Laparoscopy
A laparoscopy is a procedure that uses a camera (Laparoscope) inserted through an incision in your belly button to look inside your abdomen and operate. It is often performed as a day procedure depending on the operation to be completed.
Laparoscopy is often performed as part of the investigation into pelvic pain, heavy bleeding and infertility. The approach can also be used to perform operations, such as, sterilisation for permanent contraception and for the removal of ovarian cysts.
Similar operation can be performed by pen surgery (laparotomy) but this is a much more invasive procedure requiring a longer stay in hospital and longer recovery. However, there are times when the procedure cannot be completed through the laparoscopic approach and we need to convert to an open approach.
The operation is performed under a general anaesthetic in the operating theatre. You are examined when you are asleep and occasionally instruments are inserted into the vagina to assist with the operation. A small incision is made in your belly button. The abdomen is infiltrated with gas to allow a space between the wall of the abdomen and the organs inside. Further small cuts are made to insert instruments to perform the procedures. Following the operation the gas is released and the wounds closed.
The possible complications of a Laparoscopy are:
- Infection: May occur in the wounds, bladder or internally. The common site for infection is the belly button. It is important to keep your wounds clean and dry.
- Bleeding: may be from the wounds or internally. If there is ongoing bleeding you may require a blood transfusion. You may require an open operation to treat some deep bleeding.
- Injury to surrounding organs: Injury to bowel, bladder or blood vessels will require immediate repair. This may require and open procedure and will entail a longer hospital stay and recovery time.
- Inability to complete the operation and need to convert to an open procedure.
- In rare occasions the gas in your abdomen may place pressure on your heart and lungs causing complications.
- Bands of scar tissue (Adhesions) may form and cause bowel obstruction. This may require further surgery to fix.
- The wounds may heal abnormally; this often runs in families and is called keloid scarring. The scar tends to be thickened and red.
- Although the incisions are small there is still a risk of hernias or weaknesses developing.
- Occasionally we do not find the cause of your symptoms.
Other general complications related to all surgeries include:
- Collapse of the lower parts of the lungs that may result in infection and require physiotherapy
- Clots in the legs with pain and swelling. The risk is higher in women and surgery also increases this risk.
- An operation and anaesthetic is a strain on your heart and lungs and there is a very rare risk of heart attack, stroke and death.
Prior to any operation you should fast from midnight for morning surgery or from 6am for surgery in the afternoon. This is to prevent aspiration of food particles into your lungs.
It is also important to discuss the possible need for ceasing blood thinning agents and other medications prior to surgery.
Following the operation you will be taken to the recovery ward while you are waking up. You are then moved to the day procedure unit before you are assessed to be fit to go home. You will be given pain relief as needed. A follow-up appointment will be made to see you back in the practice rooms.
It is not uncommon to feel some discomfort from the gas following the procedure. Often you notice some shoulder tip pain or upper abdominal discomfort like a stitch. This will settle over the first few hours to days.
Following your day procedure you should have someone drive you home and be with you for the next 24 hours. You should be eating and mobilising as normal. Avoid tampons, intercourse, spas or pools, as there may be an increase in infection rates. If you have any concerns you should contact the practice for advice.
