Laparoscopy

Laparoscopy is a method of doing surgery without making a large incision. A thin, lighted tube with a small camera called a laparoscope is inserted into the abdomen through a small incision to allow the doctor to see your pelvic or abdominal organs. If a problem needs to be fixed, other instruments may be inserted through the laparoscope or through small cuts in your abdomen.

Laparoscopy is often done as outpatient surgery. You usually can go home the same day, once you recover from the procedure. More complex procedures, such as laparoscopic hysterectomy, may require an overnight stay in the hospital. Before surgery, you will be given general anesthesia, which blocks the pain and puts you to sleep, or local anesthesia, which numbs the area while you remain awake.

Laparoscopy

During the procedure, your doctor will insert the laparoscope through a small incision in your navel. He or she will then fill the abdomen with gas (carbon dioxide) to see the pelvic reproductive organs more clearly on the screen. Other incisions may be made in the abdomen to insert surgical instruments, but these incisions are usually no more than half an inch long. Another instrument, called a uterine manipulator, may be inserted through the cervix and into the uterus to move the organs into view.

After the procedure, the instruments are removed and the small incisions are closed with stitches or tape. There will be small scars that fade over time. If you had general anesthesia, you will wake up in the recovery room and feel sleepy for a few hours. You may have some nausea from the anesthesia. You must have someone drive you home.

You may feel tired and have some discomfort for a few days after the procedure. Your incisions may be sore, and the tube put in your throat to help you breathe during the surgery may leave you with a sore throat for a few days. If so, try throat lozenges or gargle with warm salt water. You may feel pain in your shoulders or back caused by the gas used during the procedure. It should go away on its own within a day or two. If it doesn’t, contact your doctor.

Your doctor will let you know when you can resume your normal activities. For minor procedures, it is often one or two days after the surgery. For more complex procedures, it may take longer. You may be told to avoid heavy activity or exercise.

Benefits

There is less pain with laparoscopic surgery than with open abdominal surgery, which involves larger incisions, longer hospital stays and a longer recovery. The risk of infection is lower and the recovery time is faster. It can be done as outpatient surgery, so you won’t have to spend the night in the hospital. Smaller incisions heal faster and leave smaller scars.

Risks

As with any surgery, laparoscopy does carry some risks. The more complex the surgery, the greater the risk. These risks include:

• Bleeding or a hernia (a bulge caused by poor healing) at the incision sites
• Internal bleeding
• Infection
• Damage to a blood vessel or other organ, such as the stomach, bowel or bladder
• Problems caused by anesthesia

In some cases, the surgeon may decide that a laparoscopy cannot be done during the surgery and he or she will create an abdominal incision instead. If this happens, you may need to stay in the hospital for a day or two. Your recovery also will take longer.

Alternative Procedures

• Medical treatments known to help your condition
• Standard open surgery with a larger incision
• No treatment