascular accident. 4. Significant dimensions of the pathological formation of internal genital organs (more than 15 cm in diameter). 5. Cardiovascular disease in the stage of decompensation. 6. Acute hepatic and renal failure. 7. Diabetes in decompensation stage. 8. Diaphragmatic hernia. Relative contraindications 1. obesity, grade 3-4. 2. Pronounced adhesions after previous operations on abdominal organs. 3. A significant amount of blood in the abdominal cavity (more than 1 liter).