Gynecologic laparoscopy
Gynecologic laparoscopy is an alternative to open surgery. It uses a laparoscope to look inside your pelvic area. Open surgery often requires a large incision. A laparoscope is a slender, lighted telescope. It allows your doctor to see inside your body. Diagnostic laparoscopy can determine whether you have conditions such as endometriosis or fibroids. It can also be a form of treatment. With miniaturized instruments, your doctor can perform a variety of surgeries. These include:
Gynecologic Laparoscopy
Laparoscopy generally has a shorter healing time than open surgery and leaves smaller scars. A gynecologist, general surgeon, or another type of specialist may perform this procedure.
Reasons for Gynecologic Laparoscopy
Laparoscopy can be used for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into treatment.
Some reasons for diagnostic laparoscopy include:
- Unexplained pelvic pain
- Unexplained infertility
- A history of pelvic infection
Conditions that might be diagnosed using laparoscopy include:
- Endometriosis
- Uterine fibroids
- Ovarian cysts or tumors
- Ectopic pregnancy
- Pelvic abscess (pus)
- Pelvic adhesions (painful scar tissue)
- Infertility
- Pelvic inflammatory disease
- Reproductive cancers
Some types of laparoscopic treatment include:
- Hysterectomy (removal of the uterus)
- Removal of the ovaries
- Removal of ovarian cysts
- Removal of fibroids
- Blocking blood flow to fibroids
- Endometrial tissue ablation (treatment for endometriosis)
- Adhesion removal
- Reversal of tubal ligation (contraceptive surgery)
- Burch procedure for incontinence
- Vault suspension to treat a prolapsed uterus
Preparing for Gynecologic Laparoscopy
Preparation depends on the type of surgery. You may need imaging tests, or your doctor might order fasting or an enema.
Inform your doctor about any medications you take, including over-the-counter drugs and supplements. You may need to stop them before the procedure.
Arrange for a friend to pick you up after the surgery or schedule a car service, as you will not be allowed to drive yourself.
Procedure
Laparoscopy is almost always performed under general anesthesia, meaning you’ll be unconscious during the procedure. However, you may be able to go home the same day.
Once you’re asleep, a small tube called a catheter will be inserted to collect your urine. A small needle will fill your abdomen with carbon dioxide gas, which keeps the abdominal wall away from your organs, reducing the risk of injury.
Your surgeon will make a small cut in your navel and insert the laparoscope, which transmits images to a screen, providing a clear view of your organs.
What happens next depends on the type of procedure. For diagnosis, your doctor might take a look and then be done. If surgery is needed, other incisions will be made, and instruments will be inserted through these holes to perform the surgery using the laparoscope as a guide.
Once the procedure is over, all instruments are removed, incisions are closed with stitches, and you’re bandaged and sent to recovery.
Advances in Laparoscopy
Robotic surgery is sometimes used for gynecological laparoscopy. Robotic arms are steadier than human hands and may be better at fine manipulations.
Microlaparoscopy is a newer approach that uses even smaller scopes. This procedure can be done with local anesthesia in your doctor’s office, meaning you won’t be completely unconscious.
Risks of Laparoscopy
Common side effects of this procedure include skin irritation and bladder infection.
More serious complications are rare but can include:
- Damage to abdominal blood vessels, the bladder, the bowel, the uterus, and other pelvic structures
- Nerve damage
- Allergic reactions
- Adhesions
- Blood clots
- Problems with urinating
Conditions that increase your risk of complications include:
- Previous abdominal surgery
- Obesity
- Being very thin
- Extreme endometriosis
- Pelvic infection
- Chronic bowel disease
The gas used to fill the abdominal cavity can also cause complications if it enters a blood vessel. Pay close attention to your body during the recovery period and discuss any side effects with your doctor.
Recovery After Laparoscopy
Once the procedure is over, nurses will monitor your vital signs. You’ll stay in recovery until the anesthesia wears off and you can urinate on your own, as difficulty urinating is a possible side effect of catheter use.
Recovery time varies depending on the procedure performed. You may be free to go home a few hours after surgery or may need to stay in the hospital for one or more nights.
After surgery, your belly button might be tender, and there may be bruises on your stomach. The gas inside you can cause chest, middle, and shoulder aches, and you might feel nauseated for the rest of the day.
Before you go home, your doctor will provide instructions on managing possible side effects. You may receive prescriptions for pain medication or antibiotics to prevent infection.
Depending on the surgery, you may be advised to rest for a few days or weeks, and it may take a month or more to return to normal activities.
Serious complications of laparoscopy are rare, but you should call your doctor if you experience:
- Serious abdominal pain
- Prolonged nausea and vomiting
- Fever of 101°F or higher
- Pus or significant bleeding at your incision site
- Pain during urination or bowel movements
The results of these procedures are usually good, as this technology allows the surgeon to easily see and diagnose many problems, with shorter recovery times compared to open surgery.