Laparoscopy is a surgical procedure that has been used widely in medicine over 30 years.faster recovery time, the minimizing of pain, hospitalization and better aesthetic result are some of the advantages which made laparoscopy very popular among patients and surgeons. Also, some technical parameters such as the magnification offered by the endoscope during the procedure and the small risk of complications resulted in the wide use of laparoscopic surgery in gynecology. Laparoscopy has gained a leading role and appears to be the gold standard method for a quiet wide range of gynecologic procedures such as tubal ligation, removal of ovarian cyst or adnexa, treatment of ectopic pregnancy, hemorrhagic rupture of a cyst, exploration of chronic pelvic pain, sterility, treatment of endometriosis, removal of fibromyomata , hysterectomy, and lately for treatment of pelvic organ prolapses, urinary incontinence and even in gynecologic cancers.
Laparoscopy is a type of surgical procedure in which a small cut is made through the navel (tummy button) through which a viewing tube (laparoscope) is inserted. The laparoscope has a small camera on the eyepiece which allows the doctor to examine the abdominal and pelvic organs on a video monitor. Other small cuts can be made to insert instruments to perform procedures (keyhole surgery). Laparoscopy can be carried out to diagnose conditions or to perform certain types of operations.
As a diagnostic procedure, a laparoscopy is done to find out the cause of pelvic pain, fertility problems, or gynecological) symptoms that cannot be confirmed by a physical examination or ultrasound. For example, a laparoscopic examination can identify ovarian cysts, endometriosis, adhesions (scarring), ectopic pregnancy or blocked fallopian tubes. It is carried out as a day- case procedure. Laparoscopy can also be used to examine the appendix, bowel, gallbladder, or liver.
As an operative procedure, laparoscopy is used for female sterilization, treating an ectopic pregnancy, treating endometriosis and/or adhesions, removal of ovarian cysts or abnormal ovaries, and opening or removing damaged tubes. Most of the fibroids in the uterus can be removed by laparoscopy. Laparoscopy can also be used to perform a hysterectomy.
While many of these procedures can be carried out using regular open surgery, laparoscopy usually involves:
Because laparoscopy is so much less invasive than traditional abdominal surgery, patients can leave the hospital sooner, usually within 12 – 24 hours.
Laparoscopy is a surgical procedure performed in the hospital under general anaesthesia. Before starting the procedure, the bladder is emptied with a small catheter and the skin of the abdomen is cleaned.
After you are anaesthetized, a hollow needle is inserted into the abdomen through a small cut through or just above the navel (tummy button), and carbon dioxide gas is pumped through the needle to expand the abdomen. This allows the surgeon to get a better view of the internal organs. The laparoscope is then inserted through this cut to look at the internal organs on the video monitor.
Usually one or two additional small cuts are made along the ‘bikini line’ to insert other instruments which are used to lift the tubes and ovaries for examination or to perform surgical procedures.
You should not eat or drink for about 6 hours before the procedure.Doctor may prescribe some medications on the previous night to swallow and to put in the vagina, so as to ascertain an empty bowel and clean aseptic lower genital tract, during the surgery. An enema may be given 2 hours prior to the procedure.
Nurses will check your vital signs (blood pressure, pulse, temperature and rate of breathing) after the operation. If there are no complications, you may leave the hospital within four to six hours of a diagnostic procedure. If you have had an operative laparoscopic procedure, you may need to stay in hospital for one night or so. (Traditional abdominal surgery requires a hospital stay of four days or more.)
There may be a some slight pain or throbbing in the first day or two after the procedure at the sites where the cuts were made. The gas that is used to expand the abdomen may cause discomfort under the ribs or in the shoulders for a few days.
Depending on the reason for the laparoscopy in operative procedures, some women may experience vaginal bleeding.
Many patients can return to work within a week of surgery and most are back to work within two weeks.