What is a laparoscopy?

Laparoscopy refers to a surgical procedure wherein a slender telescope called a laparoscope is inserted into a body cavity in order to visualize it. 

What are the uses of a laparoscopy?

A laparoscopy has both diagnostic and therapeutic applications, as to either determine the diseased region of the body or to undertake a suitable intervention to correct the defect. 

In gynaecological practice, laparoscopy can be used to either diagnose or treat the following conditions:

  • Fibroids- outgrowths present either outside or inside the uterus that can cause prolonged vaginal bleeding, mostly non-cancerous, but may turn malignant in some rare cases
  • Ovarian cysts- fluid-filled lesions present either on or inside the surface of the ovary 
  • Endometriosis- a medical condition where the normal lining of the uterus grows to involve other abdominal or extra-abdominal organs 
  • Pelvic organ prolapse- cases where pelvic organs lose their intrinsic mechanical support and fall out of the vagina
  • Pelvic inflammatory syndrome- infection of the female reproductive organs (fallopian tubes, ovaries, cervix, and the uterus)
  • Pelvic adhesions 
  • Pelvic abscess 

Some of the other indications include: 

  1. Removal of an ectopic pregnancy- A circumstance wherein the growing embryo fails to implant within the uterus. If an ectopic pregnancy ends up rupturing, it may prove to be life-threatening for the mother 
  2. Performing a hysterectomy- A surgical procedure that involves the removal of the uterus. A hysterectomy is performed in cases of uterine carcinoma, and abnormal uterine bleeding, among other conditions 
  3. Performing a tubal ligation- A contraceptive procedure wherein the fallopian tubes of a female are blocked to prevent pregnancy 
  4. Performing an endometrial tissue ablation- to treat endometriosis 
  5. Different types of vault suspension for the treatment of prolapse 
  6. Removal of adhesions

When might a physician order a laparoscopy?

A laparoscopy may be ordered in cases where a patient presents with the following symptoms: 

  • Chronic pain in the abdomen or pelvis, which seems to impair their ability to perform day-to-day activities 
  • Alteration in the frequency, volume, or duration of menstrual bleeding 
  • Trouble conceiving pointing out a possible abnormality in the reproductive tract 
  • Seeks out a more or less permanent method of surgical contraception 
  • Unintentional loss of excess weight or sudden loss of appetite prompting the diagnosis of an underlying malignancy 

What happens during a laparoscopy?

  • The patient lays down on an operating table after changing into a hospital gown
  • They're then administered either general or local anaesthesia to numb the pain. General anaesthesia is usually given through an intravenous line or via inhaling gasses from a mask. On the other hand, local anaesthesia is provided by injecting it into the abdominal area 
  • Once the anaesthetist verifies that the patient is unconscious, an incision is made by a surgeon near the umbilicus (belly button) 
  • Through this incision, the laparoscope is inserted. A gas may be used to expand the area and make it easy for the surgeon to visualize the area 
  • The laparoscope is moved around the abdomen, and the various regions are visualized on a computer screen 
  • Upon the completion of the procedure, the laparoscope, along with the gas, is removed, and the incision is closed up
  • The patient may then be moved to the recovery room

1. What are some of the risks associated with laparoscopy?

Like any other surgical procedure, laparoscopy does have its share of side effects and risks. They include: • Bleeding caused due to damage to abdominal vessels • Damage to other pelvic structures like the bladder, bowel, uterus • Nerve damage • Infections • Adhesions • Allergic reactions A patient may be prone to such complications if they're obese or have undergone previous abdominal surgery or have been diagnosed with a pelvic infection or have chronic bowel disease.

2. How can a patient prepare for laparoscopy?

If a patient is being administered general anaesthesia for performing a laparoscopy, they may be required to fast for about six hours before the procedure. Fluids may also not be allowed during this period. It's also recommended that a patient be accompanied by a family member since they may not be in a position to drive back home on their own after the procedure.

3. How long does it take to recover from a laparoscopy?

A patient is kept in the recovery room until the anaesthesia wears off and the vitals are monitored continuously. The recovery period varies from one type of procedure to another, but in most cases, a patient is discharged after one or two days. But, they may need to rest for a few days to a week, and it might take close to a month for them to resume normal activities.

4. When might a patient need to contact a doctor after being discharged?

After being discharged, a patient is asked to contact the physician if they experience: • Abdominal pain • Excessive nausea and vomiting • Bleeding at the site of the incision • Pain during defecation or urination

5. What are some of the benefits of laparoscopic surgery as opposed to open surgery?

A laparoscopy is considered to be a minimally invasive surgery as it leaves behind a smaller scar and causes less pain than a more conventional open surgery. As a consequence, a patient may be discharged from the hospital more quickly and may resume normal activities much sooner.

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