Minimal Access Surgery

What Is Laparoscopy?

Laparoscopy is a way of doing surgery without making a large incision (cut). A thin, lighted tube-known as the laparoscope-is inserted into the abdomen through a small incision. The laparoscope is a small camera that allows your doctor to see the pelvic organs. If a problem needs to be fixed, other instruments are used. These instruments are inserted either through the laparoscope or through other small cuts in your abdomen.

Why Is It Done?

There are many uses for laparoscopy. Laparoscopy is used for some procedures and to treat some conditions like Endometriosis, Fibroids, Cysts in the ovaries, ectopic pregnancies and sometimes to find a cause for a particular problem like Chronic pelvic pain

It is also used to perform the Sterilization operation, in which the doctor uses the laparoscope as a guide to block the fallopian tubes by cutting or clipping them. After this procedure, a woman can no longer get pregnant.

Laparoscopically assisted vaginal hysterectomy (LAVH)-LAVH is a type of hysterectomy in which the uterus is removed through the vagina. The laparoscope is used to guide the procedure.

What To Expect

Laparoscopy often is done as outpatient surgery. You usually can go home the same day, after you recover from the procedure. More complex procedures, such as laparoscopic hysterectomy, may require an overnight stay in the hospital.

Your doctor will make a small incision in your navel and insert the laparoscope. During the procedure, the abdomen is filled with a gas (carbon dioxide or nitrous oxide). Filling the abdomen with gas allows the pelvic reproductive organs to be seen more clearly.

The laparoscope shows the pelvic organs on a screen. Other incisions may be made in the abdomen for surgical instruments. These incisions usually are no more than half an inch long.

Another instrument, called a uterine manipulator, may be inserted through the cervix and into the uterus. This instrument is used to move the organs into view.

After the procedure, the instruments are removed and the small incisions are closed with stitches or tape. There will be small scars that usually fade over time.

Your Recovery

If you had general anesthesia, you will wake up in the recovery room. You will feel sleepy for a few hours. You may have some nausea from the anesthesia. You must have someone drive you home.

After the procedure, you may feel tired and have some discomfort and soreness around the incisions made in your abdomen and navel. You may feel pain in your shoulder or back. This pain is from the gas used during the procedure. It goes away on its own within hours or a day or two. If pain and nausea do not go away after a few days or become worse, you should contact your doctor.

Your doctor will let you know when you can get back to your normal activities. For minor procedures, it is often 1-2 days after the surgery. For more complex procedures, it can take longer. You may be told to avoid heavy activity or exercise.

Risks and Benefits

As with any surgery, there is a small risk of problems with laparoscopy .The more complex the surgery, the greater the risk. Be sure to ask your doctor about the risks associated with your specific surgery. There also may be other ways to treat your condition besides surgery, such as medications.

The common risks are

  • Bleeding or a hernia (a bulge caused by poor healing) at the incision sites
  • Internal bleeding
  • Infection
  • Damage to a blood vessel or other organ, such as the stomach, bowel, or bladder
  • Problems caused by anesthesia

Laparoscopy has many benefits.

  • Less pain than with open abdominal surgery
  • The risk of infection also is lower
  • Recovery is faster
  • It can be done as outpatient surgery, so you usually will not have to spend the night in the hospital
  • The smaller incisions that are used allow you to heal faster and have smaller scars

Finally...

Laparoscopy is a way to perform surgery without making a large incision. It has many benefits over other types of abdominal surgery but also carries some risks. Also, keep in mind that laparoscopy is still surgery. You will need time to rest and recover afterwards.