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Laparoscopy

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What is a laparoscopy?

A laparoscopy is a type of surgery that checks for problems in the abdomen or a woman’s reproductive system. Laparoscopic surgery uses a thin tube called a laparoscope. It is inserted into the abdomen through a small incision. An incision is a small cut made through the skin during surgery. The tube has a camera attached to it. The camera sends images to a video monitor. This allows a surgeon to view the inside of the body without major trauma to the patient.

Laparoscopy is known as minimally invasive surgery. It allows for shorter hospital stays, faster recovery, less pain, and smaller scars than traditional (open) surgery.

Other names: diagnostic laparoscopy, laparoscopic surgery

What is it used for?

For people with abdominal symptoms, laparoscopic surgery may be used to diagnose:

  • Tumors and other growths
  • Blockages
  • Unexplained bleeding
  • Infections

For women, it may be used to diagnose and/or treat:

  • Fibroids, growths that form inside or outside the uterus. Most fibroids are noncancerous.
  • Ovarian cysts, fluid-filled sacs that form inside or on the surface of an ovary.
  • Endometriosis, a condition in which tissue that normally lines the uterus grows outside of it.
  • Pelvic prolapse, a condition in which the reproductive organs drop into or out of the vagina.

It may also be used to:

  • Remove an ectopic pregnancy, a pregnancy that grows outside the uterus. A fertilized egg can’t survive an ectopic pregnancy. It can be life-threatening for a pregnant woman.
  • Perform a hysterectomy, the removal of the uterus. A hysterectomy may be done to treat cancer, abnormal bleeding, or other disorders.
  • Perform a tubal ligation, a procedure used to prevent pregnancy by blocking a woman’s fallopian tubes.
  • Treat incontinence, accidental or involuntary urine leakage.

The surgery is sometimes used when a physical exam and/or imaging tests, such as x-rays or ultrasounds, don’t give enough information to make a diagnosis.

Why do I need a laparoscopy?

You may need a laparoscopy if you:

  • Have severe and/or chronic pain in your abdomen or pelvis
  • Feel a lump in your abdomen
  • Have abdominal cancer. Laparoscopic surgery can remove some types of cancer.
  • Are a woman with heavier than normal menstrual periods
  • Are a woman who wants a surgical form of birth control
  • Are a woman having trouble getting pregnant. A laparoscopy can be used to check for blockages in the fallopian tubes and other conditions that can affect fertility.
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What happens during a laparoscopy?

Laparoscopic surgery is usually done in a hospital or outpatient clinic. It usually includes the following steps:

  • You will remove your clothing and put on a hospital gown.
  • You will lay on an operating table.
  • Most laparoscopies are done while you are under general anaesthesia. General anaesthesia is a medicine that makes you unconscious. It makes sure you won’t feel any pain during the surgery. You will be given the medicine through an intravenous (IV) line or by inhaling gases from a mask. A specially trained doctor called an anesthesiologist will give you this medicine
  • If you are not given general anaesthesia, a medicine will be injected in your abdomen to numb the area so you won’t feel any pain.
  • Once you are unconscious or your abdomen is completely numb, your surgeon will make a small incision just below your belly button, or near that area.
  • The laparoscope, a thin tube with a camera attached, will be inserted through the incision.
  • More small incisions may be made if a probe or other surgical tools are needed. A probe is a surgical instrument used to explore internal areas of the body.
  • During the procedure, a type of gas will be put into your abdomen. This expands the area, making it easier for the surgeon to see inside your body.
  • The surgeon will move the laparoscope around the area. He or she will view the images of the abdomen and pelvic organs on a computer screen.
  • After the procedure is done, the surgical tools and most of the gas will be removed. The small incisions will be closed up.
  • You will be moved to a recovery room.
  • You may feel sleepy and/or nauseous for a few hours after the laparoscopy.

Will I need to do anything to prepare for the test?

If you will be getting general anaesthesia, you may need to fast (not eat or drink) for six or more hours before your surgery. You may not even be able to drink water during this period. Ask your health care provider about specific instructions. Also, if you are getting general anaesthesia, be sure to arrange for someone to drive you home. You may be groggy and confused after you wake up from the procedure.

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In addition, you should wear loose-fitting clothes. Your abdomen may feel a little sore after the surgery.

Are there any risks to the test?

Many people have mild abdominal pain or discomfort afterwards. Serious problems are uncommon. But they can include bleeding at the incision site and infection.

What do the results mean?

Your results may include diagnosing and/or treating one of the following conditions:

  • Endometriosis
  • Fibroids
  • Ovarian cysts
  • Ectopic pregnancy

In some cases, your provider may remove a piece of tissue to test for cancer.

If you have questions about your results, talk to your health care provider.

References

  1. ACOG: Women’s Healthcare Physicians [Internet]. Washington D.C.: American College of Obstetricians and Gynecologists; c2018. FAQ: Laparoscopy; 2015 Jul [cited 2018 Nov 28]; [about 3 screens]. Available from: https://www.acog.org/Patients/FAQs/Laparoscopy
  2. ASCRS: American Society of Colon and Rectal Surgeons [Internet]. Oakbrook Terrace (IL): American Society of Colon and Rectal Surgeons; Laparoscopic Surgery: What is it?; [cited 2018 Nov 28]; [about 3 screens]. Available from: https://www.fascrs.org/patients/disease-condition/laparoscopic-surgery-what-it
  3. Brigham Health: Brigham and Women’s Hospital [Internet]. Boston: Brigham and Women’s Hospital; c2018. Laparoscopy; [cited 2018 Nov 28]; [about 5 screens]. Available from: https://www.brighamandwomens.org/obgyn/minimally-invasive-gynecologic-surgery/laparoscopy
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  5. Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2018. Female Pelvic Laparoscopy: Procedure Details; [cited 2018 Nov 28]; [about 4 screens]. Available from: https://my.clevelandclinic.org/health/treatments/4819-female-pelvic-laparoscopy/procedure-details
  6. Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2018. Female Pelvic Laparoscopy: Risks/Benefits; [cited 2018 Nov 28]; [about 4 screens]. Available from: https://my.clevelandclinic.org/health/treatments/4819-female-pelvic-laparoscopy/risks–benefits
  7. Endometriosis.org [Internet]. Endometriosis.org; c2005–2018. Laparoscopy: before and after tips; [updated 2015 Jan 11; cited 2018 Nov 28]; [about 3 screens]. Available from: http://endometriosis.org/resources/articles/laparoscopy-before-and-after-tips
  8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Ectopic pregnancy: Symptoms and causes; 2018 May 22 [cited 2018 Nov 28]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088
  9. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. General anesthesia: About; 2017 Dec 29 [cited 2018 Nov 28]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/anesthesia/about/pac-20384568
  10. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Minimally invasive surgery: About; 2017 Dec 30 [cited 2018 Nov 28]; [about 3 screens]. Available from: https://www.mayoclinic.org/tests-procedures/minimally-invasive-surgery/about/pac-20384771
  11. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Pelvic organ prolapse: Symptoms and causes; 2017 Oct 5 [cited 2018 Nov 28]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/pelvic-organ-prolapse/symptoms-causes/syc-20360557
  12. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Laparoscopy; [cited 2018 Nov 28]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/digestive-disorders/diagnosis-of-digestive-disorders/laparoscopy
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