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Laparoscopy

What is Laparoscopy?

Laparoscopy is a procedure that enables your surgeon to look inside the abdominal and pelvic cavities to diagnose and treat a variety of abnormal conditions. A laparoscope is a long, narrow telescope with a light source and video camera at the end. The scope is passed through a tiny incision into the abdomen where images from the camera are projected onto a large monitor for the surgeon to view the abdominopelvic cavity.

Small incision and ports allow the surgeon to pass gas in and out to expand the viewing area or to insert tiny surgical instruments for treatment purposes. The surgical instruments used in operative laparoscopy are very small but appear much larger when viewed through a laparoscope.

Types of Laparoscopy

Laparoscopy may be either diagnostic, operative, or both:

Diagnostic Laparoscopy

A laparoscopy is diagnostic when the surgeon is viewing the abdominal cavity to make a
diagnosis, without any treatment administered at that time. This is particularly useful when other tests such as x-rays, scans, or blood work are inconclusive. The laparoscope is usually smaller as no channel is needed for surgical instruments.

Operative Laparoscopy

Laparoscopy is considered operative when the surgeon is treating a problem that is found during diagnostic laparoscopy with surgical instruments through the laparoscope. If your surgeon sees an opportunity to repair a problem during a diagnostic Laparoscopy, an operative Laparoscopy will usually be performed at that time depending on the patient’s condition and the surgeon’s preference.

Gynecological Laparoscopy

This procedure is performed to assess the reproductive organs to diagnose and treat the cause of infertility, chronic pelvic pain, and the presence of fibroids, cysts, and tumors. Laparoscopy is also used to diagnose and treat endometriosis or ectopic (tubal) pregnancies.

Laparoscopy Procedure

Laparoscopy is performed as day surgery either in the hospital or outpatient surgery center under general, regional, or occasionally local anaesthesia depending on the type of procedure performed and the surgeon’s preference.

  • During laparoscopy, the patient is placed lying on their back with their body tilted so the feet are higher than the head. This position helps to move some of the abdominal organs toward the chest allowing the surgeon a clearer view.
  • The surgeon uses a needle to inject a carbon dioxide gas into the abdominal cavity near the belly button to expand the viewing area of the abdomen giving the surgeon a clear view and room to work.
  • The surgeon makes a small incision in the abdomen, usually in the belly button, and inserts a tube called a trocar through which the laparoscope is introduced into the abdomen.
  • Additional small incisions may be made for a variety of surgical instruments to be used during the procedure. The location of the incisions will depend upon the reason for the procedure.
  • With the images from the laparoscope as a guide, the surgeon can look for any pathology or anomaly. The large image on the television screen allows the surgeon to see the abdominal contents directly and to determine the extent of the problem, and then perform the particular surgical procedure, if necessary.
  • If the surgeon sees an opportunity to treat a problem, a variety of surgical instruments can be inserted through the laparoscope or through other small incisions your surgeon may make.
  • After treating the problem, the laparoscope and other instruments are removed and the gas released. The tiny incisions are closed and covered with small bandages.
  • Laparoscopy is much less traumatic to the muscles and soft tissues than the traditional method of surgically opening the abdomen with long incisions (open techniques).

Post-op Guidelines

After Laparoscopy your surgeon will give you guidelines to follow depending on the type of laparoscopy performed and the surgeon’s preference.
Recovery time varies depending on your procedure, but usually the patient can go home after a few hours.

Common post-operative guidelines following laparoscopy include the following:

  • You will need someone to drive you home after you are released as the anesthesia may make you feel groggy and tired.
  • Do not remove the dressings over the incisions for the first week and keep the area clean and dry. 
  • No tub baths or swimming during this time. The skin incisions usually heal in 4-6 weeks.
  • Your surgeon may give you activity restrictions such as no heavy lifting.
  • You may feel soreness around the incision areas. Your surgeon may give you prescription pain medicine or recommend NSAID’s (non-steroidal anti-inflammatory drugs) for the first few days to keep you comfortable.
  • No driving while on any narcotic pain medications.
  • If the abdomen was distended with gas, you may experience discomfort in the abdomen, chest, or shoulder area for a couple of days while the excess gas is being absorbed.
  • Contact your doctor immediately if you have a fever, chills, increased pain, bleeding or fluid leakage from the incisions, chest pain, shortness of breath, leg pain, or dizziness.

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