Laparoscopy is a minimally invasive type of surgical procedure that allows a surgeon to access the inside of the abdomen (tummy) and pelvis without having to make large incisions in the skin. Gynecologic laparoscopy is an alternative to open surgery.
Large incisions can be avoided during laparoscopy because the surgeon uses an instrument called a laparoscope. This is a small tube that has a light source and a camera, which relays images of the inside of the abdomen or pelvis to a television monitor.
Laparoscopy is most commonly used in gynecology (the study and treatment of conditions that affect the female reproductive system), gastroenterology (the study and treatment of conditions that affect the digestive system) and urology (the study and treatment of conditions that affect the urinary system).
The advantages of laparoscopy over “open” surgery
- a shorter hospital stay and faster recovery time
- less pain and bleeding after the operation
- reduced scarring
Gynecological laparoscopy is a procedure used to look inside your abdomen and examine your fallopian tubes, ovaries and womb. Gynecological laparoscopy can be used either to diagnose a condition or to treat a condition.
Gynecological laparoscopy can be used to:
- diagnose and treat endometriosis, a condition where the lining of your womb grows outside your womb
- diagnose and treat pelvic inflammatory disease – inflammation of your ovaries, womb or fallopian tubes
- diagnose and remove scar tissue (adhesions)
- treat an ectopic pregnancy, a condition where a fertilized egg implants outside your womb
- carry out female sterilization, which is permanent contraception
- remove an ovarian cyst
- remove your womb or ovaries (hysterectomy)
- treat fibroids – non-cancerous growths on or inside your womb
- remove lymph nodes for cancer treatment
Your surgeon may also suggest a laparoscopy if you have pain in your abdomen because it may help to diagnose what is causing the pain. If you’re having problems getting pregnant, you can have a laparoscopy to see if there are any problems with your ovaries, fallopian tubes or womb.
Laparoscopy is carried out under general anesthetic, so you will be unconscious and not feel any pain during the procedure.
During laparoscopy, the surgeon makes one or more small incisions (0.5-1 cm) in the abdomen. These allow the surgeon to insert the laparoscope, small surgical tools and a tube used to pump gas into the abdomen so it is easier for the surgeon to look around and operate. The gas keeps the abdominal wall away from your organs. It reduces the risk of injury.
With laparoscope, transmitting images to a screen, the doctor can have a clear view of your organs. Laparoscopy can be used to help diagnose a wide range of conditions that develop inside the abdomen or pelvis. It can also be used to carry out surgical procedures, such as removing a damaged or diseased organ, or removing a tissue sample for further testing (biopsy).
Once the procedure is over, all instruments are removed, the gas is let out of your abdomen and the incisions are closed using dissolvable stitches which usually disappear in seven days.
You will need to rest until the effects of the anesthetic have passed. General anesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. You can often go home on the same day you have laparoscopy, although sometimes you may need to stay overnight in hospital.
Your nurse will give you some advice about caring for your wounds, hygiene and bathing. If you have a laparoscopy to diagnose a condition you will need to rest and take it easy for up to one week, though this will depend on the type of procedure you had. If you have treatment during the laparoscopy- for example for endometriosis or a hysterectomy- your recovery will take longer.
Laparoscopic surgery is very common and generally regarded as very safe. Serious complications are rare, occurring in an estimated 1 in 1,000 cases. Possible complications that can develop include damage to organs, such as the bladder or bowel, injury to a major artery or damage to nerves in the pelvis.