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Laparoscopy

 

Laparoscopy

 

Gynaecological laparoscopy is a procedure used to look inside the abdomen and examine the uterus, ovaries and fallopian tubes. 

A very small telescope, called a laparoscope is put into the abdomen through a tiny cut in the belly button.  The surgeon can see images from inside the abdomen magnified on a screen; this gives a very clear view of the pelvic organs.

Laparoscopy can be used to:

  • Diagnose and treat endometriosis
  • Diagnose and treat pelvic inflammatory disease
  • Diagnose and remove adhesions (scar tissue)
  • Treat eptopic pregnancy
  • Perform female sterilization (permanent contraception)
  • Remove ovarian cysts
  • Remove the uterus or ovaries (hysterectomy)
  • Remove fibroids

Dr Li may suggest that you undergo laparoscopy if you suffer from severe abdominal pain, to assist in diagnosing the cause.  If you are having problems conceiving, a laparoscopy can be beneficial to see if there are any problems with your uterus, ovaries or fallopian tubes.

 

Before surgery

The doctor may ask you to stop taking some medications for a week or more leading up to the procedure.  If you are taking the oral contraceptive pill, you may be advised to cease taking it one month prior to the surgery.

If you are having laparoscopic surgery to diagnose your condition or to investigate the cause of abdominal pain, Dr Li may treat your condition during the procedure.  She will discuss possible treatments with you prior to your operation and you will be asked to sign a consent form.

 

Anaesthesia

Laparoscopy is usually performed under general anaesthesia.  Although in some cases spinal or epidural anaesthesia may be recommended.

Dr Li and your anaesthetist can discuss and explain the best options for you.

 

The procedure

A laparoscopy can take 15 minutes or more, depending on the findings and treatments required.

The surgeon will make a very small cut in your belly button.  A small tube is then fed through the small cut so that gas can be pumped into your abdominal cavity.  This gas expands your abdomen and separates your internal organs so that the laparoscope can easily see inside.

If treatment is required, or if some of your other organs need to be moved a little to get a good view, she may make some small cuts lower down on your abdomen.  Surgical instruments that may be required for treatment can then be inserted through these cuts.

A coloured dye may be injected through your cervix, into your uterus and fallopian tubes to see whether your fallopian tubes are blocked or patent (free of blockages).

Once the procedure has been completed, Dr Li will carefully remove the instruments and allow the gas to escape before closing the small incisions with stitches.

 

Recovery

If you are having a diagnostic laparoscopy, generally you will be able to return home that day.  If you are having a laparoscopy to treat a condition, you may need to stay at the hospital overnight. 

You will need to rest until the affects of the anaesthetic have worn off.  It is advisable to have a friend or relative drive you home and stay with you for the first 24 hours after your surgery. 

Over the counter pain relief is likely to be sufficient in relieving any post surgery discomfort.  Dissolvable stitches may be used.  These can take varying times to dissolve, but usually disappear within 7 days.

If your laparoscopy was diagnostic, you will need to rest and take it easy for a few days.  However, if you required further treatment during your laparoscopy (eg: endometriosis, hysterectomy), it will take longer for you to recover.  This varies depending on the individual and the procedure, it is very important to follow your doctors’ advice and to not over exert yourself.  Do not do any heavy lifting for at least 4 weeks after your surgery.

Dr Li will advise you about contraception and when you can resume sexual activity.

 

Risks/Complications

As will ALL surgeries, there are risks.  Whilst medical professionals make every attempt to minimize risks, complications can occur that may have permanent effects.  It is important that you are well informed about the possible complications so that you can weigh up the benefits and risks of the procedure.

Laparoscopies are performed commonly and are generally very safe.  A doctor cannot guarantee a patient that their symptoms will improve after having a laparoscopy.  However a majority of patients can expect very good outcomes.   

 

The most common side effects relating to laparoscopy are:

  • Abdominal pain
  • Shoulder pain – This is caused by the gas used to inflate your abdomen, this usually subsides within 48 hours.
  • Bruising on the abdomen – Some patients will experience bruising around the sites where the laparoscope or other instruments were inserted.

Please note:  Smoking, obesity and other significant medical problems greatly increase the risk of complications with any surgery.

The following are some risks specific to laparoscopy:

  • Wound may become infected or not heal properly.
  • A hernia may develop.
  • Other organs may be damaged during surgery (this is extremely rare).
  • During you laparoscopy, the doctor may decide that open surgery is necessary.  This means a larger incision would be made in your abdomen.