All about laparoscopy?
A. This is a surgical procedure in which a thin lighted telescope is put through a cut in a woman’s belly. In this type of surgery, generally, two to three small cuts are put on the belly to introduce the instruments instead of a long cut or incision. One of the instruments is a small lighted telescope which is attached to a camera. The images from the camera are projected and seen on a screen and accordingly, the other instruments are used to check the organs and operate.
Q. How long a hospital stay do you require for laparoscopy?
A. Generally, for a laparoscopy, you are admitted in the morning and undergo the procedure and are discharged the same day by evening. If there has been extensive surgery, you might require an overnight stay in hospital and may be discharged the next day.
Q. What type of anesthesia is used during laparoscopy?
A. Generally laparoscopy is done under general anesthesia in which you are put to sleep.
Q. When do your require a laparoscopy?
A. A laparoscopy may be required to check or confirm what your doctor suspects-: This is known as diagnostic laparoscopy. This may be done in the following situations-
- To examine the condition of your uterus, fallopian tubes and ovaries, and the remaining pelvis if all other tests are normal and you are unable to conceive.
- If there is some problem detected on a Hysterosalpingogram (HSG) with your fallopian tubes like a blockage or adhesions- to confirm the problem and correct it if possible.
- If there are some cysts in your ovaries like a dermoid cyst or an Endometriotic cyst.
Operative laparoscopy: When some problem is detected on laparoscopy or is already known on the basis of examination and tests like ultrasound etc and the doctor tries to intervene and correct the same it is known as operative laparoscopy. This may be done in the following situations-
- Endometriosis- Endometriotic cyst in ovaries may be removed and any patches present in the pelvis are burnt and destroyed.
- Ovarian drilling- In patients with the polycystic ovarian disease, sometimes holes need to be punctured in the ovaries.
Adhesions- If the tubes, ovaries, etc are stuck (adhered) to each other or to the uterus they may be separated.
Hydrosalpinx- if the tubes are blocked and filled with fluid, they may need to be removed or disconnected from the uterus.
- Tubal blockage- if the tubes are blocked, the doctor may try to open the tubes by passing a thin wire into the tubes by hysteroscopy. This is combined with laparoscopy.
- If the fimbrial end of tubes is blocked due to adhesions- these may be cut and the tube free.
- Tubal reanastomosis- if the tubes have previously been cut as a form of contraception and the couple now desires a pregnancy then the two cut ends of the tube are stitched together.
- Fibroid/ Adenomyoma -There may be a lump in the uterus like fibroid or Adenomyoma which may need to be removed.
- Septum – there may be a thin film dividing the upper part of the uterus which needs to be cut.
Q. What are the benefits or advantages with laparoscopy?
A. Due to small cuts compared to an open surgery, you have
- Less pain at the site of cuts
- Less chances of infection
- Shorter hospital stay
- Quicker healing and recovery
- Faster return to normal activities
Q. What are the risks associated with laparoscopy?
A. Laparoscopy is a quite safe procedure. But still some complications might occur.
You require general anesthesia
Complications like infection, bruising etc may occur
Less commonly major complications like injury to bowel and blood vessels may occur
Q. How soon can I resume my regular activities after laparoscopy?
A. After the procedure, you may feel some soreness around the cuts in the belly. Some discomfort etc. Depending on how extensive was the procedure, the doctor may allow you to resume your normal activities after 1-2 days or ask you to wait for a week or so. In the meantime avoid strenuous activity and exercises etc.