Gynecologic Laparoscopy

    Gynecologic laparoscopy is an alternative to open surgery. It uses a laparoscope to look inside your pelvic area. Open surgery often requires a large incision.

    A laparoscope is a slender, lighted telescope. It allows a doctor to see inside your body. Diagnostic laparoscopy can determine whether you have conditions such as endometriosis or fibroids. It can also be a form of treatment. With miniaturized instruments, your doctor can perform a variety of surgeries. These include:

    • ovarian cyst removal
    • tubal ligation (surgical contraception)
    • hysterectomy

    Laparoscopy generally has a shorter healing time than open surgery. It also leaves smaller scars. A gynecologist, general surgeon, or other specialist may perform this procedure.

    Reasons for Gynecologic Laparoscopy

    Laparoscopy can be used for diagnosis, treatment, or both. A diagnostic procedure can turn into treatment.

    Some reasons for diagnostic laparoscopy are:

    • unexplained pelvic pain
    • unexplained infertility
    • history of pelvic infection

    Conditions that might be diagnosed include:

    Some types of laparoscopic treatment include:

    • hysterectomy (removal of the uterus)
    • removal of the ovaries
    • removal of ovarian cysts
    • removal of fibroids
    • blocking blood flow to fibroids
    • endometrial tissue ablation (endometriosis treatment)
    • adhesion removal
    • reversal of tubal ligation (contraceptive surgery)
    • burch procedure for incontinence
    • vault suspension to treat prolapse

    Preparing for Gynecologic Laparoscopy

    Preparation depends on the type of surgery. You may need imaging tests. Your doctor might order fasting or an enema.

    Tell your doctor about any medication you take. This includes over-the-counter drugs and supplements. You may need to stop them before the procedure.

    Plan to have someone drive you home after surgery. A friend can pick you up or you can schedule a car service. You will not be allowed to drive yourself.

    Procedure

    Laparoscopy is almost always performed under general anesthesia. This means you will be unconscious for the procedure. However, you may still be able to go home the same day.

    Once you are asleep, a small tube called a catheter will be inserted. This collects your urine. Then your abdomen will be filled with carbon dioxide gas. This is done with a small needle. The gas keeps the abdominal wall away from your organs. It reduces the risk of injury.

    The surgeon will make a small cut in your navel. The laparoscope will be inserted. It transmits images to a screen. This gives your doctor a clear view of your organs.

    What happens next depends on the type of procedure. For diagnosis, your doctor might take a look and then be done. If you need surgery, other incisions will be made. Instruments will be inserted through these holes. Then surgery is performed using the laparoscope as a guide.

    Once the procedure is over, all instruments are removed. Incisions are closed with stitches. Then you will be bandaged and sent to recovery.

    Advances in Laparoscopy

    Robotic surgery is sometimes used for gynecological laparoscopy. Robotic arms are steadier than human hands. They may also be better at fine manipulations.

    Microlaparoscopy is a newer approach. It uses even smaller scopes. This procedure can be done with local anesthesia in your doctor’s office. You won’t be completely unconscious.

    Recovery After Laparoscopy

    Once the procedure is over, nurses will monitor your vital signs. You will stay in recovery until the effects of anesthesia fade. You will not be released until you can urinate on your own. Difficulty urinating is a possible side effect of catheter use.

    Recovery time varies. It depends on what procedure was performed. You may be free to go home a few hours after surgery. You might also have to stay in the hospital for one or more nights.

    After surgery, your belly button might be tender. There may be bruises on your stomach. The gas inside you can make your chest, middle, and shoulders ache. There is a chance that you will feel nauseated for the rest of the day.

    Before you go home, your doctor will give you instructions regarding medication and side effects. Your doctor may prescribe pain medication. You may also receive antibiotics to prevent infection.

    Depending on the surgery, you may be told to rest for a few days or weeks. It may take a month or more to return to normal activities.

    Serious complications of laparoscopy are rare. However, you should call your doctor if you experience:

    • serious abdominal pain
    • prolonged nausea and vomiting
    • fever of 101 degrees F or higher
    • pus or significant bleeding at your incision
    • pain during urination or bowel movements

    Risks of Laparoscopy

    Skin irritation and bladder infection are common side effects of this procedure.

    More serious complications are rare. However, they include

    • damage to the abdominal blood vessel, bladder, bowel, uterus, and other pelvic structures
    • nerve damage
    • allergic reactions
    • blood clots
    • problems urinating

    Conditions that increase your risk of complications include:

    • previous abdominal surgery
    • obesity
    • being very thin
    • extreme endometriosis
    • pelvic infection
    • chronic bowel disease

    The gas used to fill the abdominal cavity can also cause complications, if it enters a blood vessel.

    Pay close attention during the recovery period. Write down any complications and discuss them with your doctor.

    Outcomes of Laparoscopy

    The results of these procedures are usually good. This technology allows the surgeon to easily see and diagnose many problems. Recovery time is also shorter compared to open surgery.