Laparoscopy, also known as Diagnostic Laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen. It’s a low-risk, minimally invasive procedure that requires only small incisions.
Laparoscopy uses an instrument called a Laparoscope to look at the abdominal organs. A Laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.
Laparoscopy allows your doctor to see inside your body in real time, without open surgery. Your doctor also can obtain biopsy samples during this procedure.
PURPOSE
Why is Laparoscopy performed?
Laparoscopy is often used to identify and diagnose the source of pelvic or abdominal pain. It’s usually performed when non invasive methods are unable to help with diagnosis.
In many cases, abdominal problems can also be diagnosed with imaging techniques such as:
• Ultrasound, which uses high-frequency sound waves to create images of the body.
• CT scan, which is a series of special X-rays that take cross-sectional images of the body.
• MRI scan, which uses magnets and radio waves to produce images of the body.
Laparoscopy is performed when these tests doesn’t provide enough information or insight for a diagnosis. The procedure may also be used to take a biopsy, or sample of tissue, from a particular organ in the abdomen.
At PARIVAAR IVF CENTRE your doctor may also recommend Laparoscopy to examine the following organs:
Appendix
Gallbladder
Liver
Pancreas
Small intestine and Large intestine (colon)
Spleen
Stomach
Pelvic or Reproductive organs By observing these areas with a Laparoscope, we can detect:
An Abdominal mass or Tumor
Fluid in the Abdominal Cavity
Liver disease
The effectiveness of certain treatments
The degree to which a particular cancer has progressed
As well, we may be able to perform an intervention to treat your condition immediately after diagnosis.
RISKS
What are the risks of Laparoscopy?
The most common risks associated with Laparoscopy are bleeding, infection, and damage to organs in your abdomen. However, these are rare occurrences.
After your procedure, it’s important to watch for any signs of infection. Contact us if you experience:
Fevers or Chills
Abdominal pain that becomes more intense over time
Redness, swelling, bleeding, or drainage at the incision sites
Continuous nausea or vomiting
Persistent cough
Shortness of breath
Inability to urinate
Lightheadedness
There is a small risk of damage to the organs being examined during Laparoscopy. Blood and other fluids may leak out into your body if an organ is punctured. In this case, you’ll need to undergo other surgical process to repair the damage.
Less known risks include:
Complications from general Anesthesia
Inflammation of the Abdominal wall
A blood clot, which could travel to your pelvis, legs, or lungs
In some circumstances, your surgeon may believe the risk of diagnostic Laparoscopy is too high to warrant the benefits of using a minimally invasive technique. This situation often occurs for those who’ve had prior abdominal surgeries, which increases the risk of forming adhesions between structures in the abdomen. Performing Laparoscopy in the presence of adhesions will takes time and increases the risk of injuring organs.
PREPARATION
How do I prepare for Laparoscopy?
You should always let us know if you are taking prescription or over-the-counter medications. We will tell you how they should be used before and after the procedure.
We may change the dose of any medications that could affect the outcome of Laparoscopy. These drugs include:
Anticoagulants, such as blood thinners
Nonsteroidal Anti-inflammatory drugs (NSAIDs), including aspirin (Bufferin) or ibuprofen (Advil, Motrin IB)
Other medications that affect blood clotting
Herbal or Dietary supplements
Vitamin K
You should also let us know if you’re pregnant or think you might be pregnant. This will reduce the risk of harm to your developing baby.
Before Laparoscopy, we may conduct order blood tests, urinalysis, electrocardiogram (EKG or ECG), and chest X-ray. we also perform certain imaging tests, including an ultrasound, CT scan, or MRI scan.
These tests can help us to better understand the abnormality being examined during Laparoscopy. The results also give us a visual guide to the inside of your abdomen. This can improve the effectiveness of Laparoscopy.
You’ll probably need to avoid eating and drinking for at least eight hours before Laparoscopy. You should also arrange for a family member or friend to drive you home after the procedure. Laparoscopy is often performed using general anesthesia, which can make you drowsy and you might be unable to drive for several hours after surgery.
PROCEDURE
How is laparoscopy performed?
Laparoscopy is usually done as an outpatient procedure. This means that you’ll be able to our IVF Centre the same day as your surgery. It may be performed in our Surgical Centre.
You’ll likely be given general anesthesia for this type of surgery. This means that you’ll sleep through the procedure and won’t feel any pain. To achieve general anesthesia, an intravenous (IV) line is inserted in one of your veins. Through the IV, our anesthesiologist our give you special medications and well as provide hydration with fluids.
In some cases, local anesthesia is used instead. A local anesthetic numbs the area, so even though you’ll be awake during the surgery, you won’t feel any pain.
During Laparoscopy, the surgeon will make an incision below your belly button, and then inserts a small tube called a cannula. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows your doctor to see your abdominal organs more clearly.
Once your abdomen is inflated, the surgeon will inserts the Laparoscope through the incision. The camera attached to the Laparoscope will display the images on a screen, allowing your organs to be viewed in real time.
The number and size of incisions depends upon what specific diseases our surgeon is attempting to confirm or rule out. Generally, you get from one to four incisions that are each between 1 and 2 centimeters in length. These incisions allow other instruments to be inserted. For example, our surgeon may need to use another surgical tool to perform a biopsy. During a biopsy, they take a small sample of tissue from an organ to be evaluated.
After the procedure is done, the instruments are removed. Your incisions are then closed with stitches or surgical tape. Bandages may be placed over the incisions.
RECOVERY
How long does it take to recover from Laparoscopy?
When the surgical process is done, you’ll be observed for several hours before you’re releasing you from our IVF Centre. Your vital signs, such your breathing and heart rate, will be monitored closely. Our staff will also check for any adverse reactions to the anesthesia or the procedure, as well as monitor for prolonged bleeding.
The timing of your release will vary. It depends on:
Your overall physical condition
The type of anesthesia used
Your body’s reaction to the surgery
In some cases, you may have to remain in the Centre overnight.
In the days following Laparoscopy, you may feel moderate pain and throbbing in the areas where incisions were made. Any pain or discomfort would improve within a few days. Our doctor/ expert will prescribe medication to relieve the pain.
It’s also common to have shoulder pain after your procedure. The pain is usually a result of the carbon dioxide gas used to inflate your abdomen to create a working space for the surgical instruments. The gas can cause irritation in your diaphragm, which shares the nerves with your shoulder. It may also cause some bloating. The discomfort will go away within a couple of days.
You can usually resume all normal activities within a week. You’ll need to attend a follow-up appointment with our doctor for about two weeks after Laparoscopy.
Here are some things you can do to ensure a smoother recovery:
Begin light activity if possible, in order to reduce your risk of blood clots
Get more sleep than you normally do.
Use throat lozenges to ease the pain of a sore throat.
Wear loose-fitting clothes.
RESULTS
Results of Laparoscopy
If a biopsy was taken, our pathologist will examine it. Our pathologist specializes in tissue analysis and will send report detailing the results to our doctor.
Normal results from Lparoscopy indicates the absence of abdominal bleeding, hernias, and intestinal blockages. They also mean that all your organs are healthy.
Abnormal results from Laparoscopy indicate certain conditions, including:
Adhesions or surgical scars
Hernias
Appendicitis, an inflammation of the intestines
Fibroids, or abnormal growths in the uterus
Cysts or Tumors
Cancer
Cholecystitis, an inflammation of the gall bladder
Endometriosis, a disorder in which the tissue that forms the lining of the uterus grows outside the uterus
Injury or trauma to a particular organ
Pelvic inflammatory disease, an infection of the reproductive organs
Our doctor will schedule an appointment with you to go over the results. If a serious medical condition is found, our doctor will discuss the appropriate treatment options with you and work with you to come up with a plan for addressing that condition.
Test Overview
Laparoscopy is a surgery that uses a thin, lighted tube put through a cut (incision) in the belly to look at the abdominal organs or the female pelvic organs . Laparoscopy is used to find problems such as cysts, adhesions, fibroids , and infection. Tissue samples can be taken for biopsy through the tube (Laparoscope).
In many cases Laparoscopy can be done instead of Laparotomy surgery that uses a larger incision in the belly. Laparoscopy can be less stressful and may have less problems and lower costs than Laparotomy for minor surgeries. It can often be done without needing to stay overnight in the hospital.
Why It Is Done
Laparoscopy is done to:
Adhesions or surgical scars
Check for and possibly take out abnormal growths (such as tumors) in the belly or pelvis.
Check for and treat conditions such as endometriosis, ectopic pregnancy, or pelvic inflammatory disease (PID).
Find conditions that can make it hard for a woman to become pregnant. These conditions include cysts, adhesions, fibroids, and infection. Laparoscopy may be done after initial infertility tests do not show the cause for the infertility.
Do a biopsy.
See whether cancer in another area of the body has spread to the belly
Check for damage to internal organs, such as the spleen, after an injury or accident.
Do a tubal ligation.
Fix a hiatal hernia or an inguinal hernia .
Take out organs, such as the uterus, spleen , gallbladder (laparoscopic cholecystectomy), ovaries, or appendix (appendectomy). Partial removal (resection) of the colon also can be done.
Find the cause of sudden or ongoing pelvic pain.
How To Prepare
Tell our doctor if you:
Have allergies to any medicines, including anesthesia.
Have any bleeding problems or are taking any blood-thinning medicines, such as aspirin or warfarin (Coumadin).
Are or might be pregnant.
Before Laparoscopy:
Follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
Leave your jewelry at home. Any jewelry you wear will need to be taken off before the laparoscopy.
Remove your glasses, contacts, and dentures or a removable bridge before the laparoscopy. These will be given back to you as soon as you wake up after the surgery.
Arrange for someone to drive you home after the Laparoscopy.
You may be asked to use an enema or suppository several hours before or the day before the surgery to empty your colon.
At PARIVAAR IVF CENTRE we help you with instructions on how to get ready for your Laparoscopy or a nurse may call you with instructions before your surgery takes place.
You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to our doctor about any concerns you have about the need for the surgery, its risks, how it will be done, or what the results will mean.
How It Is Done
Laparoscopy is done by a surgeon or a doctor of women's health(gynecologist). General anesthesia is generally used, but other types of anesthesia, such as spinal anesthesia, may be used. Talk with your doctor about what choice is best for you.
About an hour before the surgery, you will empty your bladder. You will get fluids and medicine through an intravenous (IV) in a vein in your arm. You may get a medicine (sedative) to help you relax.
Several procedures may be done after you get your anesthesia and are relaxed or asleep.
An airway will be placed in your throat to help you breathe if you get general anesthesia.
A thin flexible tube (urinary catheter) may be put through your urethra into the bladder.
Some of your pubic hair may be shaved.
Your belly and pelvic area will be washed with a special soap.
For women, your doctor may do a pelvic exam before putting a thin tube (cannula) through your vagina into the uterus. The cannula lets your doctor move your uterus and ovaries to get a better look at the belly organs.
During laparoscopy, a small incision is made in the belly. More than one incision may be made if other tools will be used during the surgery. A hollow needle is put through the first incision and gas (carbon dioxide or nitrous oxide) is slowly put through the needle to inflate the belly. The gas lifts the abdominal wall away from the organs inside so our doctor can see clearly.
A thin, lighted tube (Laparoscope) is then put through the incision to look at the organs. Other tools can be used to take tissue samples, fix damage, or drain cysts. A laser may be attached to the Laparoscope to help with the surgery.
After the surgery, all the tools will be removed and the gas will be released. The incisions will be closed with stitches and covered with a bandage. The scar will be very small and will fade over time.
Laparoscopy takes 30 to 90 minutes, depending on what is done, but can take longer if a condition (such as endometriosis) is found and treated. After the laparoscopy, you will go to the recovery room for 2 to 4 hours. You can usually do your normal activities the next day, but do not do any strenuous activity or exercise for about a week.
How It Feels
If general anesthesia is used, you will be asleep and feel nothing. After you wake up, you will feel sleepy for several hours. You may be tired and have some pain for a few days after a laparoscopy. You may have a mild sore throat from the tube in your throat to help you breathe. Use throat lozenges and gargle with warm salt water to help your sore throat.
If you have other types of anesthesia, you may have pain for a few days when the initial numbness wears off.
Risks
There is a small chance for problems from a laparoscopy.
Bleeding from the incisions
Infection
Damage to an organ or blood vessel. This may cause more bleeding that needs another surgery to repair.
A Laparoscopy may not be done because of a higher chance for problems if you have:
Abdominal cancer.
An abdominal hernia.
Had abdominal surgeries in the past.
After the surgery
Right after surgery, you will be taken to a recovery room where nurses will care for and watch your vital signs (temperature, blood pressure, oxygen level, and heart rate). You will stay in the recovery area for 2 to 4 hours, and then you will go home. Your nurse will explain any special instructions from our doctor. You will probably go home with a sheet of careful instructions .
You may have some bloating. There may be bruising around the incisions for a few days. You may have some pain around the incisions. Do not drink carbonated beverages for 1 to 2 days after the Laparoscopy to lower your chance of gas pains and vomiting.
The gas used during the Laparoscopy can irritate your diaphragm for a few days. You may have some pain or achiness in your shoulder for a couple of days after the Laparoscopy.
Some of the gas in your belly may leak into your skin and cause a crackling sound if you rub the skin surrounding the stitches. This is not serious and will go away in a few days.
Call our doctor immediately if you have:
A large area of redness or swelling around the incisions.
Bleeding or drainage from the stitches.
Fever.
Severe belly pain.
Hoarseness in your voice that lasts more than a few days or gets worse.
Results
Laparoscopy is a surgical process that uses a thin, lighted tube put through a cut (incision) in the belly to look at the abdominal organs or the female pelvic organs. Our doctor may talk to you about the surgery once you are fully awake. She may call you at home later to talk to you about the results.
What Affects the Test
Reasons you may not be able to have the surgery or why the results may not be helpful include:
If you are obese, which may make the Laparoscopy harder to do.
If you have scar tissue from another surgery or an injury.
If a tissue sample is taken for a biopsy, but the results are not clear about what the problem is.
What To Think About
People who are obese or who have had other belly surgeries may need to have a larger incision in the belly for the surgery. This is called open Laparoscopy.