Laparoscopy

Why It Is Done

Laparoscopy is done to:

• Check for and possibly take out abnormal growths (such as tumors) in the belly or pelvis.
• Check for and treat conditions such as endometriosis, ectopic pregnancy, or pelvic inflammatory disease (PID).
• Find conditions that can make it hard for a woman to become pregnant. These conditions include cysts, adhesions, fibroids, and infection. Laparoscopy may be done after initial infertility tests do not show the cause for the infertility.
• Do a biopsy.
• See whether cancer in another area of the body has spread to the belly.
• Check for damage to internal organs, such as the spleen, after an injury or accident.
• Do a tubal ligation.
• Fix a hiatal hernia or an inguinal hernia.
• Take out organs, such as the uterus, spleen, gallbladder (laparoscopic cholecystectomy), ovaries, or appendix (appendectomy). Partial removal (resection) of the colon also can be done.
• Find the cause of sudden or ongoing pelvic pain.

How To Prepare

Tell your doctor if you:

• Have allergies to any medicines, including anesthesia.
• Take a blood thinner, or if you have had bleeding problems.
• Are or might be pregnant.

Before laparoscopy:

• Follow the instructions exactly about when to stop eating and drinking, or your surgery may be canceled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.
• Leave your jewelry at home. Any jewelry you wear will need to be taken off before the laparoscopy.
• Remove your glasses, contacts, and dentures or a removable bridge before the laparoscopy. These will be given back to you as soon as you wake up after the surgery.
• Arrange for someone to drive you home after the laparoscopy.

You may be asked to use an enema or suppository several hours before or the day before the surgery to empty your colon.

The hospital or surgery center may send you instructions on how to get ready for your laparoscopy or a nurse may call you with instructions before your surgery.

You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

Talk to your doctor about any concerns you have about the need for the surgery, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form (What is a PDF document?).

How It Is Done

Laparoscopy is done by a surgeon or a doctor of women's health (gynecologist). General anesthesia is generally used, but other types of anesthesia, such as spinal anesthesia, may be used. Talk with your doctor about what choice is best for you.

About an hour before the surgery, you will empty your bladder. You will get fluids and medicine through an intravenous (IV) in a vein in your arm. You may get a medicine (sedative) to help you relax.

Several procedures may be done after you get your anesthesia and are relaxed or asleep.

• An airway will be placed in your throat to help you breathe if you get general anesthesia.
• A thin flexible tube (urinary catheter) may be put through your urethra into the bladder.
• Some of your pubic hair may be shaved.
• Your belly and pelvic area will be washed with a special soap.
• For women, your doctor may do a pelvic exam before putting a thin tube (cannula) through your vagina into the uterus. The cannula lets your doctor move your uterus and ovaries to get a better look at the belly organs.

During laparoscopy, a small incision is made in the belly. More than one incision may be made if other tools will be used during the surgery. A hollow needle is put through the first incision and gas (carbon dioxide or nitrous oxide) is slowly put through the needle to inflate the belly. The gas lifts the abdominal wall away from the organs inside so your doctor can see clearly.

A thin, lighted tube (laparoscope) is then put through the incision to look at the organs. Other tools can be used to take tissue samples, fix damage, or drain cysts. A laser may be attached to the laparoscope to help with the surgery.

After the surgery, all the tools will be removed and the gas will be released. The incisions will be closed with stitches and covered with a bandage. The scar will be very small and will fade over time.

Laparoscopy takes 30 to 90 minutes, depending on what is done, but can take longer if a condition (such as endometriosis) is found and treated. After the laparoscopy, you will go to the recovery room for 2 to 4 hours. You can usually do your normal activities the next day, but do not do any strenuous activity or exercise for about a week.

How It Feels

If general anesthesia is used, you will be asleep and feel nothing. After you wake up, you will feel sleepy for several hours. You may be tired and have some pain for a few days after a laparoscopy. You may have a mild sore throat from the tube in your throat to help you breathe. Use throat lozenges and gargle with warm salt water to help your sore throat.

If you have other types of anesthesia, you may have pain for a few days when the initial numbness wears off.

What Affects the Test

Reasons you may not be able to have the surgery or why the results may not be helpful include:

• If you are obese, which may make the laparoscopy harder to do.
• If you have scar tissue from another surgery or an injury.
• If a tissue sample is taken for a biopsy, but the results are not clear about what the problem is.

What To Think About

• People who are obese or who have had other belly surgeries may need to have a larger incision in the belly for the surgery. This is called open laparoscopy.