What is a laparoscopy?

Why a laparoscopy is done

A laparoscopy may be done to:

• Diagnose cancer (organs are examined, tissue samples taken, determine how far cancer has spread, and/or find the cause of internal bleeding, blockages, or fluid buildup)

• Assessing and removing cysts

• Assessing pelvic inflammatory disease

• Assessing and treating endometriosis

• Removal of organs for condition treatment (e.g. uterus, ovaries, gallbladder, or appendix)

How a laparoscopy is done

 A laparoscopy is done in a hospital operating room while you are under general anaesthesia (you will be unconscious). You will receive special instructions from your healthcare team to prepare for your surgery, please make sure you follow these instructions. During the procedure, the surgeon will make a small cut (incision) in the abdomen near the belly button and put the laparoscope through the incision. Gas is then injected into the abdomen to make it expand so there is room for the surgeon to see the organs.

Depending on the complexity of the operation, 1-3 more small cuts may be made in the abdomen to allow for other specialized instruments to be used in the procedure. Specialized surgical ports (hollow plastic tubes) are inserted into the small cuts to allow these specialized tools to be used during the operation. The tools used during the procedure will depend on the specific procedure being performed. Common procedures performed include small samples of tissue being removed for further testing and examination, removing or repairing an organ, removing a cyst or scar tissue, or to stop bleeding.

At the end of the procedure, the instruments are removed, and the gas is drained from the abdomen. The small cuts for the surgical instruments are closed with stitches or a small bandage over the area. Your healthcare team may give you pain medications and antibiotics to prevent infection.

You may return home after you have recovered from the laparoscopy, often the same day. Someone must drive you home and it is recommended that a friend, family member, or caregiver stay with you for 24 hours. Your doctor will follow up with you and tell you when you can return to normal activities. Until then, do not lift heavy objects or do strenuous work until your doctor has confirmed that you are safe to do so. You can do basic self care activities such as showering, getting dressed, etc. on your own.

What to expect after having a laparoscopy?

After your laparoscopy, it may take some time for the anesthetic to wear off (you may feel drowsy and weak) and as such, it is recommended that you do not drink alcohol, drive a vehicle, or operate machinery for 48 hours after your operation. You can expect some pain that may require over-the-counter pain killers for a couple of days. Most people take 7 to 10 days off of work afterwards, but this varies according to the type of operation and individual recovery time. It is also common to have some irregular vaginal bleeding for a few days after the operation.

What are the benefits of a laparoscopy?

A laparoscopy offers many benefits for the patient and the surgeon.

• The surgeon can easily view organs affected by a condition (e.g. cancer, endometriosis, cysts, etc.) to determine the best course of treatment

• Small cuts (incisions) mean that recovery from surgery is faster and the patient spends less time in the hospital

• Patients experience less pain, have smaller scars, and a lower risk of infection

Laparoscopy is a very well-established and safe way to access the abdominal and pelvic cavities and whenever possible is preferred over open surgery.

What are the downsides of a laparoscopy?

A laparoscopy is a very complex process and requires a very specialized skillset. As such, the training period for these surgeons is very long.

Some conditions also cannot be treated with laparoscopy and may require open surgery to treat. For example, very large tumours, fibroids, or ovarian cysts may need open surgery.

What are the risks of laparoscopy?

 As with any surgery, laparoscopy has some risks:

• Infection at the surgery site

• Bleeding

• Blood clots

• Damage to organs or blood vessels

• Reaction to the anesthetic

  Factors that increase surgical risk are:

• Complex conditions such as advanced cancer or endometriosis

• Medical conditions such as high blood pressure, diabetes, heart disease, or increased likelihood for developing blood clots

• Obesity

• Emergency surgeries

Planned laparoscopic surgeries performed by experienced surgeons in well-equipped hospitals on otherwise healthy patients are usually very safe. Complications are possible but rare.