Pelvic Laparoscopy

Pelvic Laparoscopy

Pelvic laparoscopy is a procedure that examines your reproductive organs. Your doctor uses an instrument called a laparoscope to perform the procedure. A laparoscope is a long, thin tube with a high-intensity light and high-resolution camera.

Your doctor pushes the laparoscope through an incision in your abdominal wall. The camera relays images that are projected onto a video monitor. He or she can then examine your reproductive organs without performing open surgery. Your doctor can also use a pelvic laparoscopy to obtain a biopsy and treat some pelvic conditions.

Pelvic laparoscopy is called a minimally invasive procedure because only small incisions are made. Smaller incisions often allow patients to experience a shorter recovery period, less blood loss, and lower levels of post-surgical pain than in open surgery.

The procedure also is referred to as:

  • band-aid surgery
  • celioscopy
  • exploratory laparoscopy
  • gynecologic laparoscopy
  • pelviscopy

Diagnostic Uses of Pelvic Laparoscopy

Doctors use many imaging techniques to observe pelvic abnormalities. These techniques include ultrasound, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Your doctor may use a pelvic laparoscopy after other noninvasive options have been used. The procedure may be able to provide more detail when the data gathered through these methods cannot provide a definite diagnosis.

Your doctor can use a pelvic laparoscopy to investigate and treat conditions affecting the uterus, ovaries, fallopian tubes, and other organs in your pelvic area. He or she may recommend a pelvic laparoscopy to:

  • determine the cause of pelvic pain
  • examine an abnormality (such as a tissue mass, ovarian cyst, or tumor), which was possibly found in another imaging study
  • confirm the presence of endometriosis (a condition in which cells from the lining of your uterus grow outside of your uterine cavity)
  • diagnose a pelvic inflammatory disease
  • examine your fallopian tube for obstructions or ectopic pregnancy
  • investigate conditions that might cause infertility
  • observe the extent of ovarian cancer, endometrial cancer, or cervical cancer

Your doctor can take a biopsy of the abnormal tissue during a pelvic laparoscopy. He or she can also use the procedure to diagnose and treat specific conditions.

Using the video monitor as a guide, your doctor can:

  • obtain a tissue sample for biopsy
  • eliminate scar tissue or abnormal tissue from endometriosis
  • repair a damaged uterus
  • repair damage to your ovaries or fallopian tubes
  • remove an ectopic pregnancy
  • perform an appendectomy
  • perform a hysterectomy (removal of your uterus)
  • perform a tubal ligation (sterilization of your fallopian tubes)
  • remove lymph nodes affected by pelvic cancers

Preparation for a Pelvic Laparoscopy

You usually will prepare for a laparoscopy in much the same way that you would for any other surgical procedure.

For instance, it is very important that you tell your doctor about any prescription or over-the-counter medications that you are taking. Your doctor can discuss how these medications should be used before and during the test.

Certain medications could affect the outcome of your laparoscopy. Therefore, your doctor may provide special instructions if you are taking any of the following:

  • anticoagulants (blood thinners)
  • nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin or ibuprofen
  • medications that affect blood clotting
  • herbal or dietary supplements

Tell your doctor if you are pregnant or think you might be pregnant. This will ensure that your fetus is not harmed during the procedure.

Your doctor may request an additional imaging study, such as ultrasound, CT scan, or MRI before surgery. The data from that imaging study can help him or her better understand the abnormality being investigated. The imaging results can also provide your doctor with a visual guide to your pelvic region, improving effectiveness.

You cannot eat or drink anything—even water—for at least eight hours prior to your laparoscopy. If you smoke, try to quit. Ask a friend or family member to drive you to the surgical site if your doctor gives you a sedative to take at home before the procedure. The sedative will impair your ability to drive.

Procedure for Pelvic Laparoscopy

A pelvic laparoscopy can be done in a hospital, but is usually performed by a surgeon in an outpatient clinic.

Before surgery, you will be asked to change into a hospital gown. An intravenous (IV) line will be inserted into your hand or arm. You will receive general anesthesia in most cases. This will allow you to remain in a deep sleep and not feel any pain during the procedure.

In other cases, you will be given a local anesthetic. This type of anesthesia prevents you from feeling pain in your pelvic area during the procedure. However, it will not put you to sleep. You may feel a prick or burning when your doctor injects local anesthesia into your pelvis. You may still feel pressure from the laparoscope during the procedure, but you should not feel pain.

Your doctor will make a small cut above your navel about one-half inch long once the anesthesia has taken effect. He or she will place a cannula (a narrow tube-like instrument) into your abdominal cavity and expand the cavity with carbon dioxide. This makes room in the targeted area for your doctor to work. It also allows for a clearer view of the area.

Your doctor will then insert the laparoscope through the incision near your navel. He or she may make up to four dime-sized cuts closer to your pubic hairline. These cuts allow space for additional cannulas and other tools that will be needed to perform the procedure.

Your doctor may also insert a uterine manipulator through your cervix into your uterus. This will help move the pelvic organs into view. Your doctor will remove the instruments and gas from your body and will close all of your incisions once surgery has been completed. He or she will then place bandages over the tape or use stitches to close your incisions.

Recovery from Pelvic Laparoscopy

You will need to remain in the outpatient facility or hospital for recovery and observation before you can be released. Doctors and nurses will monitor your vital signs, including blood pressure, temperature, pulse, and breathing rate.

The amount of time that you will need to stay in the recovery area will vary depending on your overall physical condition, the type of anesthesia that was used, and your body’s reaction to the procedure. In some cases, you may need to remain in the hospital overnight.

You will be discharged once the effects of your anesthesia have worn off. However, you will not be permitted to drive yourself home after the procedure. Have someone accompany you to the procedure, so that he or she can drive you home.

After your pelvic laparoscopy:

  • You may feel slight pain and throbbing at the surgical sites.
  • You may experience abdominal bloating or discomfort from the carbon dioxide for up to two days. The level of pain or discomfort that you experience should decrease each day.
  • Your doctor may prescribe medication to relieve the pain.
  • It is not uncommon to experience shoulder pain after your procedure. This occurs when the carbon dioxide gas causes an irritation in your diaphragm, a muscle that shares nerves with your shoulder.
  • You may have a sore throat from the breathing tube used during the procedure.
  • You will be instructed not to lift any heavy objects for about three weeks after the procedure. This will reduce your risk of developing a hernia in one of your incisions.
  • You will need to return to your doctor in about two weeks.
  • You can resume your normal diet.

Every patient reacts differently to the procedure. Follow your doctor’s discharge instructions about when to resume normal activities, such as going to work and having sexual relations. Your post-surgical instructions will vary according to the type of procedure you had.

Risks of a Pelvic Laparoscopy

Pelvic laparoscopy is considered a surgical procedure. The most common complications are bleeding and infection. However, these risks are minimal. Still, it is important to be aware of signs of infection.

Contact your doctor if you experience:

  • vaginal bleeding
  • menstrual flow that is unusually heavy or filled with clots
  • abdominal pain that increases in intensity
  • chills and/or a fever
  • redness, swelling, bleeding, or drainage at your incision sites
  • continued nausea or vomiting
  • shortness of breath

A pelvic laparoscopy includes a risk of potential internal damage. Your doctor will conduct immediate open surgery if an organ is punctured during the pelvic laparoscopy.

Rare complications include:

  • a reaction to general anesthesia
  • inflammation or infection of the abdomen
  • blood clots that could travel to your pelvis, legs, or lungs
  • a blood clot that could enter your heart or brain
  • the need for a blood transfusion or temporary colostomy

Results of a Pelvic Laparoscopy

The doctor who performed your pelvic laparoscopy will analyze the findings. If a biopsy was taken, a pathologist (a specialist in disease diagnosis) will examine it in a laboratory. He or she will send a report detailing the results to your doctor.

Normal results of a pelvic laparoscopy indicate that the reproductive organs and any other organs examined are normal in size and appearance. A normal report also documents the absence of cysts, tumors, or other abnormalities in the pelvic area.

Abnormal laparoscopy results can indicate any one of numerous conditions including:

  • adhesions or surgical scars
  • uterine fibroids (benign tumors)
  • cancer
  • cysts or tumors
  • endometriosis (tissue from the inside of your uterus grows outside of your uterus)
  • hernias
  • injury or trauma
  • obstruction in your fallopian tube
  • ovarian cysts
  • pelvic inflammatory disease

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