There are several ways to remove tumors: excision, ectomy, etc. Enucleation refers to methods of operative removal.
The concept of
Enucleation is a method of removing a tumor by its excision, i.e., a complete removal of the formation without damaging the surrounding structures and the envelope that delimits the tumor from adjacent tissues.
If an enucleation of an internal organ is contemplated, then its removal without incisions of its membrane is performed.
When is the operation shown?
The main indications for the operation are:
- Benign small tumors located in the tissues of the prostate( adenoma), breasts( lipomas and fibromas), thyroid gland and Bartholin gland;
- Single tumors on the uterine muscular layer in patients capable of childbearing;
- Non-parasitic cystic lesions;
- Ovary teratomas and cysts of the paraovarian type;
- Retinal cysts of cervix and vagina;
- Cysts in the gums;
- Fat-tight cystic lesions;
- Cystic formations of the spleen or liver of the non-parasitic type.
Contraindications
The procedure has its own contraindications, which depend on the body in which the intervention is supposed to be performed. So, for example, such an operation is contraindicated in the presence of severe systemic pathologies, the development of the general organic infectious process, and craniocerebral trauma.
With prostatic adenoma, enucleation is contraindicated when:
- Myocardial insufficiency;
- Kidney failure;
- Pulmonary heart;
- Severe forms of cerebrovascular atherosclerosis;
- Aortic aneurysm;
- Exacerbations of cystitis or pyelonephritis of chronic forms.
For enameled adenoma, enucleation is contraindicated if during the biopsy the presence of malignant cells was detected, as well as in the presence of some systemic and infectious pathologies, problems with blood clotting, etc.
Technique for
Enucleation of any organ or formation is performed with anesthesia and requires some preoperativetraining.
The presence of intolerance to the applied anesthetics is necessarily determined, an electrocardiogram and diagnosis for infectious diseases is performed, blood is examined. Then a direct vyluschivanie.
Enucleation of the eyeball
The patient is placed on a table and a special eyelid is opened with the necessary access. The operation itself lasts about an hour and consists of several stages.
- The surgeon dissects the conjunctiva and separates the apple of the eye from its bed.
- A special hook cuts straight muscles. Then the eye extends outward and the optic nerve and oblique muscles are cut off.
- The eye is removed, bleeding is burned with peroxide, and then a pressure swab is applied.
- When the bleeding is stopped, an implant is embedded in the orbit, which is attached to the remaining muscle tendons.
It is difficult for patients to get used to the idea that they were actually without an eye, so psychological rehabilitation is shown to such patients.
In addition, in the postoperative period, various complications such as swelling, bleeding, or inflammatory defeat of the operated orbit can appear. If there is a violation of sanitary standards, an infection can enter the eye.
Ovarian cysts
Enucleation of the ovarian cyst allows women to maintain fertility. During the procedure, not all the ovaries are removed, but only capsules with cystic contents. Healthy tissues are not affected in any way.
The patient before enucleation must undergo an examination for the presence of inflammatory pathologies of the genitourinary sphere. In addition, a biopsy study of the cyst is recommended to exclude its malignant nature.
- Before the operation, the patient needs to shave the inguinal area and sign a consent to carry out the hatching.
- All manipulations are performed under anesthesia. For the procedure in the abdominal wall make 3 punctures, which lead the necessary endoscope and the necessary tools.
- In a place where the cystic contours are most clearly visible, cut-off is performed.
- In the process of vyluschivaniya try not to damage the cyst itself, to avoid getting its contents on healthy tissues of the ovaries.
- Sometimes, to facilitate the enucleation process, aspiration of the cystic contents is performed, only then the separation and extraction of the capsule is performed.
- Bleeding is stopped by an electric coagulator.
A couple of hours after the procedure the patient can eat, drink and get out of bed. Usually the patient is discharged on the second day after the operation.
During the rehabilitation, the patient takes antibiotics and pain medications. You can take a shower or bath about a week after enucleation.
For about two to three months, a woman is not allowed to lift heavy objects, and sexual intimacy is excluded for a month.
Enucleation of the ovarian cyst usually occurs without complications, although in exceptional cases bleeding, inflammation or infection may occur. Usually, such complications occur in cases of violations of postoperative rehabilitation, sterility or patient's non-compliance with medical requirements.
Mammary gland
One of the leading surgical methods for eliminating benign breast-fibrous fibroadenomatous formations is enucleation.
A similar removal technique is recommended for small size and benign tumor origin, which must necessarily be confirmed by preliminary biopsy and histological studies.
The procedure is performed under local anesthesia. The whole operation takes about an hour.
Access to education is usually done through a site on the border of the pigment zone that surrounds the nipple. The surgeon dissects the gland tissue, removes the formation to the site of the incision, neatly separates it from neighboring tissues and removes it. Then the necessary seams are applied to the wound.
The rehabilitation period assumes the patient's stay in the hospital even 24 hours after the operation.
The seam is removed for about 5 days, and the painful discomfort in the chest can persist for several more weeks. For its elimination prescribed painkillers, and for the prevention of complications - antibiotics.
Myomatous nodes
The excision of myoma nodes is, in fact, considered the gold standard for the removal of uterine fibroids. The myomatous node has a characteristic capsule surrounding it, so operative removal can be performed without damaging the tissues of the muscular layer of the uterus.
In general, enucleation can be eaten in several ways:
- Laparotomy. When the vyluschivanie is made through dissection on the peritoneum and the uterine wall. This operation is indicated for large sizes of formations. Long-term rehabilitation is 2-3 months. There is a high probability of complications such as adhesions and bleeding.
- Laparoscopy. When access to education is carried out through two small incisions. Recovery takes about 10 days, the risk of complications is minimal.
- Hysteroscopy. Instrumentation is introduced into the uterine cavity through the vagina. With the help of electro-loops the harvesting and removal is carried out. Rehabilitation takes 4-5 days. The operation can be complicated by scarring, spikes or uterine perforation.
Thyroid Nodule
If the thyroid appears to have an abnormal formation, the parenchymal glandular tissue is not altered, then enucleation is performed.
Tissues of thyroid gland are cut before site localization, then it is removed and removed. After removal, stop the blood and sew the wound layer by layer. Such an approach to surgery is able to preserve the integrity of healthy thyroid cells as much as possible.
Rehabilitation takes several days, complications are similar to operations on other organs.
Enucleation of prostatic adenoma
Most often, the enucleation of the prostatic adenoma is done through the HoLEP method or the holmium laser.
This approach to treatment allows you to get as precise as possible to the desired area of the prostate and ensures the safety of the remote biomaterial for further study histologically.
Complications that may occur in the form of urinary disorders, impotence, hematuria or infectious lesions of the genitourinary sphere are also possible.
The cost of
The cost of such treatment depends on a number of different factors and on average is:
- Laser excision of prostate adenoma - 23000-64000 rubles;
- Enucleation of the apple of the eye - 5000-41000 rubles;
- Enucleation of the dairy ferment cyst - 6000-47000 rubles;
- Surgery on the thyroid - 9800-43000 rubles;
- Enumeration of uterine nodes - 9600-56000 rubles.
Video shows laser enucleation of prostate adenoma: