What is ovarian resection, methods of implementation and rehabilitation. Surgical intervention in the ovaries Wedge resection of the ovaries pregnancy

Women's health is very delicate, and any disease can lead to undesirable consequences. In some cases, only surgical intervention can restore well-being and reproductive function. Let us consider in detail ovarian resection: what it is, what types there are, in which cases the procedure is possible and in which it is not, how the operation is performed and whether there is a possibility of conceiving a child in the future.

The essence of the operation

What is ovarian resection? This is nothing more than a surgical intervention on an organ (either one or both), as a result of which an area of damaged tissue is excised without affecting healthy tissue. In this case, as a rule, the reproductive glands are not removed, so most often the woman can become pregnant in the future.

Purpose

Basically, surgery is prescribed if it is impossible to carry out hormonal treatment or if conservative methods are ineffective. Most often this is:

ovarian endometriosis;
formation of cysts against the background of functional and pathological problems;
organ injury;
the occurrence of a benign ovarian tumor;
polycystic disease, which causes infertility;
emergency assistance for hemorrhage into the ovarian parenchyma or rupture of a corpus luteum cyst.

Contraindications

It is immediately worth noting the cases when ovarian resection is impossible:

Thrombophilia, as a result of which unexpected blood clots may form when tissue is cut.
Tumors of a malignant nature. In this case, the woman is advised to remove the entire ovary along with the appendage.
When acute inflammatory processes occur in the pelvis.
Serious problems with blood clotting, which can lead to enormous blood loss.
If the diagnosis of the disease has revealed pathology of the kidneys, cardiovascular or respiratory system, or liver in a severe stage.
Acute infectious diseases, as a result of which the operation is postponed until the woman recovers.

Is conception possible in the future?

Women who are offered surgical intervention are wondering about the connection between ovarian resection and pregnancy after surgery.

It all depends on the volume of damaged tissue. If a small amount of ovarian tissue is removed during the operation, then in the future the woman has a fairly high chance of becoming a mother. Moreover, even with polycystic disease, this percentage is quite large. You just need to start conceiving right away, because after 0.5-1 years the likelihood of pregnancy decreases very much, and after 5 years the disease may return.

Types of surgery

There are several types of surgery.

Partial resection

In this case, only part of the organ is removed. As a rule, such surgical intervention is prescribed for:

dermoid cyst;
inflammation of the organ, in particular purulent;
benign ovarian tumor;
rupture of the cyst, accompanied by bleeding into the abdominal cavity;
ectopic pregnancy (on the ovary);
single ovarian cyst;
hemorrhage in the ovary;
organ injury;
twisting of the pedicle of the ovarian cyst.

Wedge resection of the ovaries

This method is mainly used to treat polycystic disease, which is accompanied by the formation of multiple cysts on the surface of the ovaries. The causes of cysts in this disease are dyshormonal disorders in the female body. During the operation, a triangular fragment is simply removed from the organ, and in such a way that its base rests on the ovarian capsule. This will allow the mature follicles with the egg to exit into the tube and then into the uterus. Simply put, the operation is performed to stimulate ovulation.

Not long ago, another version of the operation was invented. Capsules (15-20 pieces) are made on the ovary using electrical or laser energy, which allow the eggs to come out. This is a more gentle method of ovarian resection for polycystic disease.

Preparation

Ovarian resection can be performed laparotomically or laparoscopically. Both methods require preliminary preparation of the patient. To do this, a complete examination of the entire body is carried out:

laboratory and biochemical blood tests;
urine tests;
detection of antibodies to viruses;
HIV test;
fluorographic examination;
cardiogram.

In addition, on the eve of the operation, food intake is stopped at 20.00, and liquids - at 22:00. Cleansing enemas are also given before surgery.

Execution method

Resection is performed in two ways: laparotomy and laparoscopic.

The laparotomy option is performed through an incision made with a scalpel in the woman’s abdomen, at least 5 cm long. Resection is carried out under constant visual observation by the surgeon using conventional surgical instruments.

Laparoscopic ovarian resection is performed with special miniature instruments. To do this, 3-4 holes of no more than 1.5 cm are made in the woman’s abdomen, through which trocars are inserted into the peritoneum. Next, carbon dioxide or oxygen is pumped into the abdomen so that the organs do not come into contact with each other. A miniature camera is inserted through one incision, through which all manipulations performed will be monitored.

The remaining incisions are intended for inserting instruments that are used for manipulation. At the end of the operation, the instruments are removed, the gas is released, and the holes are sutured.

After the intervention

Laparoscopy of the ovaries is generally practically not accompanied by pain. To prevent complications, the woman is prescribed antibiotics and, if necessary, painkillers. Sutures are removed one week after surgery. During the recovery period, a woman should strictly follow the doctor’s recommendations:

no sexual intercourse for a month;
You can play sports only after 4 weeks and it is advisable to start with swimming;
During rehabilitation, it is advisable to avoid traveling, especially for a long time;
any complications or poor health is a signal to consult a doctor;
It is strictly forbidden to carry weights over 3 kg;
It is mandatory to use a bandage and compression garments for a month;
Do not take a bath or visit the pool until the stitches are completely healed;
contraception for 3-6 months after surgery.

Laparoscopic ovarian resection requires a shorter rehabilitation period than strip surgery. In addition, the woman experiences much less pain and can already get up and walk on the day of the operation.

Complications

The following possible consequences of resection are identified:

accidental injury to internal organs during trocar insertion;
the body's reaction to the injected gas;
postoperative hernia;
formation of adhesions in the pelvis;
complications after anesthesia;
injury to blood vessels;
infections;
fever;
formation of seroma or hematoma.

Urgent consultation

Mostly, ovarian resection occurs without consequences. Nevertheless, you need to monitor your condition and urgently consult a doctor if: there is confusion even 6 hours after anesthesia, there is pain in the lower abdomen, after the operation there is a temperature of more than 38 ºC, which does not subside for more than a day, weakness, pain in the area stitches and redness, the appearance of yellowish-red or whitish discharge.

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If, as a result of hormonal disorders, a woman experiences fluid accumulation under the outer membranes of the ovary - a cyst develops, or malignant cells are found in it, the treating gynecologist will recommend removing the pathological area.

Surgical treatment can also be chosen for polycystic ovary syndrome if it is necessary to preserve the patient’s reproductive function. In all these cases, gynecologists say that resection of the ovarian tissue is necessary.

What is ovarian resection?

This is a surgical intervention in which only the damaged area is removed (excised) in one or both organs, while healthy tissue remains intact. This operation does not involve complete removal of these reproductive glands, so in most cases the woman’s ability to conceive is preserved. Moreover, sometimes ovarian resection is performed in order to increase the chances of pregnancy.

Intervention is performed only when strictly necessary and only after a comprehensive examination of the woman - in order to minimize the risk of postoperative complications. If you want to get pregnant after surgery, therapy may be prescribed to stimulate the female reproductive glands to increase the production of eggs.

Types of surgery and indications for it

There are three main types of surgical interventions on the ovaries:

Partial resection.
Wedge resection.
Oophorectomy.

Partial resection of the ovary

This is the cutting off of part of an organ. It is used to treat diseases such as:

a single ovarian cyst, when it reaches a significant size and does not respond to conservative treatment methods;
hemorrhage into the ovarian tissue;
severe inflammation of the organ, especially when it is saturated with pus;
a benign ovarian tumor confirmed by a preliminary biopsy (puncture and removal of part of unhealthy tissue), for example;
organ injury, including during a previous operation, for example, on the intestines or urinary tract;
rupture of an ovarian cyst with bleeding into the abdominal cavity;
torsion of the pedicle of the ovarian cyst, which is accompanied by severe pain;
ectopic ovarian pregnancy, when the embryo develops on top of the organ.

Wedge resection

They can proceed to oophorectomy with the initial planning of partial resection of ovarian tissue - if during the operation it turns out that it is not a glandular pseudomucinous cystoma. In the latter case, after 40 years of age, both reproductive glands are removed altogether in women to avoid their cancerous degeneration.

Resection of both ovaries will be carried out if cysts develop in both of them, especially with glandular pseudomucinous cystomas. If a papillary cystoma is discovered, which is dangerous due to its high risk of cancerous degeneration, both ovaries are removed in women of any age.

Methods for performing ovarian resection

Ovarian resection can be performed by two methods: laparotomy and laparoscopic.

Laparotomy excision of the organ is carried out through an incision at least 5 cm long, made with a scalpel. Resection is performed under direct visual control using conventional instruments: scalpel, clamp, tweezers.

Laparoscopic ovarian resection

Laparoscopic ovarian resection is performed as follows. 3-4 incisions no longer than 1.5 cm are made in the lower abdomen. Medical steel tubes - trocars - are inserted into them. Through one of them, a sterile gas (oxygen or carbon dioxide) is pumped into the abdomen, which will move the organs away from each other. The camera will be inserted through the second hole. It will transmit an image to the screen, and gynecological surgeons will be guided by it when performing an operation. Small instruments are inserted through other incisions and used to perform the necessary actions. After carrying out the necessary actions, carbon dioxide is removed and the incisions are sutured.

Preparing for the intervention

Before the operation, you need to be thoroughly examined: undergo general clinical and biochemical blood tests, determine the presence of antibodies to viruses in it, which can reduce blood clotting (hepatitis B and C) or reduce immune defense (HIV). A cardiogram and fluorogram are also needed.

Both laparotomy and laparoscopic interventions are performed under general anesthesia, during which all muscles, including those located between the stomach and esophagus, are relaxed. As a result, stomach contents can be thrown into the esophagus, and from there into the respiratory tract, which can cause pneumonia. Therefore, before surgery, you need to stop eating, taking your last meal at 8 pm (no later), and liquids at 10 pm.

In addition, you will need to cleanse the intestines: after all, surgical intervention will temporarily slow down intestinal motility, so the feces formed in it will be absorbed into the blood, poisoning the body. To prevent this from happening, you need to perform cleansing enemas. They are done with cool water in the evening and in the morning the day before until the water is clear.

How is the operation performed?

The intervention is performed under general anesthesia, so after getting on the operating table and injecting drugs into a vein, the woman falls asleep and stops feeling anything.

Meanwhile, the operating gynecologist makes either one large (laparotomy) or several small (laparoscopic) incisions, and with the help of instruments the following is performed:

Freeing the organ and its cyst (tumor) from adjacent organs and adhesions.
Applying clamps to the suspensory ligament of the ovary.
An incision is made into the ovarian tissue that extends slightly higher than the pathologically altered tissue.
Cauterization or suturing of bleeding vessels.
Suturing the remaining gland using absorbable thread.
Examination of the second ovary and pelvic organs.
Check for the presence of bleeding vessels, their final suturing.
Installation of drainage(s) into the pelvic cavity.
Stitching of cut tissues through which the instrument was inserted.

The patient is warned that even with a planned laparoscopic intervention, in the case of suspected cancer, or with extensive purulent inflammation or blood soaking, gynecologists can proceed to a laparotomy approach. In this case, the life and health of the patient are given priority over the faster recovery of her ovary after resection, which is noted during laparoscopic surgery.

Consequences and postoperative period

Performed using minimally traumatic methods (laparoscopy), with the minimum possible amount of tissue removed, the operation usually goes smoothly. The consequences of ovarian resection can only be the onset of menopause soon after the operation - if a lot of tissue has been removed from both organs, or the acceleration of its onset - since the tissue from which new eggs could appear has disappeared.

The second common consequence is adhesions between the intestines and reproductive organs. This is the second reason why pregnancy may not occur after ovarian resection (the first is the removal of a large amount of ovarian tissue).

Complications may also develop. These are infections of the pelvic organs, hematomas, postoperative hernias, and internal bleeding.

Pain after resection of the ovary begins within 5-6 hours, and therefore the woman in the hospital is given an anesthetic injection. Such injections are performed for another 3-5 days, after which the pain should decrease. If the pain syndrome persists for more than a week, you need to notify the doctor about this - this indicates the development of complications (most likely, adhesive disease).

The sutures are removed within 7-10 days. Complete recovery after surgery occurs in 4 weeks with laparoscopic surgery, and in 6-8 weeks with laparotomy.

After the operation, blood discharge from the vagina is observed, which resembles menstruation. The intensity of the discharge should decrease, and the duration of this reaction of the body should be about 3-5 days. Menstruation rarely comes on time after ovarian resection. Their delay of 2-21 days is considered normal. A longer absence of menstruation requires consultation with a doctor.

Ovulation after ovarian resection is usually observed after 2 weeks. This can be found out by measuring basal temperature or by (ultrasound) data. If the doctor has prescribed you to take hormonal medications after surgery, then you may not have it at all that month, but you need to ask your treating gynecologist about this.

Is it possible to get pregnant after ovarian resection?

If a large amount of ovarian tissue has not been removed, then it is possible. Even with polycystic disease, this is possible, and even necessary, otherwise after 6-12 months the chance of getting pregnant will decrease, and after 5 years a relapse of the disease is possible.

Only in the first 4 weeks after surgery, sexual intercourse will need to be excluded for normal healing of the operated tissue, and then, perhaps, hormonal contraceptives will need to be taken for another 1-2 months. During the same period, you need to pay active attention to the prevention of adhesive disease: active motor regimen, physical therapy, and a diet rich in fiber.

If pregnancy does not occur after 6-12 months, you need to consult a doctor and exclude the possibility of tubal infertility.

If, as a result of a hormonal disorder, a woman accumulates fluid under the outer lining of the ovary, a cyst may develop. It is also possible that malignant cells may be detected. In this case, the gynecologist will recommend removal of the pathological area. Doctors also choose a surgical treatment option for polycystic ovary syndrome if it is necessary to preserve the patient’s reproductive functions. In all such situations, gynecologists talk about the need for resection of ovarian tissue. We will talk about the types of ovarian resection, indications for its implementation and the consequences of such operations below.

What is resection?

In this case, we are talking about a surgical intervention in which only the damaged area in one or both organs is removed (excised), while healthy tissue remains intact. This operation does not mean complete removal of the reproductive glands; therefore, in most situations, a woman’s ability to give birth to a child is preserved. In addition, sometimes ovarian resection is prescribed in order to increase the woman’s chances of becoming pregnant.

Such an intervention is performed only when necessary and only after a comprehensive examination, in order to minimize the risks of postoperative complications. If a woman wishes to become pregnant immediately after surgery, she may be prescribed therapy that helps stimulate the female reproductive glands to intensively produce eggs.

Types of surgery

There are only three main types of ovarian resection, which are currently performed:

Carrying out partial resection.
Performing wedge resection.
Performing an oophorectomy.

Indications for partial resection

In this case we are talking about cutting off part of an organ. This operation is performed to treat the following diseases:

The patient has a single ovarian cyst that reaches a significant size and does not respond to conservative treatment.
Development of a dermoid cyst.
The presence of hemorrhage in the ovarian tissue.
The presence of severe inflammation of the organ, especially when it becomes saturated with pus.
The presence of a confirmed preliminary biopsy (puncture and removal of part of the unhealthy material), for example, with cystadenoma.
The presence of organ trauma, including due to a previous operation, which was performed, for example, on the urinary tract or intestines.
The presence of rupture of an ovarian cyst with bleeding into the abdominal cavity.
The presence of torsion of an ovarian cyst, which can be accompanied by very severe pain.
The appearance of an ectopic in which the embryo develops on the organ from above.

Wedge resection of the ovaries and indications for it

In the presence of polycystic disease, resection is most often performed using a wedge-shaped method. The purpose of this operation is to stimulate ovulation. This becomes possible when, as part of the operation, a wedge-shaped piece of tissue is cut out of the ovary, the base of which is directed to the organ capsule, which is thickened in this disease. Thus, the formed eggs are able to leave the ovary to meet the sperm. The effect of wedge resection of the ovaries can usually last for six to twelve months and is eighty percent.

More recently, another method of surgical treatment of polycystic disease was invented. Instead of wedge resection, pinpoint incisions are now performed, which are made on the thickened ovarian membrane. This also allows the eggs to be released. Such destructions are produced in quantities of up to twenty-five pieces each through laser or electrical action. The effectiveness of this technique is seventy-two percent.

What else is it used for?

Wedge resection of the ovary is used not only for the treatment of polycystic disease. Doctors also perform a similar intervention if there is a need to perform a biopsy. In this case, when any dense formation is detected on the ovarian tissues, to exclude cancer, a triangular area is excised from the patient, which is then examined under a microscope.

Indications for oophorectomy

When the ovaries are completely removed, they speak of an oophorectomy. This method of surgery is planned in the presence of ovarian cancer. In this case, the fallopian tubes and part of the uterus are removed. Also, this type of operation is necessary in the presence of large cysts in women after forty-five years, and in addition, against the background of a gland abscess that formed immediately after invasive intervention or against the background of widespread endometriosis.

Doctors can proceed to oophorectomy against the background of initial planning of partial resection of ovarian tissue. This can happen if during surgery it turns out that there is not a retention type of cyst, but a glandular pseudomucinous cystoma. In this case, in women over the age of forty, both reproductive glands are completely removed in order to avoid their cancerous degeneration.

Resection of the ovaries, among other things, is carried out when both cysts develop in them. If a papillary cystoma is found, which has a high risk of degeneration into cancer, both ovaries are removed at once in patients of any age.

How else is ovarian resection performed? Laparoscopy is currently used most often.

Laparoscopic and laparotomic resection

Doctors can perform ovarian resection using two methods, namely laparotomy or laparoscopic. Laparotomic excision of an organ is carried out through an incision at least five centimeters long, which is made with a scalpel. Doctors perform resection under visual control using conventional instruments such as a clamp and tweezers.

Laparoscopic resection of an ovarian cyst is performed as follows. Four incisions no more than one and a half centimeters long are made in the lower abdomen. Medical steel tubes are inserted into them along with trocars. Through one of them, sterile gas is pumped into the patient’s stomach, which moves the organs away from each other. The camera is inserted through another hole. The camera, in turn, transmits the image to the surgeons on the screen. Doctors are guided by this image when performing laparoscopic ovarian resection. Through other incisions, small instruments are inserted, with the help of which all the necessary actions are performed.

Upon completion of the necessary actions and manipulations, carbon dioxide is removed and the incisions are sutured. Next, we will find out how ovarian resection is performed for polycystic disease.

How is the operation performed?

The intervention is usually performed under general anesthesia; therefore, after the patient gets on the operating table and drugs are injected into her vein, she immediately falls asleep, ceasing to feel anything. In the meantime, the operating surgeon makes either one large laparotomy or a couple of small laparoscopic incisions, and with the help of instruments the following is carried out:

The organ and its cyst are freed from adjacent adhesions.
Clamps are applied to the suspensory ligament of the ovaries.
An incision is made into the ovarian tissue, which is made slightly higher than the pathologically altered material.
Performing cauterization or suturing of bleeding vessels.
Carrying out suturing of the remaining gland using absorbable thread.
Conducting an examination of the pelvic organs and second ovary.
Carrying out a check for the presence of bleeding vessels along with their final suturing.
Installation of drainage in the pelvic area.
Sewing the cut tissue through which the instrument was inserted.

The patient is warned that even in the case of a planned laparoscopic intervention, in the case of suspected cancer or in the presence of extensive purulent inflammation, as well as blood soaking, surgeons may proceed to the use of a laparotomy approach. In this case, the life and health of the woman are given priority over a faster process of restoration of her ovary after the intervention, which is observed against the background of laparoscopic operations.

What are the consequences of ovarian resection?

Consequences of the operation and postoperative period

Carrying out the most gentle methods (laparoscopy) with the removal of a small amount of tissue, the operation, as a rule, goes smoothly. The main consequence of ovarian resection can only be menopause, which occurs very soon after surgery if too much ovarian tissue was removed from both organs at once. There may also be an acceleration in the onset of menopause due to the disappearance of tissue from which new eggs could be formed.

Many people are interested in when menstruation will begin after ovarian resection.

Another common consequence is adhesions, which are adhesions between the reproductive organs and the intestines. This is the second reason why pregnancy may not occur after ovarian resection. The development of complications is also possible. We are talking about infection of the pelvic organs, hematomas, postoperative hernias and internal bleeding.

As a rule, pain after resection of the right ovary begins within six hours, and therefore the patient, who is in the hospital, is given an anesthetic injection. Such injections are performed for another three days, after which the pain should decrease. If pain persists for more than a week, you should notify your doctor. Such a sign may indicate the development of a complication; most likely, in this case, the matter will concern adhesive disease.

Sutures are usually removed on the seventh day. The patient's complete recovery after surgery occurs within four weeks provided laparoscopic intervention is performed. It takes eight weeks to recover from laparotomy surgery. Immediately after the operation, blood may be discharged from the vagina, which resembles menstruation. The intensity of such secretions should decrease, and the duration of this reaction of the body will take five days.

Period

How is your period after ovarian resection?

Menstruation very rarely comes on time after surgery. Their delay, which lasts from two to twenty-one days, is considered normal. A longer absence of menstruation requires mandatory consultation with a doctor.

As for ovulation after resection surgery, this is usually observed after two weeks. You can always find out about this thanks to basal temperature measurements. Folliculometry can also be performed. If the doctor prescribes hormonal medications after surgery, there may not be ovulation at all this month, but it is best to ask your doctor about this.

Can a woman get pregnant?

If too much ovarian tissue has not been removed, this is possible. Even in the presence of polycystic disease, this is quite possible, moreover, in such a case it is even necessary, otherwise twelve months after the operation the chances of getting pregnant will decrease to a minimum, and after five years a relapse of this disease is completely likely.

Having children is a unique ability of the female body. Some diseases of the genital organs lead to reproductive dysfunction and require surgical treatment. Why ovarian resection is performed, how it affects the body and whether pregnancy is possible after it, you will learn from the article.

Every month, one or more follicles are formed in the ovaries, each of which contains a mature egg ready for fertilization. In addition, the ovaries synthesize female sex hormones, which affect all types of metabolism and the emotional state of a woman. For various reasons, tumors, cysts and other diseases arise in them, the treatment of which is only possible through surgery.

Complete removal of the gonad leads to hormonal imbalance, early menopause, and infertility. Ovarian resection - what is it? This is the surgical removal of only part of an organ, which helps preserve the woman’s health and her ability to conceive a child.

Methods and indications for use

The attending physician determines the type and extent of the upcoming operation based on the patient’s age, her state of health and the severity of the disease. Resection is indicated for:

confirmed benign tumors;
injuries.

Resection is performed using one of the following methods:

laparoscopic - minimally invasive intervention, access is made through 3-4 small incisions. Manipulators are inserted into the abdominal cavity along them, through which the surgeon performs the operation;
laparotomy - full abdominal surgery, access through a midline incision in the anterior abdominal wall.

The essence of surgery

For any indication for surgery, resection serves one purpose - to preserve as much as possible the healthy tissue of the organ in which the eggs are located.

The surgeon removes a benign tumor or ovarian cyst in such a way as to minimally affect the gland itself. He opens the lining of the organ and excises the required minimum of tissue to gain access to the tumor. Next, the tumor is isolated from the organ with a blunt instrument and excised. Sutures are not applied to the remaining defect in order to reduce the depth and size of the postoperative scar. Bleeding vessels in the wound are cauterized with a coagulator.

Video: "Technique for performing ovarian resection"

Resection of the ovary in polycystic disease is carried out to stimulate ovulation. To do this, the surgeon either removes part of the dense membrane of the organ, or makes 6-8 incisions on it in different places.

Sometimes a wedge-shaped resection of the ovary is performed - a triangular section of tissue is cut out of it, the base of which faces the organ capsule. In this way, it is possible to remove a significant area of the membrane and preserve a large mass of ovarian tissue.

Surgery for ovarian trauma, rupture of a cyst with hemorrhage into the abdominal cavity (apoplexy) is carried out in order to remove the damaged part of the organ. Removal of the pathological focus is performed sparingly, that is, minimally involving healthy tissue. In some cases, only drain the wound and stop the bleeding with a coagulator.

Sometimes an ovarian biopsy is performed for diagnostic purposes. To do this, the surgeon cuts out a small section of the organ in the form of a wedge, which is then sent to the laboratory for examination. Sutures are not placed at the site of the defect; bleeding vessels are cauterized.

The gland is completely removed when:

large size benign tumor;
an abscess that developed after invasive intervention.

Recovery period and possible consequences of ovarian resection

With partial resection of the ovary, the postoperative period is 2 weeks, with complete removal of the ovary - 6-8 weeks.

Complications are the same as with any other operation:

bleeding;
perforation of abdominal organs;
side effects of anesthesia;
adhesive process;
postoperative hernia;
wound infection.

With any volume of surgical intervention, there is a decrease in the amount of tissue of the reproductive gland, which contains immature eggs. Their supply in the female body is limited and averages from 400 to 600 cells. Each ovulation, at least 3-4 of them are consumed, one matures into a full-fledged egg, and 2-3 help it grow. As a result of the operation, the period during which a woman is able to conceive is artificially reduced.

Immediately after surgery, the level of sex hormones decreases significantly, since the damaged organ is not able to produce the same amount. In response to this, the hypothalamic-pituitary system increases the release of follicle-stimulating and luteinizing hormones into the blood, under the influence of which the remaining gland tissue begins to more actively synthesize its own. Restoring the balance takes 2-3 months, and during this period the gynecologist prescribes a hormonal contraceptive drug to support the process from the outside.

Menstruation after ovarian resection often begins the next day after the operation, as the body’s reaction to it. After two weeks, ovulation occurs and the previous cycle is restored.

When to plan pregnancy?

Sexual activity after laparoscopic ovarian resection is possible from the seventh day of the postoperative period. Surgery and removal of part of the ovarian tissue do not disrupt the ovulation process, so the woman remains able to conceive a child. For nulliparous women or those who want to have more children, gynecologists recommend planning a pregnancy in the next year or two after surgery.

With polycystic disease, when surgery is performed to stimulate ovulation, the likelihood of conception is greatest in the first six months after surgery. Then the capsule of the gland thickens again and it will be much more difficult to get pregnant, since the egg cannot reach its surface.

If pregnancy does not occur within six months after resection of the ovarian cyst and there are other factors of infertility in one of the spouses, the couple is referred to a reproductive specialist to resolve the issue of IVF (in vitro fertilization). Hormonal stimulation with a limited egg reserve is most often carried out with high doses of drugs during one cycle (short protocol), which allows obtaining a sufficient number of mature follicles. Recently, androgen priming has been used - the introduction of a precisely selected dose of testosterone, which in the female body serves as a precursor to its own sex hormones. This technique allows you to achieve egg maturation in a more natural way.

Estimated cost

The cost of surgical treatment depends on the volume of the intervention, its technical complexity and the level of the clinic. On average, the price for removal of an ovarian cyst ranges from 30 to 70 thousand rubles, surgical treatment of polycystic disease from 25 thousand and above.

The development of modern surgery is aimed at making the intervention as gentle as possible on the organ, but at the same time effective. This approach is especially relevant when treating diseases of a woman’s reproductive system, because not only the ability to conceive and bear a child, but also her health in general depends on it.

Ovarian laparoscopy is a minimally invasive operation using an endoscope. The device is inserted into the abdominal cavity through small punctures that heal quickly. Small, barely noticeable scars remain in their place. The device itself is equipped with a miniature camera and other tools that allow cutting tissue. Such interventions are used not only for pathologies of the female reproductive system, but also for treatment.

During laparoscopic surgery, surgeons have the opportunity to carefully examine the structure of the ovary, see as much as possible the problem and carefully eliminate it. It is used for desquamation, removal of part or the entire organ, and elimination of foci of endometriosis.

The dimensions of the incision through which the instrument is inserted do not exceed 0.5-1 cm. A total of three holes are made. An endoscope is inserted through one, and operating instruments are inserted through the others. This operation is minimally traumatic, so the recovery period is relatively short.

As for the advantages of laparoscopic intervention in the area of the appendages, they are as follows:

since the size of the holes is very small, the tissues are not greatly traumatized;
minimization, because internal organs are not influenced to such a significant extent as with;
recovery in the postoperative period is faster and better;
reducing the risk of developing infection or blood poisoning;
there is no danger of sutures coming apart and bleeding, since the tissues are amenable to slight coagulation;
preserving a woman’s ability to have children, because complete removal of the ovary or uterus is not always required;
the ability to perform even the most complex operations in a relatively short time.

All necessary manipulations are carried out under supervision via a video camera and monitor. Specialists have the opportunity to see the smallest details of the operation without cutting into the abdomen.

Indications and contraindications for

Ovarian laparoscopy is considered one of the most common operations, which is more often prescribed to women of reproductive age. Indications for the use of the procedure include:

A tumor that has a risk of degeneration or is increasing in size.
Cyst.
accompanied by the formation of pus.
Torsion of the uterine appendages.
Proliferation of the endometrium.
Fibroids affecting the uterus.
An adhesive process that develops both on the ovary itself and on other pelvic organs.
Violation of the patency of the fallopian tubes.
Ovarian biopsy, as well as monitoring the ovulation process in women who have problems conceiving.
that cannot be treated with conservative therapy.
Polycystic syndrome.
Ovarian apoplexy (hemorrhage into the follicle).
Infertility of unknown origin.

However, ovarian laparoscopy is not suitable for everyone. There are the following contraindications:

pathologies of the cardiac or respiratory system in the stage of decompensation;
problems with blood clotting - hemophilia;
acute liver or kidney failure;
diathesis;
stroke or heart attack;
diffuse peritonitis;
the tumor size is too large (more than 10 cm);
infectious diseases suffered 1.5 months before surgery;
subacute or acute chronic inflammation of the fallopian tubes or ovaries (you must first get rid of it);
3-4 degrees of vaginal cleanliness;
presence of purulent vaginal discharge;
adhesive process in the abdominal cavity;
high degree of obesity;
bloating.

Laparoscopic intervention is used to remove the right or left ovary affected by the oncological process. Moreover, the organ may not be completely excised, which allows the reproductive function to be preserved.

Features of preparation for surgery

Preparation for ovarian laparoscopy includes laboratory tests of blood and urine, chest x-ray, biochemical blood test, electrocardiogram and ultrasound of internal organs. If necessary or in particularly complicated cases, a CT scan is required. The examination is carried out only if removal of the uterus and ovaries by laparoscopy is planned in advance. If urgent intervention is necessary, it is not required.

In addition, as preparation before surgery, you must follow the following recommendations from doctors:

A few days before the proposed intervention, it is necessary to exclude psycho-emotional and physical stress. They can affect blood pressure and heart function during and after the procedure.
Before surgery, it is better not to eat foods that cause increased gas formation. Food should be easily digestible so that it does not create additional stress on the body.
The day before the intervention, the patient must go to the hospital. In the evening, the patient is allowed to drink a glass of kefir, sweet tea, or yogurt.
During laparoscopy, you cannot eat anything at all in the morning. Breakfast is allowed if the operation is rescheduled for the evening.
It is important to cleanse the intestines before surgery. Nowadays laxatives and microenemas are used for this purpose.
When removing cysts or foci of endometriosis laparoscopically, it is necessary to prevent any complications in those people who are prone to them. Purulent processes are prevented by antibiotic therapy, and the formation of blood clots should also be avoided. Before removal surgery, specialists bandage the lower limbs with an elastic bandage.

If you need to operate on the ovaries, you can do this on any day of the cycle, except for the time of direct menstrual bleeding. The discharge may be too heavy. There is also a risk of bleeding that will be difficult to stop.

What laparoscopy is is already clear, but not everyone knows that its duration ranges from 20-90 minutes. It all depends on how complex the pathology is.

Rules for the procedure and possible complications

Incisions on the ovaries are made only under general anesthesia. Moreover, it is not a mask that is used, but an endotracheal tube. This anesthesia allows you to increase the operation time and also completely relax the patient. Sometimes intravenous anesthesia is used. Further, the instructions provide for the following actions:

First, the patient is positioned correctly on the operating table. It should be slightly inclined on one side. The head lies below the body. This position will allow you to slightly move the intestines and improve visibility of the affected ovary.
Next, incisions are made in the abdominal area. Through them, a special device is inserted to supply carbon dioxide, pushing aside other internal organs. It is supplied throughout the intervention.
Now the endoscope equipped with a flashlight and camera is inserted. Surgical instruments are inserted through the other two holes. All cuts must be treated with a disinfectant solution.
Next, all the necessary manipulations are carried out: resection, coagulation, removal. For subsequent biopsy, incisions are made on the ovaries and material is collected.
After the operation is completed, the blood vessels are coagulated to prevent bleeding. The instruments are pulled out, and the incisions are further processed and bandaged.

If there is any discharge, we can talk about infection in the wound. Other complications are also possible:

emphysema (accumulation of air under the skin) or adhesions;
hernia;
damage to the vessels of the abdominal wall;
intestinal obstruction;
chronic pain syndrome in the abdominal area;
damage to large vessels.

If the operation is performed correctly, the likelihood of complications occurring is negligible.

Postoperative and rehabilitation period

After laparoscopy of the ovaries, the woman will need. This period passes quite quickly. Already during the first day the patient is allowed to slowly get out of bed. In a week (or even earlier) the woman can go home. The patient's ability to work resumes after a maximum of 3 weeks. If a woman is not bothered by any discharge, she can continue to see a gynecologist as usual.

The early postoperative period requires proper nutrition. It will allow you to restore strength faster. To reduce the load on the stomach and intestines, food should be pureed, liquid, and as light as possible.

In the first days, recovery may be accompanied by mild pain in the lower abdomen. But after a few days it goes away on its own. Antibiotics are prescribed to a woman only if the intervention was long and extensive. To improve the condition, multivitamin preparations that strengthen the immune system are prescribed: Vitrum, Centrum.

During the rehabilitation period, a woman is prohibited from having sex for a month. In the future, all restrictions will be lifted. The patient may continue to have sexual relations and even become pregnant. recovers very quickly.

Laparoscopy is an effective and minimally invasive operation that allows you to quickly get rid of serious problems of the reproductive system. However, it should only be done by highly qualified specialists.