What is laparoscopy?
A Laparoscopy is a minimally invasive technique of performing a surgery through smaller skin incisions. A thin fibre-optic instrument called laparoscope is inserted into the abdomen through a small cut usually made within the belly button. It allows visualisation of pelvic organs and also treatment of problems if detected.
Why is it required?
A Laparoscopy in gynaecology is used to check for any abnormalities in the uterus, ovaries, fallopian tubes, and other organs which are not evident by other diagnostic procedures such as X-rays and other scans. Laparoscopy is used to diagnose and treat the conditions of pelvic pain, infertility, fibroids, cysts, endometriosis, ectopic (tubal) pregnancies, pelvic inflammatory disease and other gynaecological problems.
How is laparoscopic surgery done?
The procedure is performed under general anaesthesia in the operating theatre. After the laparoscope is inserted through the belly button incision the abdomen is inflated with carbon dioxide gas which creates space (akin to putting a tent up) allowing visualisation of the pelvic organs. Other small incisions may sometimes be required to be made to into the lower abdomen to allow insertion of surgical instruments if any treatment is required. Once the treatment is complete, the incisions are closed with an invisible stitch and glue. The procedure may take from thirty minutes to an hour and a half if there is significant endometriosis.
What precautions should be taken before the procedure?
You can continue taking your regular medications, unless your doctor advises. Avoid smoking and if you develop signs of illness prior to your surgery, please contact our office immediately.
What can be expected during recovery period?
You will be in the recovery room when you wake up from anaesthesia. You may feel sleepy for the next few hours. You may have pain in the shoulder or back which is because of the gas used in the procedure. It resolves within a day or two. You may have some discomfort or feel tired for a few days after the procedure. Please contact us if pain and nausea does not go away or is becoming worse. You should avoid heavy activities or exercise until you recover completely. Which may be up to two weeks.
What are the possible risks and complications of this procedure?
As with any surgical procedure, laparoscopic surgery is also associated with certain risks and complications and they include:
- Problems of anaesthesia
- Injury to internal or surrounding organs
- Bleeding and infection
- Any specific risks and complications will be discussed prior to the procedure.
What if I come across any problem during recovery period?
You should seek immediate medical attention if you experience any of the below mentioned conditions:
- Offensive vaginal discharge or heavy bleeding
- Severe nausea or vomiting
- Inability to empty your bladder or bowels
- Severe pain
Surgical procedures that are commonly performed laparoscopically include:
A cyst is a fluid-filled swelling that can sometimes grow on the surface of the ovary. Ovarian cystectomy is removal of the cyst (not removal of the ovary). A cyst on the ovary does not always need to be removed, however it can be removed laparoscopically if:
- it is causing discomfort, perhaps due to its size
- it is putting the ovary at risk of being damaged
- there is a possibility of the cyst being abnormal.
Treatment for endometriosis
Endometriosis is a common condition in which small pieces of the womb lining (the endometrium) are found outside the womb.
Laparoscopic surgery is used to:
- destroy or remove areas of endometriosis
- destroy or remove endometriotic cysts
- divide adhesions to free tissues and/or improve fertility.
It may be recommended that you also use medication for a period of time before and/or after surgery to suppress further disease.
Pelvic adhesions are bands of scar tissue that form as a result of previous surgery, infection or endometriosis. Adhesions can cause pain, infertility and pain with intercourse. A laparoscopy may be suggested to allow division or removal of the adhesions to improve symptoms.
Laparoscopic oophorectomy is a procedure to remove one or both ovaries. It can sometimes be recommended as a preventative procedure if a woman is known to be at high risk of developing cancer of the ovary. Sometimes a large ovarian cyst can result in the ovary being removed as well as the cyst.
Laparoscopic Sterilisation (Tubal Ligation)
This is a permanent method of contraception. It involves blocking, sealing or cutting the fallopian tubes to prevent an egg and sperm meeting and pregnancy from occurring.
Removal of the fallopian tube is sometimes required if the tube has been damaged by infection or ectopic pregnancy.