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Laparoscopy


What is it?


A laparoscopy is a surgical procedure where a narrow fibre optic instrument is inserted through the skin of the abdomen through very small incisions to enable the specialist to see the abdominal contents and reproductive organs.  


Why is it used? 


Laparoscopy is the most reliable technique for the diagnosis of otherwise unexplained infertility.

It also allows the surgeon the ability to operate within the abdominal cavity without making any large skin incisions making such operations less painful and speeding recovery.  


Who is it suitable for? 

In patients who have symptoms that are suggestive of gynaecological disease it provides the means for both diagnosis and treatment of any condition that may be identified.


It is also used to investigate otherwise unexplained infertility and poor response to infertility treatments.  


How is it done? 


For a diagnostic operation two incisions are made - one just at the base of the navel and the other at the top of the pubic hair line. These are both small, not requiring sutures to close them. The resulting scars will gradually fade until they are almost unable to be detected.


For operative procedures an extra small incision is made in the lower left side of the abdomen and for more complicated procedures, in the right lower abdomen also.


To create the space necessary to work within the abdominal cavity, warmed, humidified carbon dioxide gas is pumped in and then let out at the end of the operation.  


How will I feel? 

Anaesthetic agents affect people in different ways but common side effects include drowsiness, dizziness and nausea. These effects are generally short lived, lasting less than 24 hours, and are managed by the anaesthetic specialists involved.


The small incisions from the operation cause a variable amount of post operative pain according to the thickness of the abdominal wall and the degree of local bruising. It generally persists and hinders mobility for 3-5 days. The carbon dioxide gas may also cause a variable degree of irritation of the diaphragm resulting in post operative shoulder and chest soreness (referred pain), and occasionally vomiting.


Some relief from this may be achieved by putting your hips on a pillow so that they are higher than your chest and also taking mild pain killers as directed. These symptoms will disappear gradually over 3-5 days.


In more involved operative laparoscopic procedures, the recovery usually takes 7 to 14 days and initially involves 24 to 48 hours of abdominal cramping, nausea, loss of appetite and a variable degree of constipation followed by generalised weakness and tiredness.  


What are the risks involved? 


Laparoscopy is a minor procedure with relatively low risks, however, it is still a surgical procedure involving a general anaesthetic. Risks that are specific to laparoscopy are bowel injury (approximately 1 in 1000 cases) and vascular injuries (approximate risk of 1 in 10,000 cases).


Other risks which accompany any form of surgery are haemorrhage, reactions to general anaesthesia, and the risk of post-operative infection.  


Will I need time off work? 


Yes!! You will probably be admitted to hospital on the morning of the operation and for diagnostic operations, be able to go home in the evening. For operative laparoscopies you will be fine to go home the following morning.


Additionally, you will probably require 2-3 days off work to recuperate for diagnostic procedures and for up to 2 weeks for bigger procedures.


Will I have a scar? 


Some scarring is inevitable but because the skin incisions are approximately 5mm long, once healed they are very hard to see.

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