Laparoscopy is a procedure in which a surgical telescope is passed through an incision in the abdomen, usually in the umbilicus, allowing the gynaecologist to look at and operate on the organs of the pelvis and abdomen. Using a camera with laparoscope, so that a television monitor is used, allows minimally invasive (keyhole) surgery. Instruments can be passed through one or more other small incisions in the wall of the abdomen. The gynaecologist can perform operations without the need for a large incision.
Laparoscopy and minimally invasive surgical techniques provide the patient with a number of important advantages: more rapid recovery; reduced pain; and, smaller scars.
Use of laparoscopy allows the gynaecologist to determine whether any disease is present. Examples of conditions commonly diagnosed with laparoscopy are endometriosis and ovarian cysts.
One of the important roles of laparoscopy is to undertake surgery. By using the laparoscope to view the pelvis then passing instruments through other small incisions in the abdomen, the gynaecologist can perform many operations, for example:
View a YouTube video clip of a laparoscopy here:
If your gynaecologist determines that you would benefit from laparoscopy, preparations will be made that include the following:
The gynaecologist will explain the nature and purpose of your laparoscopy.
Your consent will be obtained.
Arrangements will be made with the hospital or day procedure unit.
Tests may be arranged, for example blood tests, x-rays or heart tests.
The anaesthetist or hospital pre-admission clinic may wish to speak with, or examine you.
Patients are usually asked to fast (not drink or eat) for at least 6 hours before surgery. In some cases, additional measures such a bowel preparation (use of fluids to empty the bowel prior to surgery) will be undertaken.
It is very important to ask your gynaecologist and anaesthetist whether any of your medications need to be stopped before surgery. This is especially important for blood thinning medications (such as aspirin).
It is important to recognize that laparoscopy is a common and safe procedure. More than 25000 gynaecological laparoscopy procedures are performed in Australia every year.
Large studies show that the rate of all complications in laparoscopy is less than 1% (1 in 100), with the rate of major complications less than 0.5% (1 in 200).
When you wake from the anaesthetic, it is normal to feel disoriented and sleepy. Some patients will experience nausea or vomiting, but these feelings should pass quite quickly.
There might be some pain at the site of the incisions, and you will commonly be given analgesics (pain relieving medication). The carbon dioxide gas that is used to inflate your abdomen can sometimes cause a sensation of bloating and pain in the shoulder tips.
Depending on the complexity of surgery and the length of the operation, you will feel tired and have abdominal discomfort for a few days. There may be some vaginal discharge, particularly if there has been a hysteroscopy or curette procedure performed at the same time.
You will be given instructions about dressings over the wounds, and the stitches used to close the incisions.
It is important to notify the hospital or your doctor if you have:
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