Surgery performed through several tiny "keyhole incisions." A fiberoptic instrument is inserted through one of the incisions to view the inside of the abdomen. Surgical instruments are inserted through other incisions. Laparoscopy can be used for a variety of procedures and operations.

PARTS OF THE BODY INVOLVED

Abdomen

REASONS FOR PROCEDURE

Laparoscopy is done to examine, diagnose, and treat problems inside the abdomen. The procedure is most often performed for the following reasons:

  • Diagnose cause of acute or chronic abdominal or pelvic pain
  • Visualize and obtain a tissue specimen from a mass in the abdomen
  • Evaluate the cause of infertility
  • Evaluate source of fluid accumulating in the abdomen
  • Monitor the status of previously treated cancer
  • Assist in determining the "stage" or spread of certain cancers

Many types of surgery that have traditionally been performed with an open incision can now be performed laparoscopically, these include:

  • Hernia repair
  • Biopsy of abdominal organs
  • Appendectomy
  • Colectomy
  • Gall bladder or gallstone removal
  • Tubal ligation
  • Ectopic pregnancy surgery
  • Egg retrieval for assisted reproductive technology
  • Hysterectomy
  • Removal of fibroid tumors
  • Adrenal gland removal
  • Removal of part of the liver
  • Splenectomy

RISK FACTORS FOR COMPLICATIONS DURING THE PROCEDURE

  • Pre-existing heart or lung condition
  • Obesity

WHAT TO EXPECT

Prior to Procedure

Depending on the reason for your laparoscopy, your doctor may do any of the following:

  • Physical exam
  • Review of medications
  • Blood tests
  • Ultrasound – a test that uses sound waves to visualize the inside of the body
  • CT scan – a type of x-ray that uses a computer to make pictures of the inside of the body
  • MRI scan – a test that uses magnetic waves to make pictures of the inside of the body

·         In the days leading up to your procedure:

  • Review your regular medications with the surgeon; you may need to stop taking some drugs
  • Depending on the type of operation to be performed, you may be asked to take a laxative and/or perform an enema before your procedure
  • Arrange for a ride to and from the procedure
  • The night before, eat a light meal and do not eat or drink anything after midnight unless told otherwise by your doctor
  • Wear comfortable clothing

During Procedure - IV fluids, anesthesia, possibly a sedative

Anesthesia - General or local, with sedation

Description of the Procedure - The surgeon cuts a small opening in the abdomen. The location of this incision varies depending on the procedure, either near the navel or in the lower abdomen for pelvic conditions. A needle is inserted, and used to inject carbon dioxide gas into the abdomen. This gas causes the abdominal cavity to expand and makes it easier for the doctor to see the internal structures. The doctor inserts a long, thin tubular instrument (laparoscope) that lights, magnifies, and projects an image of the internal organs onto a video screen. The internal organs are inspected.

If necessary, several other tiny incisions may be made in the abdomen through which to insert instruments that can take biopsies or perform various types of surgery (such as removal of an organ). After the laparoscope and any other tools are removed, the incisions are closed with stitches or clips and covered with a dressing.

After Procedure - Laboratory exam of removed fluid or tissue

How Long Will It Take? Usually less than 1 hour, but this depends on the type of procedure being done

Will It Hurt? Anesthesia prevents pain during the procedure. You may experience soreness for a couple of days during recovery, but you will receive pain medication to relieve this discomfort. You may also feel bloated or have pain in your shoulder from the gas used during the procedure. This can last up to three days

Possible Complications:

  • Infection
  • Excessive bleeding
  • Damage to blood vessels or organs, sometimes requiring immediate open surgery for repair
  • Anesthesia-related problems
  • Sometimes it becomes evident during laparoscopic surgery that the operation would be better carried out using a traditional, open incision

Average Hospital Stay - Most patients having a diagnostic laparoscopy go home the same day. Laparoscopic surgery may require a few days of hospital care, depending on the procedure.

Postoperative Care:

  • The operative dressing can usually be removed the morning after surgery
  • Avoid heavy lifting
  • Do not drink carbonated beverages for two days

OUTCOME

Depending on the procedure, you should be able to resume regular activities in about one week.

If the laparoscopy was performed to help diagnose a condition, your doctor will suggest treatment options. Biopsy results may take 3-5 days.

CALL YOUR DOCTOR IF ANY OF THE FOLLOWING OCCURS

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Headache, muscle aches, feeling faint or dizzy
  • Difficulty urinating
  • Following procedures with general anesthesia: cough, shortness of breath, chest pain, or severe nausea or vomiting
SOURCE:

American Gastrointestinal Endoscopic Surgeons

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