If you have a fallopian tube laparoscopy, what tests need to be done? Preparing the patient for surgery is an extremely important stage, thanks to which you can protect her from many complications and make laparoscopy as painless as possible for the body. The collection of tests before surgery is included in the mandatory list of preoperative preparations.

1. Detailed clinical blood test. Necessary to determine the quantitative content of blood cells (erythrocytes, leukocytes, platelets) and some other parameters, such as ESR. Deviations in this analysis may indicate, for example, the presence of anemia or an inflammatory process in the body. Blood is collected from a finger (capillary blood) or from the ulnar vein.
2. Blood test for blood group and Rh factor. This test is mandatory because with any operation you need to be prepared for the possibility that you may need a blood transfusion during or after the operation. Blood is drawn from a vein.
3. Biochemical blood test. Necessary for assessing the functioning of organs and systems of the body, reflecting the functions of the kidneys, liver, etc. Blood is drawn from a vein, always on an empty stomach in the morning.
4. Coagulogram. This analysis reflects the state of the blood coagulation system and is necessary to prevent both bleeding and thrombosis during and after surgery.
5. Blood test for HIV and RW (serological test for syphilis), as well as hepatitis B and C. Blood is drawn from the ulnar vein. The analysis is necessary to exclude the patient from HIV infection, viral hepatitis and syphilis.
6. General urine analysis. Based on the results of this analysis, one can judge the presence of any somatic diseases, such as pyelonephritis, glomerulonephritis, diabetes mellitus and some others. For the study, morning urine is required, after preliminary hygiene of the external genitalia. In some cases, urine culture may be necessary; the material is collected in the same way.
7. Urogenital smear for flora and cytology. This study is necessary to determine the qualitative composition of the microflora and to exclude cervical cancer. If necessary, it will be necessary to sanitize the vagina before surgery if the results of smears are unsatisfactory. In order for these tests to be most reliable, it is necessary to fulfill a number of conditions before taking them: 3-5 days before taking smears, you must refrain from douching, the administration of any vaginal medications, and sexual intercourse. A hygienic shower should be taken the night before taking smears.

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The term “laparoscopy” literally translated from Greek means “to examine the womb.” This is not a specific operation, but a way for the doctor to access the organs of the pelvic and abdominal cavities, which differs from traditional laparotomy. Laparoscopy is considered the least traumatic method of performing surgical procedures, however, in any case, it is a serious intervention in the structure of the body. Laparoscopic operations require careful preparation; the patient must undergo tests and undergo a series of studies.

Access to the body cavity is carried out using a modern device - a laparoscope connected to a video camera. Its design allows the doctor to examine organs, assess the severity of the patient’s condition on the spot, confirm or refute the preliminary diagnosis and, if necessary, immediately perform surgical procedures. This makes laparoscopy an indispensable diagnostic and treatment tool for a number of diseases.

Laparoscopic surgery technique

Laparoscopy allows you to perform almost all those operations that can be performed through an incision (open method): separation of adhesions, removal of ovarian cysts and uterine fibroids, various gynecological and urological operations. For some conditions, laparoscopy is the only treatment option (genital endometriosis, tubal obstruction).

Immediately before the operation begins, carbon dioxide is injected into the patient's body cavity, raising the abdominal wall. This measure is necessary to create a working space for the movement of tools. The gas is harmless to the body; after a few days it is completely absorbed by the tissues.

The surgeon makes small incisions (punctures) in the abdominal wall with a special thin tube (trocar). There are usually three of them: 10 mm above the navel and two 5 mm on the sides.

For comparison: the length of the abdominal wall incision during laparotomy is 15-20 cm.

The surgeon's working instruments are inserted through the punctures, as well as a telescopic tube with a lens system and a video camera equipped with a cold light source (halogen lamp). The image is displayed on the monitor, allowing the doctor to monitor the progress of the operation.

Before the operation, the patient is given general anesthesia. Diagnostic laparoscopy can be performed under local anesthesia. The duration depends on the complexity of the pathology and the qualifications of the surgeon; it can range from 40 minutes (separation of postoperative adhesions) to 2 hours (removal of multiple myomatous nodes).

Application of the laparoscopic method

Why is laparoscopy needed? In fact, it can replace almost any laparotomy operation, while being less traumatic for the patient. In this case, laparoscopic intervention can be either planned or emergency (in critical conditions requiring urgent action).

Planned therapeutic and diagnostic laparoscopy is performed for:

• infertility treatment;
• suspected neoplasms of the uterus and appendages (cysts, fibroids, tumors);
• chronic pain in the pelvis that is not amenable to conservative treatment.

Emergency laparotomy is performed if there is suspicion of:

• rupture (apoplexy) of the ovary;
• perforation of the uterine wall;
• ectopic (tubal) pregnancy;
• rupture of the cystic bladder or torsion of the tumor stalk;
• acute inflammatory process in the appendages;
• loss of the intrauterine device.

Necessary tests and preparation for laparoscopic surgery

Laparoscopy is a relatively gentle operation. But it is also accompanied by a violation of the body’s structures, interference with its anatomical and functional integrity. There are contraindications for laparoscopy, and the operation itself requires special preparation. If a doctor considers it necessary to prescribe surgical treatment to a patient, he first of all gives him a referral for a series of tests.

What tests need to be taken?

Before surgery, you should make sure that the patient will tolerate it well. The attending physician determines what tests need to be taken:

• clinical and biochemical blood tests;
• general urinalysis;
• mandatory before any operation, blood tests for coagulation (coagulogram), determination of clotting time, platelet and prothrombin levels in the blood;
• determination of the patient’s blood type and Rh factor;
• blood test for the presence of the causative agent of syphilis (Wassermann reaction), hepatitis B and C, HIV;
• vaginal smear to examine the degree of purity and microbial flora;
• cytological analysis of a smear for the presence of oncological processes.

The patient also needs to undergo an electrocardiography procedure to detect cardiac pathologies and a therapeutic consultation to establish other systemic diseases.

If necessary, your doctor may prescribe other tests. Most tests are only valid for a certain time (2 weeks), so they must be done immediately before laparoscopy. In addition, the patient must tell the doctor what medications he is taking. Some medications may need to be temporarily stopped before surgery.

Contraindications to laparoscopy

It should be taken into account that during laparoscopy, the cavity of the patient’s body area is filled with gas, creating pressure on the diaphragm from below. Due to this, the lungs cannot work independently; breathing during the operation is carried out using a special apparatus. In addition, cardiac decompensation is possible. Thus, contraindications to laparoscopy are any conditions that during surgery may pose a threat to the life and health of the patient:

• cardiovascular diseases;
• decompensated diseases of the respiratory system;
• any bleeding disorders (hemophilia);
• liver or kidney failure;
• gynecological and urological infectious diseases, including those suffered less than 2 months ago;
• chronic and acute colds;
• inflammation of the appendages;
• any abnormalities in blood and urine tests;
• microbial contamination of the vagina;
• developed adhesive process;
• metabolic disorders.

Metabolic disorders accompanied by obesity are relative contraindications to surgery. The fact is that a thick layer of adipose tissue can significantly complicate surgical procedures. The success of laparoscopy in this case largely depends on the skill of the surgeon.

Preparation for laparoscopic surgery

Preparation for laparoscopy is practically no different from preparation for traditional operations. The necessary measures are determined, first of all, by the fact that the intervention is carried out under general anesthesia.

• On the day of surgery, you must refrain from eating and drinking from midnight.
• 1 week before the scheduled intervention, you should follow a light diet that excludes foods that contribute to intestinal gas formation (legumes, bread, vegetables and fruits).
• Before surgery, bowel cleansing is performed using enemas.
• It is necessary to temporarily stop using certain medications, for example, Aspirin, Ibuprofen.

Laparoscopy is performed on any day of the cycle, except for menstruation itself and a few days before it (due to increased bleeding). During this cycle, a woman must protect herself from pregnancy using barrier contraception.

After surgery

The laparoscopic method promotes rapid recovery after surgery. The very next day the patient can move and lead a moderately active lifestyle; after 7-10 days, the sutures are removed, which are much smaller than with laparotomy. Sick leave is usually issued for 1 week. Complications are rare; moderate pain and discomfort that bother patients in the first days after surgery quickly disappear.

Laparoscopy is the most modern surgical method. It gives the surgeon the opportunity to conveniently access the affected organ and perform precise manipulations. Laparoscopy is in many cases the best replacement for traditional surgical methods.

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:

1. Complete blood count (CBC).
2. Biochemical analysis.
3. General urinalysis (UCA).
4. General smear of flora.
5. Coagulogram.
6. Test for HIV, hepatitis B and C.
7. Wasserman reaction (test for syphilis).
8. Oncocytology.
9. Electrocardiogram.
10. 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 test

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

Biochemical blood test

This diagnostic method before laparoscopy allows one 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:

1. Total protein. A decrease indicates starvation, liver disease and serious bleeding of an acute and chronic nature. Increase – about dehydration, oncology, acute infections.
2. 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.
3. 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.
4. 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.
5. 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 test

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:

1. 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.
2. 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.
3. Transparency. Cloudy urine is characteristic of cystitis and pyelonephritis.
4. Smell. Harshness or a specific odor is observed with hereditary diseases, increased acidity or diabetes.
5. Reaction. High acidity indicates previous infectious diseases.
6. Protein. An increase in the amount is observed with inflammation and kidney disease.
7. Glucose. Presence in urine indicates diabetes mellitus.
8. 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:

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

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

Interpretation of 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:

1. PT and INR. A decrease in readings may be a sign of thrombosis. Increased – liver diseases, intestinal dysbiosis, amyloidosis, nephrotic syndrome, etc.
2. APTT. Shortening the value is a sign of increased coagulability. Lengthening – insufficient coagulation, severe liver disease, etc.
3. PTI. A decrease is observed with increased coagulability during pregnancy, thrombosis, cirrhosis, and hepatitis. Increased – deficiency of blood factors, vitamin K, etc.
4. 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.
5. 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 the operation, 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 treating 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.

Preoperative examination involves the following tests:

• Clinical blood test. To obtain reliable results, it is recommended to refrain from eating for 6-8 hours before the procedure. The study is carried out 2-3 days before surgical treatment so that the doctor can assess the presence and stage of inflammatory processes. With chronic inflammation, the erythrocyte sedimentation rate increases (more than 30 mmol per liter). During infectious diseases or in the presence of purulent wounds, the number of leukocytes is increased. With a reduced hemoglobin level, various complications can be expected in the postoperative period. Therefore, the patient needs a special diet and iron supplements. It is important to determine the number of platelets that are involved in blood clotting and wound healing;
• Biochemical blood test. Allows you to determine the functionality of internal organs and systems and detect serious diseases. The analysis helps determine the level of total protein in the bloodstream, ALT and AST, creatinine, sugar, bilirubin and other vital compounds;
• Clinical examination of urine. Allows you to assess the condition of the urinary system. For analysis you will need an average portion of morning urine. If proteins or a large number of red blood cells are detected in the urine, it is recommended to postpone surgery. If there is an urgent need, surgery is performed while using drugs to improve kidney function. If salts and sand are found in the urine, then additional preventive measures will need to be taken to prevent the movement of stones;
• Determination of blood group and Rh factor. This information allows you to prepare donor blood in advance in order to provide emergency assistance in the event of bleeding. The study is carried out once in a lifetime;
• Analysis for syphilis, hepatitis B and C, HIV infection. A blood test for the listed infections allows you to determine how dangerous the patient is to other patients and medical personnel;
• Coagulogram. The test is a blood clotting test to determine the risk of bleeding during or after surgery. If a low prothrombin index (PTI) level is detected, the blood clot will take too long to form. In such a case, the patient is prescribed drugs that can increase the level of clotting. If the PTI is high, the risk of developing blood clots increases. In such cases, blood thinning drugs are prescribed;
• ECG. The study allows you to assess the functionality of the heart, find out the presence of contraindications or restrictions to surgical procedures. ECG results help the surgeon determine the tactics of the operation, and the anesthesiologist - the optimal dose and nature of anesthesia;
• Fluorography or x-ray of the chest organs. Allows you to exclude the development of tuberculosis and inflammatory processes in the lungs.

Important! The validity period of tests varies significantly. Clinical and biochemical blood tests, coagulogram, ECG are valid for 10 days. Fluorography is performed once a year. Tests for infections are valid for no more than 3 months.

Additional tests before surgery

Before some surgical procedures, a standard examination of the patient is not enough. If vein surgery is to be performed, duplex scanning (Doppler ultrasound) is additionally prescribed. Before laparoscopy, you will need to perform a fibrogastroscopy to exclude pathologies of the digestive organs, and a blood test for hormones to exclude diseases of the endocrine system.

Important! If abnormalities are found during the examination, the patient is referred for additional consultation to specialized specialists: endocrinologist, cardiologist, otolaryngologist.

Often, before surgery, a dental examination and sanitation of the oral cavity are prescribed. The absence of inflammatory processes in the oral cavity reduces the risk of developing infectious diseases after surgery. A dental examination is a mandatory stage of preoperative preparation before installing metal implants.

For male patients over 50 years of age, it is recommended to determine the prostate-specific antigen PSA. The study allows us to establish the presence of inflammatory processes that can lead to the development of severe complications in the postoperative period. For patients with ischemic heart disease and cardiac arrhythmias, Holter monitoring with ECG recording is recommended. This is necessary to determine the presence of contraindications to surgery, the dosage and type of anesthesia.

Specialized tests before gynecological operations

Examination before surgery on the uterus or appendages involves standard tests and additional studies. The latter include the following manipulations:

• Taking a smear of vaginal flora. The analysis allows us to identify some bacterial infections and inflammatory processes for which gynecological operations are not performed. The validity period of the smear is no more than 2 weeks;
• Cytological analysis of the cervix and cervical canal. The study is carried out to determine malignant changes in tissues before any surgical procedures. The results of the study are valid for 6 months;
• Taking an aspirate from the uterine cavity. The analysis is carried out to exclude cancer pathology in the uterus. Validity period – 6 months;
• Blood test for tumor markers CA 125, CA 19.9. The analysis is prescribed if there are cysts or tumors in the uterine appendages. The results are valid for 3 months;
• Carrying out magnetic resonance imaging with contrast in the presence of a tumor helps to determine the extent of damage to the uterus and appendages, and the involvement of healthy neighboring tissues in the pathological process. The study is valid for 3 months.

Preoperative examination is an important stage in preparation for surgical treatment. It allows you to minimize the risk of complications, determine treatment tactics, and select the optimal type of anesthesia.

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Shelf life of gastroscopy before surgery

The examination before surgery always raises as many questions as the operation itself. Despite the same laws and requirements, we still have different requirements for tests in different clinics.

Quite often I am asked the following questions regarding the examination before surgery:

• What examinations need to be completed before surgery? (download list)
• Why do different clinics have different lists of examinations before surgery?
• Why do tests have different expiration dates?
• Why don’t I demand that everyone undergo gastroscopy and colonoscopy?

In order to answer them, it is necessary to refer to the regulatory documents. Today, the activities of any medical institution in the Russian Federation should not contradict the order of the Ministry of Health of Russia dated November 12, 2012 No. 572n (“On approval of the Procedure for providing medical care in the field of obstetrics and gynecology”).

This order contains a complete list of examinations, treatment and rehabilitation measures necessary in the treatment of a particular gynecological pathology.

The examination for the operation in this order is divided into 3 sections:

• mandatory minimum examinations of gynecological patients
• preoperative preparation of patients with gynecological diseases
• examination related to the presence of a specific pathology - in our case, these are benign ovarian tumors

I. Mandatory minimum examinations of gynecological patients.

These are the examinations that should be carried out for every woman who consults a gynecologist, regardless of the presence of gynecological diseases. In addition to medical history and examination, such examinations include:

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1. Colposcopy (examination of the cervix)
2. Microscopic examination of the discharge of the female genital organs for aerobic and facultative anaerobic microorganisms (this is a common vaginal smear for the Sami)
3. Smear cytology (PAP test)
4. Ultrasound examination (ultrasound) of the genitals (once a year, then as indicated)
5. Examination of the mammary glands: Ultrasound of the mammary glands (once a year, then as indicated). Mammography (first mammography, first screening - once every 2 years, over 50 years old - once a year).

II. Preoperative preparation of patients with gynecological diseases

When the question of surgical treatment arises, additional examination is necessary to perform surgical intervention. Today this list includes:

1. Clinical blood test.
2. Biochemical blood test: study of the level of total blood protein, creatinine, ALT, AST, urea, total bilirubin, direct bilirubin, blood glucose, cholesterol, sodium, blood potassium.
3. Coagulogram.
4. Clinical urine analysis
5. Determination of blood group and Rh factor.
6. Determination of antibodies to Treponema pallidum in the blood, HIV, HBsAg, HCV.
7. X-ray examination of the chest organs (fluorography) - once a year

III. And finally, examinations that need to be carried out in connection with the presence of a cyst or other benign ovarian tumors.

1. Ultrasound of the kidneys, bladder, urinary tract (for symptomatic tumors, i.e. if there are signs of dysfunction of these organs)
2. If the tumor grows rapidly and it is impossible to exclude an oncological process:
   • Ultrasound+CDC;
   • study of the level of CA19-9, Ca 125 in the blood
   • rheoencephalography (according to indications)
   • colonoscopy/irrigoscopy (according to indications)
   • Esophagogastro-duodenoscopy (according to indications)
3. Ultrasound of the retroperitoneal space (with intraligamentous tumor location).

As you can see, all additional examinations are marked “according to indications” or taking into account clinical manifestations. That is, they do not need to be done to absolutely all patients with ovarian cysts.

In my opinion, there is only one indication for gastroscopy and colonoscopy. This is a suspicion that the formation on the ovary is a metastasis of a malignant tumor from the stomach or intestines (the so-called Krukenberg metastasis). Fortunately, they don't happen that often. And before carrying out these unpleasant examinations, the doctor should think about whether there really are indications for them?

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This is the minimum indicated by the order of the Ministry of Health. But some important studies were not included in the list. In some unclear situations, it is important to conduct examinations such as MRI and HE4 level testing (tumor marker). They allow you to make a more accurate diagnosis before surgery and, accordingly, carry it out properly.

Shelf life of tests

Order 572n does not indicate the expiration date of most examinations. The implication is that they must be current.

Often patients come with tests that she took 1-2 months ago (and sometimes more). In these cases, I proceed from the following principle: if I have no reason to believe that the tests have changed during this time, I do not repeat them.

But most medical institutions have adopted artificial deadlines, after which tests are considered invalid and they are forced to be retaken. To avoid troubles, always check these dates exactly where you are going to have the operation.

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How often can a gastroscopy procedure be performed?

Gastroscopy is one of the most informative methods for studying the state of the gastrointestinal tract (its upper section), since this procedure allows you to visually assess the presence of damage to the gastric mucosa, the presence of polyps, erosions, ulcers, bleeding and other pathologies of the walls of the stomach and duodenum. Many patients are interested in the question of how safe this generally unpleasant procedure is, and how often gastroscopy can be done in the presence of various pathologies of the digestive tract.

The frequency of gastroscopy is determined by the attending physician.

However, this study is also prescribed for many other diseases. For example, cardiovascular: before performing a coronography, an endovascular cardiologist must ensure that there are no gastric erosions or ulcers. Otherwise, the operation will be postponed, since the patient on the eve of surgery must take strong antithrombotic drugs that thin the blood and promote bleeding.

Indications for gastroscopy

General symptoms such as nausea, diarrhea, vomiting do not always indicate the presence of diseases of the digestive tract, but if the patient complains, he will most likely be prescribed a series of tests that should confirm or refute suspicions of gastritis, duodenitis or other gastric pathologies.

Other indications for prescribing gastroscopy include the following:

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• suspicion of the presence of malignant neoplasms in the stomach/esophagus;
• the need for constant monitoring of the condition of the gastric epithelium in the treatment of gastrointestinal diseases;
• symptoms of gastric bleeding;
• if a foreign object enters the stomach;
• if the patient often experiences pain in the epigastric region;
• difficulties experienced by the patient when eating;
• to clarify the diagnosis for a number of diseases not related to gastrointestinal pathologies.

FGDS should be prescribed with caution to children under six years of age, if there is a history of severe mental disorders, if the patient is diagnosed with exacerbation of chronic gastritis or gastric ulcer, or if there is a respiratory tract infection. In any case, the appointment of this procedure can occur repeatedly, and not knowing in what cases and how often gastroscopy of the stomach can be done is very worrying for many patients.

As for contraindications to the appointment of esophagogastroduodenoscopy (the official medical name for gastroscopy), there are few of them:

• some heart diseases;
• narrow entrance to the stomach compared to the standard one;
• obesity 2 – 3 degrees;
• hypertension;
• kyphosis/scoliosis;
• a history of stroke/heart attack;
• congenital/acquired blood diseases.

How is gastroscopy performed?

An instrument that allows you to examine the condition of the inner walls of the stomach (and, if necessary, the duodenum) is a type of endoscope. A gastroscope consists of a hollow elastic tube containing a fiber-optic cable with an optical and illuminating device at the end. Through the mouth and esophagus, the hose is inserted into the stomach cavity for a thorough examination. Through the cable, the image is transmitted to the eyepiece or monitor screen, and the doctor conducting the study has the opportunity to study the condition of the epithelium in different parts of the stomach by turning and moving the tube in the desired direction.

Is gastroscopy harmful from the point of view of the condition of the esophagus and stomach walls in contact with a solid foreign object? Before the procedure, the gastroscope is thoroughly disinfected, so the likelihood of external infection is extremely low (no more than when eating fruits, bread or vegetables). The possibility of damaging the walls of the esophagus, stomach or duodenum is also close to zero, since the device in its basic form does not have sharp protrusions.

But the procedure itself requires compliance with certain restrictions on the part of the patient. First of all, it should be done on an empty stomach: the presence of food mass makes it very difficult to examine the mucous membrane, so it is very important not to eat 10 - 12 hours before gastroscopy. Approximately 100 - 120 minutes before the procedure, you should drink about 200 grams of liquid (weak tea or boiled water), which will clear the stomach walls of food debris and mucus. It is highly recommended to refrain from smoking the day before, as this provokes the secretion of gastric juice.

Immediately before insertion of the probe, the pharynx and upper part of the esophagus are anesthetized with a spray, and excessive anxiety is relieved with a subcutaneous injection of a mild sedative - the patient’s calm during the manipulation is very important, since fear can lead to involuntary sudden movements, which will make it difficult to examine the walls of the stomach.

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Important: the shelf life of gastroscopy before surgery is one month, after which you will have to do a second examination (in a month, significant changes can occur in the stomach cavity, which can affect the result of the operation or be a direct contraindication to its implementation).

The gastroscopy itself is carried out in the following sequence:

• the patient undresses to the waist; if he has glasses or removable dentures that do not adhere well, they must also be removed;
• manipulation is carried out only in a lying position with a straight back, usually on the right side;
• a special mouthpiece is inserted into the mouth, which must be held firmly in order to prevent reflexive clenching of the teeth;
• after instructions to take a few sips and completely relax the larynx, the endoscope is inserted and lowered until it reaches the entrance to the stomach (the most unpleasant moment is the transition from the oral cavity to the esophagus, during which a natural urge to vomit occurs);
• then the doctor begins to turn the gastroscope, which allows you to examine the condition of the gastric cavities from all sides (the viewing angle of the device, as a rule, does not exceed 150 degrees).

Duration of the procedure

When performing a gastroscopy for diagnostic purposes, an experienced doctor only needs 12 to 15 minutes to examine the entire inner surface of the stomach, however, in some cases, it may be necessary to perform a biopsy (taking a sample of epithelial tissue for laboratory testing) or other therapeutic manipulations (for example, administering medications). Such a comprehensive study can last up to 25–40 minutes.

For some time after the manipulation, the patient should be in a supine position; eating during gastroscopy without a biopsy is allowed after 60 minutes. If the procedure was carried out with a biopsy taken, the first meal of non-hot food is allowed after 180 - 240 minutes. If the procedure is performed on a child under 6 years of age or a patient with a history of mental disorders, gastroscopy can be performed under general anesthesia.

Decoding the results

The uninitiated will probably not be able to interpret the resulting images, since the resulting picture will more likely resemble some kind of fantastic landscape. But an experienced doctor is able to make an accurate diagnosis, guided by the method of comparison with mucous membranes without pathologies.

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It looks like this:

• the color of the mucous membrane ranges from red to pale pink;
• even with an empty stomach, there is always a little mucus on the surface of the walls;
• the front wall looks smooth and shiny, and the back wall is covered with folds.

With gastritis, ulcers, and stomach cancer, deviations from the norm appear that neither x-rays nor ultrasound can detect. But gastroscopy will definitely reveal them: with gastritis, the disease will be indicated by an increased amount of mucus, swelling and redness of the epithelium, and local minor hemorrhages are possible. With an ulcer, the surface of the walls is covered with red spots, the edges of which have a whitish coating, indicating the presence of pus. With stomach cancer, the back wall of the stomach becomes smooth, and the color of the mucous membrane changes to light gray.

How often can a gastroscopy be done?

In life, there are often situations when we do not attach importance to certain symptoms that indicate the presence of pathology, and when a diagnosis is made, we begin to intensively look for ways to get rid of it, undergoing consultations and examinations with different specialists. In the case of gastritis, no doctor will undertake treatment without receiving accurate information about the condition of the mucous membrane. And there are often cases when, after undergoing a gastroscopy, a new specialist may refer the patient for a re-examination to make sure that no significant changes have occurred over time. Therefore, many patients are interested in how long it will take to repeat gastroscopy.

In principle, in the absence of contraindications, the number of such manipulations is not limited, but in practice they try not to prescribe a test more than once a month - this is the shelf life of the results of the previous study. In the chronic course of the disease, in order to prevent complications (peptic ulcer, oncology), this study is prescribed 2–3 times a year. In the process of treating gastritis, if the actual effect of drug therapy does not coincide with the expected one, gastroscopy can be performed more often.

Conclusion

FGDS is a generally safe procedure, although quite unpleasant. Complications are extremely rare: minor damage to the walls of the esophagus/stomach, infection, allergic reaction to medications. Sometimes after the procedure, painful sensations in the throat occur, which disappear after 2–3 days. How many times gastroscopy can be done over a certain period of time is decided by the attending physician. If necessary, the procedure is performed with the frequency necessary for successful treatment of the pathology.

Free legal advice:

Laparoscopy. Tests and examinations before surgery.

Question about laparoscopy

Half a year is not a long time after lapara!?

Comments

Katyusha! I’m reading it.. It’s scary.. But I probably need to prepare mentally. Who did you do it for? Can I take all the tests at a paid clinic and bring them? How much did the operation cost? And how did you negotiate? Money in the doctor's hands? Or a contract? I just know that you got the result.. We’ll take the SG in July. I'll go on vacation in September and then I'll probably do it. There's a lump stuck in my throat :(

I’m thinking of coming to a paid family clinic for two days to collect tests there... And then to 31 GB. Although in the family the girl also wrote that she did everything in the world for her. There are some types of operations, but the amount is this... I haven’t read anything more about the SM Clinic yet.

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And in the hospital there, it’s a hell of a Soviet Union hospital? Or a normal attitude? Conditions?

I’ll write to you in a personal message about the doctor and the details) It turned out much cheaper for me than 65 thousand) I don’t recommend doing it commercially, but this is my point of view) And the conditions and attitude were excellent, I was in a double room with a TV and a separate shower and toilet )

Hi! So 8 months have passed and now I’m going to the lapara. I started my communication here completely green. I didn’t know what the phases of the menstrual cycle and ovulation were)))))

Ahahha)) hi-hi, my dear)) Well. We all go through ignorance to one degree or another) The main thing is that we are moving towards the goal)) Everything will be fine, don’t worry (TTT)

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Did you swallow a light bulb and have your colon checked?

Crap. That’s a lot of time off work you’ll have to take: first for tests, then sick leave for surgery.

Thank you! Will wait!

(11) Consultation with a mammologist

(12) Consultation with a therapist

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(13) Blood for oncology markets CA-125, SA – 19.9

(16) Doppler ultrasound of the arteries of the lower extremities

And if there is a cyst, then the tumor marker c-125 should be increased?

So we made do with a shortened version. For you, in principle, this is not bad at all. There is less unnecessary running around.) These are tests for City Clinical Hospital No. 31 of Moscow.

Smear for tumor markers? o_O And what should he show?))) It seems to me that you need to clarify - I definitely donated blood. And it’s a good idea to go to the mammologist on your own initiative to know for sure that everything is fine. As a rule, when all sorts of problems with the female apparatus begin, it all creeps up.

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Why is the lapara repeated? And the first was for what reason, if it’s not a secret, of course?

Oh, lapara, of course the operation is not the most difficult, but still, going to the operating table is like going to work, it’s a little sad. Isn’t it possible to check the pipes during the pipe lapar? In my report it is written that they checked.

About tumor markers - better donate blood. Will the tests be overdue if you haven’t made an appointment yet? They have an expiration date, as the doctor explained to me.

Calm, just calm, as Carlson said))

Blood for oncology markets CA-125, SA – 19.9

What kind of emergency happened to you, if it’s not a secret?

It's true. I recovered from the anesthesia normally and soon recovered))

Tests required for hospitalization of patients

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All tests must be on separate official forms with clearly visible hospital stamps.

1. Results of blood tests for syphilis using the ELISA method, HRsAg and Antn - HCV using the ELISA method (shelf life - 30 days);

2. Chest X-ray (image and description, shelf life - 12 months).

Tests required during hospitalization in surgical departments:

If necessary, as prescribed by the attending physician, additionally:

1. Gastroscopy (expiration date - 1 month);

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3. Hormonal blood test: free T3, free T4 (shelf life - 10 days).

A. Upon receiving positive results for hepatitis, the patient is required to provide data from a biochemical blood test for ALT and AST and a conclusion from an infectious disease specialist.

B. For women of the reproductive period (with a menstrual cycle of 28 days), hospitalization in the surgical department is carried out from the 5th to the 20th day of the menstrual cycle.

B. You also need to have 2 elastic bandages with you (length 3.5 - 5 meters).

When planning a surgical operation, the patient may receive the following document from the attending physician:

To the clinic at your place of residence (work)

In connection with the upcoming surgical operation, I request that the patient be examined

and attach the results of the following studies (analyses):

4. General blood test (expiration date - 10 days);

6. Coagulogram (shelf life - 10 days);

7. Biochemical blood test: total protein, total bilirubin, amylase, creatinine, urea, potassium, sodium, calcium, chlorine, ALT, AST, iron, glucose (shelf life - 10 days);

8. ECG (expiration date - 1 month);

9. Consultation with a cardiologist.

If necessary, as prescribed by the attending physician, additionally:

10. Gastroscopy (shelf life - 1 month);

12. Hormonal blood test: free T3, free T4 (shelf life - 10 days).

13. Upon receiving positive results for hepatitis, the patient is required to provide data from a biochemical blood test for ALT and AST and a conclusion from an infectious disease specialist.

Tests required for eye surgeries:

1. Results of blood tests for HIV, syphilis by ELISA, HRsAg and Antn - HCV by ELISA (expiration date - 30 days);

2. Chest X-ray (image and description, shelf life - 12 months);

3. Blood type, Rh factor;

4. General blood test - blood formula (expiration date - 10 days);

5. General urine test (expiration date - 10 days);

6. Biochemical blood test: K+, Na+, CI, ALT, AST, bilirubin, urea, amylase, creatinine, glucose (expiration date - 10 days);

7. Prothrombin index, blood clotting (shelf life - 10 days);

8. ECG with interpretation (expiration date - 1 month);

9. X-ray of the paranasal sinuses (description);

10. Dentist’s conclusion on oral sanitation;

11. An otolaryngologist’s conclusion about the absence of contraindications to eye surgery;

12. Therapist’s conclusion about the absence of contraindications to eye surgery;

13. Opinion of other specialists on the absence of contraindications to eye surgery (if necessary; agreed with the attending physician).

When planning an eye operation, the patient can receive the following document from the attending physician at the clinic at his place of residence (work):

FSBI "ENDOCRINOLOGICAL RESEARCH CENTER"

Moscow, st. Dm. Ulyanova, 11 Contact center: (4

To the clinic at your place of residence (work)

In connection with the upcoming eye surgery, I request that the patient be examined

1. General blood test (formula), blood sugar;

2. Biochemical blood test (K+, Na+, CI, ALT, AST, bilirubin, urea, amylase, creatinine);

3. General urine analysis;

4. Result of the Wasserman reaction, HIV, HBS antibodies, ACV antibodies, blood group;

5. Prothrombin index, blood clotting;

6. Dentist’s conclusion on oral sanitation;

7. An otolaryngologist’s conclusion about the absence of contraindications to eye surgery;

8. X-ray of the paranasal sinuses (description);

9. X-ray (fluorography) of the chest organs (description);

10 Electrocardiogram with interpretation;

11 Therapist’s conclusion about the absence of contraindications to eye surgery;

12 Opinion of other specialists on the absence of contraindications to eye surgery (if necessary) _______________________________

Tests required during hospitalization female patients

for IVF treatment:

for both partners;

for both partners;

Blood test for TORCH infection (for women) - indefinitely.

Photocopies of both spouses' passports.

Expert opinion if you have chronic diseases.

When receiving positive results for hepatitis, the patient is required to provide data from a biochemical blood test for ALT and AST and a report from an infectious disease specialist.

When planning IVF treatment, the patient can receive the following document from the attending physician at the clinic at her place of residence (work):

FSBI "ENDOCRINOLOGICAL RESEARCH CENTER"

Moscow, st. Dm. Ulyanova, 11 Contact center: (4

To the clinic at your place of residence (work)

In connection with the upcoming IVF treatment, I request that the patient be examined

and attach the results of the following studies (analyses):

1. Results of blood tests for AIDS, syphilis by ELISA, HRsAg and anti-HCV by ELISA (expiration date - 30 days) for both partners;

2. X-ray (x-ray) of the chest organs (image and description, shelf life - 12 months);

3. Blood test for group and Rh factor (indefinitely) for both partners;

4. Clinical blood test (valid for 14 days);

5. Blood biochemistry + electrolytes (valid for 14 days);

6. Coagulogram (valid for 14 days);

7. General urine test (valid for 14 days);

8. Smears on flora and art. purity (valid for 21 days);

9. Smears for cytology (valid for 1 year);

10. STI smears (PCR) (valid for 6 months);

11. ECG (valid for 3 months);

12. Physician’s report (valid for 1 year).

13. Blood test for TORCH infection (for women) - indefinitely.

14. Expert opinion if there are chronic diseases.

15. Upon receiving positive results for hepatitis, the patient is required to provide data from a biochemical blood test for ALT and AST and a conclusion from an infectious disease specialist.

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