Laparoscopy

Laparoscopy is a type of surgical procedure that allows a doctor to observe awoman's uterus, ovaries and fallopian tube. It is often used to detect ovarian cysts, scar tissue, and diagnose pelvic or abdominal pain, endometriosis,ectopic pregnancy, or blocked fallopian tubes.

Laparoscopies are usually done as an outpatient procedure under general anesthesia. The viewing tube (called the laparoscope)--which is equipped with a small camera on the eyepiece--is inserted through a small incision in the navel. The doctor can then examine the abdominal and pelvic organs on a video monitor connected to the tube. Other small incisions can be made to insert instruments to perform a variety of procedures. Laparoscopy is less invasive than regular open abdominal surgery (laparotomy).

Laparoscopy was first used by gynecologists to diagnose and treat conditionsrelating to the female reproductive organs: uterus, fallopian tubes, and ovaries. It is now used for a wider range of procedures, including operations that in the past required open surgery, such as removal of the appendix (appendectomy) or as an important tool in trying to find out the cause of infertility. Laparoscopy can also be used to examine the appendix, gallbladder, or liver.

Laparoscopy is also used during surgery for female sterilization (tubal ligation), some vaginal hysterectomies, for the treatment of ectopic pregnancy orendometriosis, and to collect eggs for in vitro fertilization. It also is a useful technique for taking a biopsy, aspirating a cyst, or locating and removing an intrauterine device (IUD) that has perforated the uterus.

Laparoscopy also can be used as an alternative to surgery for some non-gynecologic operations, such as removal of the appendix, gallstones, or gallbladder.

While many of these procedures can be done using regular open surgery, laparoscopy usually involves less pain, less risk, less scarring, and faster recovery. Because laparoscopy is so much less invasive than traditional abdominal surgery, patients can leave the hospital sooner.

Laparoscopy is a surgical procedure that is usually done in the hospital on an outpatient basis. After the patient is anesthetized, a hollow needle is inserted into the abdomen in or near the navel so that carbon dioxide gas can bepumped through the needle to expand the abdomen. This allows the surgeon a better view of the internal organs. The laparoscope is then inserted through this incision. The image from the camera attached to the end of laparoscope can be seen on a video monitor.

Sometimes, other small incisions are made to insert other instruments which are used to lift internal organs for examination or to perform surgical procedures.

One of the most common reasons for having diagnostic laparoscopy is to discover the cause of infertility. A laparoscopy can be used to uncover the reasonsfor infertility, such as physical problems or disease. Laparoscopy is also often used to discover the source of pelvic pain. There are many possible causes of pelvic pain that can be diagnosed with this technique, such as endometriosis, ovarian cysts, ectopic pregnancy, pelvic inflammatory disease (PID), and uterine abnormalities.

Patients should not eat or drink after midnight on the night before the procedure; afterwards, patients may leave the hospital within four to eight hours.(Traditional abdominal surgery requires a hospital stay of four days).

There may be some slight pain or throbbing at the incision sites in the firstday or so after the procedure. The gas that is used to expand the abdomen may cause discomfort under the ribs or in the shoulder for a few days. Depending on the reason for the laparoscopy in gynecological procedures, some women may experience some vaginal bleeding.

Many patients can return to work within a day or so after having this type ofprocedure. The risk of complications is less than 0.5%. The procedure carries a slight risk of puncturing an organ, which could cause blood to seep intothe abdominal cavity. Puncturing the intestines could allow intestinal contents to seep into the cavity. These are serious complications and major surgerymay be required to correct the problem.

In rare cases, one of the following complications may occur:

  • Hemorrhage
  • Inflammation of the abdominal cavity lining
  • Abscess
  • Problems related to general anesthesia.

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