Laparoscopy, also known as diagnostic laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen. It is a low-risk, minimally invasive procedure. Only small incisions are made.
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.
Laparoscopy is often used to identify and diagnose the source of abdominal or pelvic pain. It’s usually performed when other, noninvasive 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, which uses magnets and radio waves to produce images of the body
Laparoscopy is performed when these tests don’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.
Your doctor may recommend laparoscopy to examine the following organs:
- small and large bowel
- pelvic or reproductive organs
By observing these areas with a laparoscope, your doctor 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
The most common risks associated with laparoscopy are bleeding and infection. However, these are rare occurrences.
After your procedure, it’s important to watch for any signs of infection. Contact your doctor if you experience:
- stomach 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
There’s also 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 other surgery to repair the damage.
Other, less common risks include:
- complications from general anesthesia
- inflammation of the abdominal wall
- a blood clot, which could travel to your pelvis, legs, or lungs
You should tell your doctor about any prescription or over-the-counter medications you’re taking. Your doctor will tell you how they should be used before and after the procedure.
Your doctor 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 or ibuprofen
- other medications that affect blood clotting
- herbal or dietary supplements
- vitamin K
You should also tell your doctor if you’re pregnant or think you might be pregnant. This will reduce the risk of harm to your developing baby.
Before laparoscopy, your doctor may order blood tests, urinalysis, electrocardiogram (EKG or ECG), and chest X-ray. Your doctor might also perform certain imaging tests, including an ultrasound, CT scan, or MRI scan.
These tests can help your doctor better understand the abnormality being examined during laparoscopy. The results also give your doctor 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 unable to drive for several hours after surgery.
Laparoscopy is usually done as an outpatient procedure. This means that you’ll be able to go home the same day as your surgery. It may be performed in a hospital or an outpatient surgical center.
You’ll likely be given general anesthesia for this type of surgery. This means that you will sleep through the procedure and will not feel any pain. In some cases, local anesthesia is used instead. A local anesthetic numbs the area, so even though you will be awake during the surgery, you will not feel any pain.
During laparoscopy, an incision will be made below your belly button. A small tube called a cannula will then be inserted. 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 the abdomen is inflated, the laparoscope will be inserted through the incision. The camera attached to the laparoscope will display the images on a screen, allowing your doctor to see your organs in real time.
Up to a total of four cuts will be made. These incisions allow other instruments to be inserted. For example, your doctor may need to use another surgical tool to perform a biopsy. During a biopsy, your doctor will take a small sample of tissue from an organ to be evaluated.
After the procedure is done, the instruments will be removed. Your incisions will be closed with stitches or surgical tape. Bandages may be placed over the incisions.
When the surgery is over, you’ll be observed for several hours before you’re released from the hospital. Your vital signs, such your breathing and heart rate, will be monitored closely. Hospital 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 hospital overnight.
A family member or friend will need to drive you home if you received general anesthesia. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure.
In the days following laparoscopy, you may feel moderate pain and throbbing in the areas where incisions were made. Any pain or discomfort should improve within a few days. Your doctor may 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. The gas can irritate your diaphragm, which shares nerves with your shoulder. It may also cause some bloating. The discomfort should 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 your doctor about two weeks after laparoscopy.
If a biopsy was taken, a pathologist will examine it. A pathologist is a doctor who specializes in tissue analysis. A report detailing the results will be sent to your doctor.
Normal results from laparoscopy indicate 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
- appendicitis, an inflammation of the intestines
- fibroids, or abnormal growths in the uterus
- cysts or tumors
- 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
Your doctor will schedule an appointment with you to go over the results. If a serious medical condition was found, the appropriate treatment will be given.