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gynaecology
Laparoscopy
Laparoscopy is an endoscopic surgical technique that uses a small cut in the abdominal wall through which a laparoscope is introduced inside the body. The laparoscope is a long thin tube (only a few millimetres in diameter) with a tiny camera at the end, used to visualise the abdominal cavity.
Laparoscopy is an endoscopic surgical technique that uses a small cut in the abdominal wall through which a laparoscope is introduced inside the body. The laparoscope is a long thin tube (only a few millimetres in diameter) with a tiny camera at the end, used to visualise the abdominal cavity. This procedure allows the gynaecologist to diagnose and treat many diseases and conditions of the uterus, the ovaries, the fallopian tubes, the colon and the uppermost part of the cervix. If surgical treatment is necessary, thin laparoscopic instruments can be inserted through several tiny incisions so that the respective tissues can be grabbed, moved, cut, removed or burnt.
The gynaecologist operates using hand-eye coordination while observing the movements of the laparoscopic instruments on a video display. This type of surgery requires special skills and solid experience.
Why laparoscopy?
Indications for gynaecological laparoscopy can be:
- Pelvic pain
- Infertility
- Endometriosis
- Tubal ligation (having the fallopian tubes tied for permanent contraception)
- Tubal (extrauterine) pregnancy
- Pelvic inflammation
- Surgical repair of the fallopian tubes
- Removal of adhesions after previous surgeries or diseases
- Removal of ovarian cysts or the whole ovary
- Removal of the uterus with or without its associated anatomical parts (ovaries and fallopian tubes)
- Inspection and removal of pelvic lymph nodes
- Diagnosis and surgical treatment of some uterine abnormalities
- Removal of uterine fibroids (myomas)
Possible complications and period of recovery
The decision to do a laparoscopy (instead of non-surgical treatment or of an open surgery) is taken on a case-by-case basis, as it requires an in-depth consultation between the patient and her treating physician and a benefit-risk assessment.
Possible complicationsAlthough complications are infrequent, laparoscopy remains a surgical procedure and bears a certain risk. Possible complications include trauma on the intestines or blood vessels, bladder or ureters, damage or scratching of internal reproductive organs. In cases of high technical complexity or when a complication arises in the course of laparoscopy, it is also possible that the operation is converted to open surgery (laparotomy).
If after the procedure you experience any of the following symptoms, please immediately report to your doctor:
- A growing bruise under the cut – this can be due to a blood clot or a subcutaneous haemorrhage;
- Vomiting, fever or abdominal bloating;
- Intense vaginal bleeding (spotting is frequent and is usually innocent);
- Intensifying pain despite pain-relief medication or a sharp piercing pain around the kidneys can be due to trauma on the ureter.
To secure a close follow-up of patients in the immediate postoperative period, they are required to stay overnight at the hospital after laparoscopy.
After laparoscopy and a short hospital stay, most patients go home with a prescription for pain relief medication and advice to avoid heavy lifting and stress for a certain period.
Recovery is different for each patient. Many women report shoulder pain caused by the extension gas used in the abdominal cavity during laparoscopy. Some feel hurting around the cuts. Others tell of a sharp or dull ache deep in the pelvis, caused by the irritation to the tissues that have been moved, touched or cut during surgery. All those symptoms are normal and can be relieved by appropriate pain medication and rest.
Most gynaecologists recommend that patients abstain from driving, physical exercise, sexual activity and heavy lifting for a certain period after surgery.
See also
Laser office hysteroscopy
Office hysteroscopy
