​Laparoscopy & Laparoscopic Surgery

​Laparoscopy & Laparoscopic Surgery

Laparoscopy is a surgical procedure, which uses a special surgical instrument called a laparoscope to look inside the body or to perform certain operations.

Understanding laparoscopy

Laparoscopy is a procedure to look inside the tummy (abdomen) by using a laparoscope. A laparoscope is like a thin telescope with a light source. It is used to light up and magnify the structures inside the abdomen. A laparoscope is passed into the abdomen through a small cut (incision) in the skin.

A laparoscopy may be done to find the cause of symptoms such as abdominal pain, pelvic pain or swelling of the abdomen or pelvic region. Or, it may be done if a previous test such as an X-ray or scan has identified a problem within the abdomen or pelvis. A laparoscopy enables a doctor to see clearly inside one’s abdomen. Some common conditions which can be seen by laparoscopy include:

Endometriosis

Pelvic inflammatory disease

Ectopic pregnancy

Ovarian cyst

Appendicitis

Understanding laparoscopic operation

In addition simply to looking inside, a doctor can use fine instruments, which are also passed into the tummy (abdomen) through another small cut (incision) in the skin. These instruments are used to cut or trim tissues, perform sample taking (biopsies), grasp organs, etc, inside the abdomen. This laparoscopic surgery is sometimes called ‘keyhole surgery’ or ‘minimally invasive surgery’. Laparoscopic surgery can be used for various procedures.

Some commonly performed operations include:

Removal of the gallbladder. This is sometimes called a laparoscopic cholecystectomy, or ‘lap choly’, for short. It is now the most common way for a gallbladder to be removed, usually for gallstones which are causing pain.

Removal of the appendix.

Removal of patches of endometriosis.

Removal of parts of the intestines.

Female sterilisation

Treating ectopic pregnancy.

Taking a biopsy of various structures inside the abdomen, which can be looked at under the microscope and/or tested in other ways.

In general, compared with traditional surgery, with laparoscopic surgery there is usually:

Less pain following the procedure.

Less risk of complications.

A shorter hospital stay and a quicker recovery.

A much smaller scar.

The procedure

Laparoscopy and laparoscopic surgery are usually done whilst one is asleep under general anaesthesia. The skin over the tummy (abdomen) is cleaned. The surgeon or gynaecologist then makes a small cut (incision) about 1-2 cm long near to the belly button (navel). Some gas is injected through the cut to ‘blow out’ the abdominal wall slightly. This makes it easier to see the internal organs with the laparoscope, which is gently pushed through the incision into the abdominal cavity. The surgeon or gynaecologist then looks down the laparoscope or looks at pictures on a TV monitor connected to the laparoscope.

If one has a surgical procedure, one or more separate small incisions may be made in the abdominal skin. These allow thin instruments to be pushed into the abdominal cavity. The surgeon or gynaecologist can see the ends of these instruments with the laparoscope and so can perform the required procedure. A more recent technique called single-port laparoscopy involves operating through the same incision through which the laparoscope was passed and does not require additional cuts to the abdomen.

When the surgeon or gynaecologist has finished, the laparoscope and other instruments are removed, the incisions are stitched and dressings are applied.

Getting prepared

As one will usually be under a general anaesthetic, one’s hospital should give instructions about fasting before the operation. Depending on the reason for each individual operation, there may be more specific instructions. One’s doctor will give you this information if necessary.

Post- laparoscopy

One may feel a little sore around the cuts (incisions). One may have some pain in one’s shoulder tip. This is caused by the gas, which had been pumped inside irritating the diaphragm which has the same nerve supply as the shoulder tip. This pain soon passes off. The length of time to recover can vary, depending on why the procedure was done and what operations were performed.

Probable complexities from a laparoscopy

There may be some minor bleeding or bruising around the skin incisions. Otherwise, in most cases a laparoscopy just to look inside goes without any problem. Possible problems which may occur include the following:

Accidental damage to structures inside the tummy (abdomen), such as the intestines or certain blood vessels. This is rare but, if it occurs, an emergency traditional operation may be needed to correct the damage.

As with any operation, there is a small risk of complications of anaesthesia. Occasionally, the incision becomes infected which may require a course of antibiotics.

If one has laparoscopic surgery, the risk of complications may increase, depending on what operation is performed.