LAPAROSCOPY

Laparoscopy is a minimally invasive surgical procedure performed using a laparoscope, a thin fibre-optic instrument with a camera and lens attached to it. Laparoscopes can be used for diagnosing and treating various conditions.  

Why have a Laparoscopy?

Laparoscopy in gynaecology is used to check for any abnormalities in the uterus, ovaries, fallopian tubes, and other organs which are not evident by other diagnostic procedures such as X-rays and other scans.

Laparoscopy is used to diagnose and treat the conditions of

  • pelvic pain,
  • infertility,
  • fibroids,
  • cysts,
  • tumours,
  • endometriosis,
  • ectopic (tubal) pregnancies,
  • pelvic inflammatory disease and
  • other gynaecological problems.

Laparoscopy is used to investigate and treat a wide range of gynaecological presentations. Laparoscopy can be used to investigate fertility.Pelvic pain is one of the common gynaecological problems which may be caused by various conditions.

Laparoscopy helps in assessing the exact cause of the pain such as:

  • presence of scar tissue,
  • infections,
  • ovarian cysts,
  • gastrointestinal problems,
  • urinary problems,
  • musculoskeletal problems and
  • other conditions.

ABOUT LAPAROSCOPY PROCEDURE

A laparoscopy is performed in a Day Stay Unit and the woman is under general anaesthesia. During the procedure, Dr Cook makes a small incision in the abdomen, usually at or below the belly button, and inserts a tube through which the laparoscope is introduced into the abdomen.

The laparoscope helps in examining the pelvis and the images from the camera are projected onto a large screen for Dr Cook to view. Other small incisions (about 5mm) are made and used to insert small instruments to assist in carefully examining the entire pelvic and abdominal area - including bladder, rectum, appendix, liver, stomach, diaphragm.

A special contrast dye may also be injected before the procedure for better visualization of the fallopian tubes.

After the procedure, the incisions are closed with stitches and covered with bandages.

POST OPERATIVE EXPECTATIONS

It is common to experience right shoulder tip pain  for about 24 hours after a laparoscopy. This is referred pain from the gas which is trapped under the diaphragm. It is common to experience a bloated sensation and sharp, shooting pains for about 3 days after. Most women will feel tired for about 5 days. You can expect to return to work after about 5 days.

Dr Cook will call the following day after the laparoscopy to briefly discuss how everything went and to make sure you are OK. You will be reviewed by Dr Cook at 7 days to check your progress and discuss the recent procedure - including laparoscopic pictures and pathology results.

POST OPERATIVE CARE

The best advice is to take it easy for 5 days. Avoid strenuous activity and exercise. There will be four cuts (from the small keyhole incisions) and these are covered with waterproof dressings.

You can have a shower or a bath. You will be given spare dressings from the hospital to allow you to change the dressings if required.

LAPAROSCOPY COMPLICATIONS

Like all surgical procedures, laparoscopic procedures may be associated with certain complications, which include:

  • Bleeding
  • Some women can have problems emptying the bladder for a short period of time
  • Urinary tract infection
  • Injury to bladder or ureter
  • Injury to bowels
  • Irritation or inflammation at the opening of the vagina

The advantages of laparoscopic procedures when compared to open laparotomy include:

  • Reduced hospital stay
  • Smaller incisions and less scarring
  • Less postoperative pain
  • Faster recovery
  • Enhanced view of pelvis and abdomen
  • Less Risk of adhesions