Laparoscopy
What is a laparoscopy?
Laparoscopy is a procedure used to check the organs in the belly (abdomen). It can
also check a woman’s pelvic organs.
Laparoscopy uses a thin lighted tube that has a video camera. The tube is called a
laparoscope. It is put into a tiny cut or incision in your belly. The video camera
images can be seen on a computer screen.
One benefit of laparoscopy is that it's minimally invasive. That means it uses a very
small cut in the belly. Laparoscopy usually takes less time and has a faster recovery
than open surgery.
Laparoscopy may be used to take a small tissue sample for testing (a biopsy). It can
also be used to remove organs such as the appendix (appendectomy) or the gallbladder
(cholecystectomy).
Why might I need a laparoscopy?
An abdominal laparoscopy can be done to check the abdomen and its organs for:
A laparoscopy is often done when the results of a physical exam, X-ray, or computed
tomography (CT) scan are not clear.
Laparoscopy may be used to determine a stage of cancer for an abdominal organ. It
may also be used to check an abdominal injury. It can see where the injury is and
how deep it is. It can also see how much internal bleeding you have.
For women, a gynecologic laparoscopy may be used to check:
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Pelvic pain and problems
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Ovarian cysts
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Fibroids
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The fallopian tubes
Laparoscopy can also be used to diagnose and treat endometriosis. This is when tissue
that normally lines the uterus grows outside it. Laparoscopy may be done to treat an
ectopic pregnancy or to do a tubal ligation (tie the fallopian tubes) to permanently
prevent pregnancy.
Laparoscopy can also be used to do bariatric surgery, such as gastric bypass or gastric
sleeve. It has become very common in treating obesity.
There may be other reasons for your provider to suggest a laparoscopy.
What are the risks of a laparoscopy?
Possible complications may include bleeding from the incision, injury to the organs
in the abdomen, or the carbon dioxide gas going into places other than the abdomen.
Sometimes a laparoscopy is not advised. This may be the case if you:
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Have advanced cancerous growths on your abdominal wall
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Have long-term (chronic) tuberculosis
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Have a bleeding problem such as low blood platelet count (thrombocytopenia)
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Have a lot of scar tissue (adhesions) from other surgeries
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Are taking blood-thinning medicine
There may be other risks based on your health condition. Talk about any concerns with
your provider before the procedure.
Certain conditions may stop a laparoscopy from working well. These include being obese
or having bleeding inside your abdomen.
How do I get ready for a laparoscopy?
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Your healthcare provider will explain the procedure to you. Ask him or her any questions
you have.
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You may be asked to sign a consent form that gives permission for the procedure. Read
the form carefully and ask questions if anything is not clear.
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Your provider will ask questions about your past health. He or she may also give you
a physical exam. This is to make sure you are in good health before the procedure.
You may also need blood tests and other diagnostic tests.
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You must not eat or drink for 8 hours before the procedure. This often means no food
or drink after midnight.
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Tell your provider if you are sensitive to or allergic to any medicines, latex, tape,
and anesthesia medicines (local and general).
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Tell your provider about all the medicines you take. This includes both over-the-counter
and prescription medicines. It also includes vitamins, herbs, and other supplements.
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Tell your provider if you have a history of bleeding disorders. Let your provider
know if you are taking any blood-thinning medicines, aspirin, ibuprofen, or other
medicines that affect blood clotting. You may need to stop taking these medicines
before the procedure.
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Tell your provider if you are pregnant or think you may be pregnant.
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You will need to remove any piercing jewelry near your naval (belly button).
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Depending on the surgery, you may be asked to take an oral laxative to cleanse your
bowel before the surgery. Or you may have a solution put into your rectum and lower
intestine (a cleansing enema) a few hours before the procedure. You may also be given
an antibiotic.
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You may be given a medicine to relax you (a sedative) before the procedure. This depends
on the type of laparoscopy being done. If this is an outpatient procedure, someone
must drive you home.
Your healthcare provider may have other instructions for you based on your medical
condition.
What happens during a laparoscopy?
A laparoscopy may be done on an outpatient basis or as part of your stay in a hospital.
The way the test is done may vary. It will depend on your condition and your healthcare
provider's practices.
A laparoscopy is generally done while you are asleep under general anesthesia. Your
provider will choose the type of anesthesia based on the procedure and your overall
health.
Generally, a laparoscopy follows this process:
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You will be asked to take off any jewelry or other objects that may interfere with
the procedure.
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You will be asked to remove clothing and be given a gown to wear.
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An IV (intravenous) line will be inserted in your arm or hand.
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A tube (urinary catheter) may be placed in your bladder to collect urine.
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You will be placed on your back on the operating table.
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The anesthesiologist will check your heart rate, blood pressure, breathing, and blood
oxygen level during the surgery.
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If there is too much hair at the surgical site, it may be clipped off.
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The skin over the surgical site will be cleaned with a sterile (antiseptic) solution.
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If general anesthesia is not used, a local anesthetic may be shot (injected) into
the incision site. This will numb the area. You will feel a needle stick and a brief
sting.
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A urinary catheter (small tube) may be put into your bladder to drain urine.
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A small cut or incision will be made in your belly just below the belly button.
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More small cuts may be made so that other surgical tools can be used during the procedure.
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Carbon dioxide gas will be put into your belly so that it swells up. This makes it
easier to see organs and other structures.
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If general anesthesia is not used, you may feel some mild pain in your belly and the
top of your shoulder. This may happen as the carbon dioxide is injected and surgical
tools are moved around.
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The laparoscope will be put in and the procedure will take place.
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Once the laparoscopy and any other procedures are done, the laparoscope and other
surgical tools will be taken out.
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The cuts will be closed with stitches, tape, or surgical staples.
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A sterile bandage, dressing, or adhesive strips will be applied.
What happens after a laparoscopy?
After surgery, you will be taken to the recovery room. Your recovery process will
vary depending on the type of anesthesia you had. You will be watched closely. Once
your blood pressure, pulse, and breathing are stable and you are alert, you will be
taken to your hospital room. Or you may be sent home if this was an outpatient procedure.
When you are home, you must keep the cut clean and dry. Your healthcare provider will
give you instructions on how to bathe. Any stitches or surgical staples will be taken
out at a follow-up office visit. If adhesive strips were used, they should be kept
dry. They will often fall off in a few days.
You may feel pain from the carbon dioxide gas still in your belly. This pain may last
for a few days and may be felt in your shoulders. It should feel a bit better each
day. You may take a pain medicine as directed by your provider. Aspirin or other pain
medicines may raise your risk of bleeding. Only take medicines that your provider
has approved.
Don’t have any carbonated drinks for 1 or 2 days after the procedure. This will help
reduce the mild pain from the carbon dioxide gas. Also, carbonated drinks may upset
your stomach.
You may be allowed to drink clear fluids a few hours after the procedure. You may
slowly move on to more solid foods as directed. Tell your healthcare provider if you
have nausea or vomit.
You may be told to limit your physical activity for a few days.
Call your healthcare provider if you have any of the following:
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Fever or chills
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Redness, swelling, or bleeding or other drainage from the incision site
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More pain around the incision site
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Vomiting
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Trouble urinating
Your healthcare provider may give you other instructions, depending on your situation.
Next steps
Before you agree to the test or the procedure make sure you know:
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The name of the test or procedure
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The reason you are having the test or procedure
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What results to expect and what they mean
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The risks and benefits of the test or procedure
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What the possible side effects or complications are
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When and where you are to have the test or procedure
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Who will do the test or procedure and what that person’s qualifications are
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What would happen if you did not have the test or procedure
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Any alternative tests or procedures to think about
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When and how you will get the results
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Who to call after the test or procedure if you have questions or problems
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How much you will have to pay for the test or procedure