Laparoscopy is a procedure that involves using a small telescope-like instrument called a laparoscope to view the inside of the abdomen and/or pelvis.
Laparoscopy can be performed as an investigation to see what might be causing certain problems, such as pelvic pain or infertility. Laparoscopic surgery is also commonly used in Australia to treat some conditions.
What happens during a laparoscopy?
During a laparoscopy, a laparoscope (a thin instrument with a camera on the end of it) is gently inserted through a small cut into the abdomen. The laparoscope allows your doctor to see inside your abdomen and pelvis.
Laparoscopy is usually performed under general anaesthetic, so you will not be conscious during the procedure.
A small cut is made in or near your umbilicus (belly-button), and a narrow tube is inserted. Carbon dioxide gas is introduced into the abdominal cavity through this tube, ‘blowing it up’ slightly, and making it easier to see inside. The laparoscope is then inserted into the abdomen. The laparoscope has a video camera on the end of it which takes video images that are projected onto a television screen so that your doctor can see the inside of your abdomen.
Why is laparoscopy done?
Laparoscopy may be recommended as a test to help with the diagnosis of a variety of symptoms and conditions, including:
- endometriosis (a condition affecting women, where uterus lining tissue grows outside the uterus);
- unexplained severe pelvic or abdominal pain;
- infertility in women; or
- cancers in the abdomen or pelvis.
During the procedure, your doctor may take some small tissue samples – biopsies – to help make a diagnosis.
Sometimes treatment can be carried out at the same time as a laparoscopic investigation.
Laparoscopy can also be used to treat certain conditions, often with the help of additional instruments inserted through further tiny cuts made in the wall of the abdomen. Laparoscopic surgery (or minimally-invasive surgery) is also often referred to as keyhole surgery.
An increasing number of problems that used to require major surgery can now be treated with laparoscopic surgery.
Laparoscopic surgery is commonly used by gynaecologists (specialists in conditions affecting the female reproductive system) to perform procedures such as:
- female sterilisation (having your fallopian tubes ‘tied’ or clipped as a permanent form of contraception);
- hysterectomy (removal of the uterus);
- removal of ovarian cysts; and
- treatment of ectopic pregnancy (where a pregnancy implants outside the uterus – most often ectopic pregnancies occur in a fallopian tube).
Common non-gynaecological laparoscopic operations include the following.
- Removal of the gallbladder (called laparoscopic cholecystectomy), which is a very common procedure and is usually done to treat people with gallstones that are causing problems.
- Removal of the appendix (appendicectomy) to treat appendicitis.
- Weight loss surgery (also known as bariatric surgery) such as laparoscopic adjustable gastric banding (LAGB) or laparoscopic sleeve gastrectomy.
- Hernia repairs.
It is also possible to remove some cancers from the abdomen or pelvis laparoscopically. Sometimes this involves removal of the whole organ that is affected by cancer.
Recovery from laparoscopy and laparoscopic surgery
A laparoscopy is usually done as a day procedure, meaning you can go home on the same day. If you had a laparoscopy as a diagnostic procedure (where no surgery was performed), you can usually return to your usual activities within about 5 days.
People who have had laparoscopic surgery need more recovery time, and the amount of time will depend on the procedure performed. However, the recovery time is much shorter than would be needed for an open operation.
Because only tiny cuts are required with laparoscopic surgery, there is much less pain after the operation compared with open surgery (where a much larger incision is needed). This means that having a laparoscopy reduces the length of your hospital stay. Depending on the type of surgery you have, you may be able to leave hospital on the same day as your operation. It may take several weeks before you are able to participate in all of your usual activities – check with your doctor.
Because only small incisions are made, you will also have smaller, less noticeable scars. Your surgeon may wish to see you a week or so after the surgery to check that the wounds are healing well.
Side effects and complications of laparoscopy
After having a laparoscopy, there is usually a small amount of discomfort where the instrument was inserted. It is normal to feel tired and sore for a couple of days after the procedure.
Some people have a bloated feeling and pain felt at the tips of the shoulders after having a laparoscopy. This is due to the small amount of gas that is pumped into the abdomen to make it easier to see. These side effects generally settle within a few days , but bloating can take several weeks to resolve in some people.
As with any surgery, there is usually some pain following laparoscopic surgery. However, because the cuts with laparoscopic surgery are much smaller than with open surgery, there is usually less pain after laparoscopic surgery.
There is a very small risk of more serious complications. These include bleeding, infection, or damage to an organ (such as your bladder or bowel).
When to contact your doctor after a laparoscopy
You should contact your doctor if any of the following symptoms develop after having a laparoscopy:
- persistent or worsening pain after a few days;
- new abdominal pain;
- nausea or vomiting;
- fainting or feel light-headed;
- redness, swelling, discharge or bleeding at the wound site(s); or
- difficulty urinating.
2. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Laparoscopy: Information for patients (updated 26 Oct 2012). http://www.ranzcog.edu.au/treatments/laparoscopy.html (accessed 15 Sep 2016).
3. NHS Choices. Laparoscopy (keyhole surgery) (updated 24 Sep 2015). http://www.nhs.uk/Conditions/Laparoscopy/Pages/Introduction.aspx (accessed Sep 2016).