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laparoscopy in the female Images (Click to view larger image)
Alternative Names
pelvic laparoscopy, diagnostic laparoscopy, exploratory laparoscopy
Definition
A laparoscopy is any surgical procedure that uses a laparoscope. A laparoscope is a thin tube attached to a light source. With it, a doctor can see the pelvic and abdominal organs.
Who is a candidate for the procedure?
The goal of laparoscopy is to find the cause of a problem without making a big cut, or incision, in the upper or lower abdomen. If a pelvic or abdominal ultrasound has shown something abnormal, laparoscopy is often used to confirm the findings. A woman may need a laparoscopy for many reasons. Some symptoms that may lead to the procedure include: - chronic pelvic pain that a doctor suspects is from a pelvic infection, endometriosis (a condition where tissue of the lining of the uterus grows outside the uterus, resulting in pain and/or infertility), or ovarian cysts.
- infertility, which is difficulty in getting pregnant.
A doctor may also use laparoscopy to remove these organs or growths: - hernia
- gallbladder
- appendix
- small fibroids (benign or non-cancerous tumours of the uterus)
A doctor may also choose this procedure to diagnose, evaluate, or treat these conditions: - a hole, tear, or puncture in the uterus that occurred after a dilatation and curettage (a procedure in which the inside lining of the uterus is scraped with a special instrument), hysteroscopy (a thin tube with a light source is inserted through the vagina in order to examine the inside of the uterus), or placement of an IUD, or intrauterine device
- endometriosis, which is the growth of uterine tissue outside of the uterus
- cysts, or small growths, in the ovaries
- unruptured ectopic pregnancy, which occurs when the developing baby is outside the uterus
- the presence of fluid in the abdomen, which could be due to blood, ascites (fluid other than blood in the abdomen), or cancer cells
- a pelvic mass
A doctor may also use this procedure for these reasons: - to follow-up after surgery for ovarian cancer
- to aid in a sterilisation procedure, which keeps the woman from becoming pregnant
- to treat scar tissue, called adhesions, in the pelvic area
How is the procedure performed?
First, the woman receives general anaesthesia. This relaxes the abdominal muscles, leads to a deep sleep, and prevents the sensation of pain. Then, the doctor makes a small cut below her belly button. The doctor puts the laparoscope through this cut. Then, the doctor uses two to five litres of carbon dioxide gas to inflate the abdominal cavity. This helps the doctor see the organs in the region. Next, the doctor makes one to three smaller cuts on the lower abdomen. These are used for instruments that might be needed to hold an organ, or to take a biopsy, or to laser any lesions. The doctor uses the laparoscope to see the following parts of the body: - uterus
- fallopian tubes
- ovaries
- bladder
- intestines
- liver
- spleen
- appendix
- surfaces of the cavities themselves
After the doctor has viewed or removed what is needed, the cuts are closed with stitches. These may heal by themselves or may need to be removed in the doctor's office a week later. The laparoscopy usually takes about 30 minutes. The woman recuperates in a recovery room for 30 minutes. Occasionally, the woman may need to stay overnight in the hospital if she cannot wake up or if any complications have occurred.
What happens right after the procedure?
The doctor talks about the findings and treatment options after the procedure.
What happens later at home?
For a few hours after the surgery, the woman may feel sleepy or groggy. She should not drive or use heavy machinery for 24 hours. The most common complaints after laparoscopy include: - shoulder pain, caused from gas under the diaphragm.
- feeling bloated.
- pain from the cuts, or incisions.
- cramping.
- constipation.
These symptoms usually improve within 24 to 48 hours after surgery.
What are the potential complications after the procedure?
Because sharp instruments are placed within the abdomen, trauma may occur to any organ within this space. Other complications include: - problems related to the anaesthesia, which include reactions to medications and difficulty breathing
- a bloody swelling, or haematoma, around the cut
- infection of the cut
- puncture of the aorta, the main artery of the heart
- bleeding in the abdomen
Author: Eva Martin, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 12/06/2005
Contributors
Potential conflict of interest information for reviewers available on request |
