Preparing for Laparoscopy

What is laparoscopy?

Laparoscopy is a method of performing surgery through small (1 cm) incisions. While conventional surgery requires an incisions of several inches (5-7 inches, typically). The same procedure is finished through 3-4 rather smaller incisions. Hence, laparoscopic surgery is also called as minimally invasive surgery.

How is laparoscopic surgery done?

Laparoscopic surgery requires special equipment to make it possible to work through small incisions. The abdomen is filled with carbondioxide gas to inflate it and thus provide sufficient working space. There is a long slender device called laparoscope, that is inserted into the abdomen through the incision. It is attached to a camera, that allows the doctor to visualise the inside of the abdomen on an electronic screen. Surgery id done through other long instruments inserted through additional incisions.

What are the benefits of laparoscopy?

There are many benefits with laparoscopy as compared to conventional open surgery like:

• Less pain
• Shorter hospital stay
• Shorter recovery time
• Less risk of infection
• Less risk of adhesions
• Smaller scars give better cosmetic appearance

What are the risks associated with laparoscopy?

Although, laparoscopy is very safe in experienced hands, as with any surgery there can be some risks like :

• Bleeding
• Infection
• Damage to a blood vessel or other organ, such as the stomach, bowel, bladder, or ureters
• Conversion to open surgery
• Hernia (a bulge caused by poor healing) at the incision sites

What problems can laparoscopy be used to diagnose and treat?

Laparoscopy can be done in a number of cases to look for the cause of the condition. If a problem is found, it can be treated during the same surgery. The common conditions where laparoscopy is done are:

• Infertility – Laparoscopy helps to find out the cause of infertility and treat it at the same time. A detailed visualisation of the internal organs is necessary to understand the reason for infertility.
• Endometriosis — Laparoscopy is the only way to confirmly diagnose endometriosis. If it is found, it can be removed in the same procedure.
• Fibroids — Fibroids are benign growths from uterine wall. Sometimes, they may cause infertility, heavy bleeding or pain. Laparoscopy helps to remove these fibroids safely.
• Ovarian cyst — There is some role for laparoscopy in case of benign ovarian cysts. But if any suspicion of malignancy is there, it is better removed through open surgery without spill.
• Ectopic pregnancy — Laparoscopy may be done to remove an ectopic pregnancy.
• Pelvic floor disorders — Laparoscopic surgery can be used to treatpelvic organ prolapse.
• Cancer — Some types of early stage uterine cancer can be removed using laparoscopy.
• Appendix removal – Appendicitis
• Gall -bladder removal – Gall-bladder stones, polyps, etc

What kind of pain relief is used during laparoscopy?

Laparoscopyis usually performed with general anesthesia. This type of anesthesia puts you to sleep.

What happens during laparoscopy?

After anesthesia is given, a small incision is given on your abdomen and gas is filled into your abdomen. This will give sufficient working space and helps in visualising the internal organs in a better way. The laparoscope is inserted into the abdomen through this incision. The camera is attached to the laparoscope to visualise the organs on the screen. Other instruments are inserted through additional incisions and procedure is completed.

What happens after laparoscopy?

After the procedure is completed, the gas from the abdomen is removed and the small incisions are closed. You will be taken out of anesthesia and moved to recovery room, where you will be observed for a couple of hours. Pain medications will be given to control your pain. You may feel chilly, as you recover fully from anesthesia. We will make sure that you are kept warm.

As most of the procedures are done as day care services, you will be sent home on the same day, once you can stand and walk by yourselves and empty your bladder. You must have some responsible person to drive you home. Some complex procedures require overnight stay in the hospital.

What should I expect during recovery?

• Following the procedure, there may be mild pain and discomfort
• The incision sites on the abdomen may feel sore
• There can be pain in the shoulders and back, due to some amount of gas left behind in the abdomen. This will settle by itself in a few hours to days.
• Your throat may be sore due to the tube put in during anesthesia. Warm salt water gargle or lozenges will help you.
• Of the pain and nausea do not decrease or if they get worse, contact us immediately.

How soon after laparoscopy can I resume my regular activities?

This depends on the type of surgery done and the pain tolerance of the woman. For minor procedures, you will be able to resume your regular activities in 1-2 days. For more complex procedures, it can take longer. You may be advised to avoid heavy activity or exercise for 6 weeks atleast.

What warning symptoms should I look out for after laparoscopy?

Contact us immediately in case of the following signs or symptoms:

• Pain that is severe or gets worse, not relieved with oral medication
• Fever
• Heavy vaginal bleeding
• Redness, swelling, or discharge from the port site
• Fainting
• Inability to empty your bladder
• Repeated vomiting and distension of abdomen