Gastro-Intestinal Laparoscopic Procedure - Essay Example

Name: Lecturer: Course: Date: Gastro-Intestinal Laparoscopic Procedure Introduction Laparoscopic surgery is one of the main procedures applied in treating gastrointestinal disorders. The minimally invasive procedure aims to address diseases that affect gastrointestinal tract (Ganatra, et al. 1091). It is important to note that gastrointestinal disorders can be treated through medications or adjustment to the patient’s lifestyle. In this case, most conditions do not require any surgical procedure to treat. However, significant percentage of gastrointestinal diseases fails to respond to medications and therapy. At this point, the invasive procedure becomes an option in treating the gastrointestinal disorder (Vestweber, et al. 3227). The main aim of this paper is to identify health conditions that require laparoscopic procedure with emphasis on a particular case of a patient with gastrointestinal condition. The paper demonstrates various steps involved in the procedure from pre-operative to the post-operative care. The laparoscopic procedure becomes necessary when all other options fail to respond to the gastrointestinal condition. Doctors always try to explore other options such as therapy and medications before settling on invasive procedure (Grantcharov, et al. 1130). Note that any invasive procedure has risks to the patient hence other options are first exhausted. In this particular case study, Jim (not his actual name) was diagnosed with bowel incontinence which is one of the common gastrointestinal conditions. The condition is also referred as faecal incontinence which is characterised by the inability to control bowel movement. From the patient’s past records, the condition started with occasional leakage of stool which was in small quantity. The patient could also experience passing of gas. The doctor recommended medication and therapy where the nurse took charge of guiding the patient in the path of recovery. Unfortunately, both medication and therapy did not respond and the condition worsened. This aspect forced the patient to seek further medical attention, where laparoscopic procedure became the ideal option to treat the worsening bowel incontinence. Patient Background Jim is in his teenage and he was diagnosed with the bowel incontinence initially at the age of five years. The stool leakage could not be detected by parents since they assumed they boy was still growing and would learn to control the bowel movement as he matures. At the age of five, the mother consulted the family paediatrician who conducted the diagnostic procedure and found out the boy had bowel incontinence. The paediatrician recommended therapies and medication which did not improve the situation. At age thirteen, the problem worsened and Jim was put under medication again. He has been undertaking therapy for the last past two years, and the problem persisted to the point of seeking alternative option. The patient has not only suffered physically and emotionally which would require comprehensive approach that would address both medical and psychological problem. Pre-operative Health Condition In light of the above description of initial symptoms and medication of the gastrointestinal condition, it is clear that the patient needed an alternative medical attention to address the worsening situation. The leakage frequency had increased and stool could be noticed on the clothes. The patient had lost control of the bowel completely hence putting him in a condition of unexpected and frequent leakage from the rectum. The condition causes dehydration due to the excessive passage of stool in liquid form (Franke, et al. 2065). In addition, the patient has suffered psychologically due to the frustrating state of the bowel condition. Jim could not move beyond his house due to fear of abrupt loss of bowel control. He has even lost confidence to face people other than his immediate family which offered care at home. From the medical history and clinical observation, anal dysfunction was evident in the patient. The doctor identified two main preoperative tests to pave way for the main invasive procedure. These tests include flexible signoidoscopy and magnetic resonance imaging (MRI). Signoidoscopy uses endoscope which examines the lining of lower part of the digestive tract. The main aim of this examination is to evaluate extent of damage to the tract which consists of rectum (Carraro, et al. 142). MRI pre-operative procedure identifies sections of weaknesses along the rectal wall. Inter-disciplinary approach is involved in this case where team of health professionals seeks to identify the actual cause of the problem. The result of the preoperative tests serves the purpose of informing the decision of the inter-disciplinary team concerning the main invasive procedure. Preoperative Nursing Care After receiving Jim at the casualty, the case needed immediate admission. The team of nurses I included received the patient and laid him in a bed. There was need to remove the clothes and clean various parts of the body using the sponge. Considering the patient had soiled the clothes, we had to get the hospital cloth for him and handed over other clothes to family members. After receiving and admitting the patient in the ward, I was charged with the responsibility of leading the nursing team in providing care for the patient. In this case, we prepared all the necessary tools of work for the purpose of preoperative tests recommended by the doctor. With consultation of the general practitioner and other health professionals in the team, we had to prepare tools and avail them for the purpose of preoperative tests. Before the inception of the preoperative tests, I had to take the patient through all procedures. The patient-centred approach requires the nurse to inform the patient of all the planned care and involve him in the process of care planning (Lin, et al. 257). I engaged the patient in a detailed discussion on what the health care providers intend to do. Fortunately, the patient had enough composure to talk and comprehend whatever we were discussing. The patient has no problem going through the tests and the main procedure. I had also to prepare the patient concerning the pain associated with the minimally invasive procedure. It was important to ensure the patient get the adequate information and become part of the care planning. Finally, I had to discuss several elements of post-operative care which would facilitate recovery from bowel incontinence. Laparoscopic Procedure After conducting the preoperative tests which included flexible signoidoscopy and magnetic resonance imaging, the healthcare team identified sphincter damage as the main cause of the underlying problem (Boons, et al. 529). The problem required sphincteroplasty, an invasive procedure that required surgeon to perform the repair on the damaged anal sphincter. The surgeon was able to identify injured section of the muscle and remove tissues that surrounded the anal sphincter. The doctor/surgeon was able to sew the edges of the sphincter in an overlapping manner. The main purpose of sewing is to strengthen the weak muscle and tighten the loose sphincter (Londono-Schimmer, et al. 112). There was proper coordination of healthcare team. As a nursing leader in the operation, I was taking clinical notes as the procedure progressed from one stage to another. In addition, I ensured instructions of the surgeon are following during the procedure. This aspect helps in eliminating unnecessary delays and inconveniences in the operation room. After successful laparoscopic procedure, surgeon in collaboration with general practitioner provided instructions on how to handle the patient. At that point, I had to lead other nurses in taking back the patient to the general ward from the operation room. The main task of the nurse at this point is to help the patient in the course of recovery. After approximately thirty minutes, the patient recovered his consciousness. I had prepared the patient in advance and he was psychologically ready to go through the process. In this case, the recovery process from unconsciousness was quick. Post Operative Nursing Care Plans were ready for the post operative patient care which aimed at fast tracking the recovery process. The post operative care begins by allowing the patient adequate time to gain consciousness and provide the appropriate environment for the patient to recover completely. The nurse must be present by the bedside to offer the necessary support to the patient. The most critical part of the post operative care is administration of medication to the patient. The nurse has to follow the instruction from the doctor and provide any other support necessary for healing. For this particular case, the doctor put the patient under medication for three weeks in the hospital setting. There was prescription that aimed at healing the wound and regulating post operative pain. The administration of medication started three hours after the patient gained consciousness. As the nursing leader, I had the responsibility of assigning other nurses the task of ensuring the medication is administered according to the instructions of the doctor. The second role of a nurse in post operative care is to record progress and report to the general practitioner on daily basis. I had the responsibility of recording progress and observing any case that might require the special attention of the specialist. In addition, I had the duty to coordinate nursing care and cooperate with the doctor to ensure Jim remains in the path of recovery while in the hospital. The progress report serves the purpose of informing the decision of the inter-disciplinary team (Merkel, et al. 76). It is through the progress report that the general practitioner decides the kind of medication to recommend for the patient’s recovery. In this case, I had to constantly observe the patient and collaborate with other care givers to ensure proper progress report. The last part of the post operative care is to provide the patient centred support to the patient and the family. The gastrointestinal condition especially the bowel inconsistence is a frustrating and it mostly causes both physical and psychological torture to the patient and the family (Menees, et al. 151). In this case, the family members especially those who have been close to the patient require counselling and social support. I had to plan on how to take the family through counselling in collaboration with social workers. I organised sessions with psychology counsellors who supported the family to take the role of care givers to Jim while at him. It is through counselling both the patient and the family felt relieved. I ensured that parents and other family members understand bowel inconsistence as any other disease. In addition, positive response to medication and other forms of nursing and social care provided hope and inspiration to the family. After three weeks, the wound was healed and the patient was in a positive path of recovery. The general practitioner discharged the patient from the hospital. Conclusion Laparoscopic procedure is the ideal option doctors utilise when gastrointestinal condition fails to respond positively to the medication and therapy. The case of Jim is just the reflection of how invasive procedures respond to conditions that defeat other interventions. To realise successful preoperative and postoperative interventions, nursing care plays a vital role. Nursing profession ensures coordination of activities from the time the patient is received in the hospital to the time the same patient is discharged. Works Cited Boons, P., et al. "Laparoscopic ventral rectopexy for external rectal prolapse improves constipation and avoids de novo constipation." Colorectal Disease 12.6 (2010): 526-532. Franke, Andreas, et al. 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