It is a surgical, diagnostic procedure used to examine the organs inside the abdomen. It is minimally invasive with low risk that requires only tiny incisions.
Through an instrument called a laparoscope, you can observe the abdominal organs. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera in the front.
The instrument is inserted through an incision in the abdominal wall. As you go, 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 may also obtain biopsy samples during this procedure.
Why is laparoscopy performed?
Laparoscopy is often used to identify and diagnose the source of pelvic or abdominal pain. It is usually done when non-invasive methods can not help with the diagnosis.
In many cases, abdominal problems can also be diagnosed with imaging techniques such as:
- Ultrasound uses high-frequency sound waves to create images of the body.
- Computed tomography is a series of special x-rays that take cross-sectional images of the body.
- Magnetic resonance image uses magnets and radio waves to produce body images.
- Laparoscopy is performed when these tests do not provide enough information for a diagnosis. The procedure can also be used to take a biopsy or tissue sample of a particular organ in the abdomen.
Your doctor may recommend a laparoscopy to examine the following organs:
- Small intestine and large intestine (colon).
- 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 specific treatments.
- The degree to which particular cancer has progressed.
In addition, your doctor may be able to operate to treat your condition immediately after diagnosis.
What are the risks of this procedure?
The most common risks associated with laparoscopy are bleeding, infection, and damage to organs in your abdomen. However, they rarely occur.
After the procedure, it is essential to watch for signs of infection. Contact your doctor if you experience:
- Fever or chills
- Abdominal pain becomes more intense over time.
- Redness, swelling, bleeding, or drainage at the incision sites.
- Continuous nausea or vomiting.
- Persistent cough
- Difficulty breathing.
- Inability to urinate.
There is a small risk of damage to organs examined during laparoscopy. Blood and other fluids can leak into your body if an organ is pierced. In this case, you will need another surgery to repair the damage.
Less common risks include:
- Complications of general anesthesia.
- Inflammation of the abdominal wall.
- A blood clot could travel to the pelvis, legs, or lungs.
In some circumstances, your surgeon may believe that the risk of diagnostic laparoscopy is too high to justify the benefits of using a minimally invasive technique.
This situation often occurs for those who have had previous abdominal surgeries, which increases the risk of forming adhesions between the structures in the abdomen.
Performing laparoscopy in the presence of adhesions will take much longer and increases the risk of damaging the organs.
How do I prepare for laparoscopy?
It would help if you told your doctor about any prescription or over-the-counter medications. Your doctor will tell you how to use it before and after the procedure.
Your doctor can change the dose of any medication that may affect the result of laparoscopy. These medications include:
- Non-steroidal anti-inflammatory drugs include aspirin or ibuprofen.
- Herbal or dietary supplements.
- Vitamin K.
You should also tell your doctor if you are pregnant or think you might be pregnant. This will reduce the risk of harm to your developing baby.
Before laparoscopy, your doctor can order blood tests, urinalysis, electrocardiogram (EKG or ECG), and chest x-ray. Your doctor may also perform specific imaging tests, such as an ultrasound, a CT scan, or an MRI.
These tests can help your doctor better understand the abnormality 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 should probably avoid eating and drinking for at least eight hours before laparoscopy.
You should also arrange for a family member or friend to take you home after the procedure. Laparoscopy is often performed under general anesthesia, which can cause drowsiness and the inability to drive for several hours after surgery.
How is it performed?
Laparoscopy is usually performed as an outpatient procedure. This means that you can go home the same day of your surgery. It can be done in a hospital or an ambulatory surgical center.
You are probably given general anesthesia for this type of surgery. This means that you will sleep during the procedure and not feel any pain. An intravenous line is inserted into one of your veins to achieve general anesthesia.
Your anesthesiologist can give you particular medications and provide fluid hydration through the intravenous route.
In some cases, local anesthesia is used instead. A local anesthetic numbs the area; therefore, you will not feel any pain even if you are awake during surgery.
During laparoscopy, the surgeon makes an incision below your navel and then inserts a small tube called a cannula. 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 your abdomen is inflated, the surgeon inserts the laparoscope through the incision. The camera connected to the laparoscope displays the images on a screen, allowing your organs to be seen.
The number and size of the incisions depend on the specific diseases that the surgeon tries to confirm or discard.
You get one to four incisions between 1 and 2 centimeters in length.
These incisions allow other instruments to be inserted. For example, your surgeon may need to use another surgical tool to perform a biopsy. They take a small tissue sample from an organ to evaluate during a biopsy.
After the procedure is performed, the instruments are removed. Your incisions are closed with stitches or surgical tape. Bandages can be placed over the incisions.
How long does it take to recover from laparoscopy?
When the surgery is over, you will be observed for several hours before leaving the hospital. Your vital signs, such as breathing and heart rate, will be monitored closely.
Hospital staff will also check for adverse reactions to the anesthesia or procedure and if there is prolonged bleeding.
The time of its launch will vary and will depend on:
- Your general physical condition
- The type of anesthesia used.
- The reaction of your body to surgery.
- You may have to stay in the hospital at night in some cases.
A family member or friend should take you home if you receive general anesthesia. The effects of general anesthesia usually take several hours to disappear, so it can be unsafe to drive after the procedure.
In the days after laparoscopy, you may feel moderate pain and vibrations in the areas where the incisions were made. Any pain or discomfort should improve in a few days. Your doctor may prescribe medications to relieve pain.
It is also common to have pain in the shoulder after the procedure. The pain is usually the result of carbon dioxide gas used to inflate your abdomen and create a workspace for surgical instruments.
The gas can irritate your diaphragm, which shares the nerves with your shoulder. It can also cause some swelling. The discomfort should disappear in a couple of days.
In general, you can resume all normal activities in a week. You should attend a follow-up appointment with your doctor approximately two weeks after the laparoscopy.
Here are some things you can do to ensure a smoother recovery:
- Start light activity as soon as possible to reduce the risk of blood clots.
- Sleep more than usual.
- Use pills to relieve sore throat.
- Wear loose clothing.
If a biopsy is taken, a pathologist will examine it. A pathologist is a doctor who specializes in tissue analysis. A detailed report of the results will be sent to your doctor.
The expected results of laparoscopy indicate the absence of abdominal bleeding, hernias, and intestinal obstructions. It also means that all your organs are healthy.
Abnormal results from laparoscopy indicate certain conditions, which include:
- Adhesions or surgical scars.
- Appendicitis is an inflammation of the intestines.
- Fibroids or abnormal growths in the uterus.
- Cysts or tumors
- Cholecystitis is an inflammation of the gallbladder.
- Endometriosis is a disorder in which the tissue that forms the uterus lining grows outside the uterus.
- Injury or trauma to a particular organ.
- Pelvic inflammatory disease is an infection of the reproductive organs.
Your doctor will schedule an appointment with you to review the results. If a severe medical condition is found, your doctor will discuss the appropriate treatment options with you and work with you to develop a plan to treat that condition.
A relatively recent development in laparoscopy is robots to help with procedures. This is known as “robot-assisted laparoscopy.”
During robotic-assisted laparoscopy, your surgeon uses a console located in the operating room to perform the procedure by controlling the robotic arms. The robotic arms hold a special camera and surgical equipment.
The robotic system provides a magnified 3D vision and a more excellent range of motion for the instruments that work within the body.
Robotic-assisted laparoscopy allows surgeons to perform complex procedures with greater precision and smaller incisions.
The amount of robot-assisted laparoscopy used in the United Kingdom has increased rapidly. In particular, assisted robotic surgery for prostate cancer.