Laparoscopy

What is Laparoscopy?

Laparoscopy is an operation in which a telescope is inserted through the umbilicus (belly button) to inspect the pelvic organs i.e. uterus, fallopian tubes and ovaries. Diagnostic laparoscopy is used to try and find a cause for symptoms. Laparoscopy may also be therapeutic, when treatment is performed.

What are the advantages of laparoscopy?

Laparoscopy has many advantages over open surgery like, Recovery is faster, pain is less, scars are smaller, hospital stay is less and it allows early return to work and normal activities Laparoscopy is useful in evaluating pelvic pain, endometriosis and sub-fertility. It is feasible to do most of the procedures laparoscopically. It can be used for ovarian cystectomy, treatment of endometriosis, adhesiolysis, sterilisation, removal of the tubes and ovaries and even hysterectomy in selected cases.

What are the risks of laparoscopy?

Laparoscopy is a relatively safe procedure. However, it does carry some risks. The overall risk of serious complications is 2 out of every 1000 cases. Your risk will be higher if you are obese, have had previous abdominal surgery or have pre-existing medical problems. Possible risks include risk of infection, wound haematoma, thrombosis, bleeding, damage to abdominal organs like bladder, bowel, vessels and need for laparotomy (open surgery).

How is laparoscopy performed?

General anaesthetic is administered. Your bladder is emptied with a catheter. A small cut (1cm) is made inside the umbilicus. A needle is introduced via the incision into the abdominal cavity, which fills the abdomen with gas (carbon dioxide). This allows the pelvic organs to be seen more clearly. The telescope (laparoscope) is inserted. Up to three other small incisions may be made to introduce other necessary instruments into the abdominal cavity.

What type of anaesthetic is used?

Laparoscopy is performed under a general anaesthetic.  It is important to follow the advice on your admission letter and that given by the pre-admission assessment nurse. You will be advised when to stop eating and drinking and whether to stop or continue regular medication.  Please follow the pre-operative fasting instructions given by the pre-admission nurse specifically for day surgical procedures to aid recovery.

When will I go home after the operation?

If you have a laparoscopy as a Day surgery procedure, you will be allowed to go home a few hours after the procedure if there are no complications. You should have emptied your bladder and not been in severe pain or actively bleeding. Patients should not drive for 48 hours after the procedure so private transport home with a companion must be arranged.

When can I go back to work?

People vary in how quickly they recover after surgery. Depending on your job you may be able to return to work 1–3 weeks after the operation, if you feel well.

When can I have sexual intercourse?

Once the vaginal bleeding has stopped and you feel comfortable.

What about the stitches?

Small plasters will be covering your wounds when you wake up. The stitches normally dissolve, but may require removal at yours doctors practice, if still present after 5-7 days.  Showers are preferable to baths and dry plasters should cover your wounds for three days, so try not to get them wet. After three days, the wounds should be left uncovered and kept clean and dry.

When should I seek urgent medical advice after laparoscopy?

If you experience increasing abdominal pain, distension, high temperature (fever), loss of appetite, nausea or vomiting, this may be caused by damage to your bowel or bladder. Burning or stinging when you pass urine or pass urine frequently- this may be due to a urine infection. If you develop a painful red swollen leg, shortness of breath, chest pain or start coughing up blood, this may be a sign of a clot in the leg or lung. In such cases, you will need to be admitted to the hospital urgently.