When performed for diagnostic purposes only, this is a simple operation, allowing the immediate examination of the internal genital organs (ovaries, uterus, fallopian tubes) as well as of the intestine, the gull bladder etc.
Laparoscopy is performed under general anesthesia. The laparoscope goes through a small incision (of about 0.5cm) under the belly button. The laparoscope is a special small camera that provides a clear picture of the internal organs, so that the doctor can identify possible problems. It also allows for the doctor to decide whether any further surgery is needed and to shape the best strategy, in order to deal with the problem, in general.
Laparoscopy is particularly useful for treating conditions that cause infertility, such as endometriosis adhesions (internal scars from previous surgery or infection), ovarian cysts, fibroids, ectopic pregnancy etc. Only laparoscopy can provide the definite diagnosis for all of the above clinical situations, while non-invasive tests (sonogram, salpingogram etc) can only indicate the possible diagnosis.
Laparoscopy should not be performed in case of the following contra-indications:
• Cardiovascular, respiratory or haemopoetic disease
• Large masses in the pelvis
• Extended internal bleeding
Before the surgery
Three days before the surgery you should follow a special diet. You should avoid fibers (that cause bloating), carbohydrates (potatoes, pasta, bread), beans, fruits and dairy products. The ideal diet includes proteins (red or white meat) and salads (green salad or boiled vegetables) or soup. You may have coffee or tea or other refreshments. The night before the surgery, you should not eat or drink anything past midnight. If you take any medication, you might have to stop taking it before the surgery; please check with your doctor.
The day before the surgery you should rest. You should take a mild laxative, so that the bowel is empty. In this way, the surgery will be easier and safer. Take ‘X-prep’ (half a bottle around noon) which acts 2-10 hours later.
On the day of the surgery, in the morning, you will undergo the standard pre-operative checkup that includes blood tests, a cardiogram and a chest X-ray.
After the surgery
In order to recover swiftly, the woman should get out of bed as soon as possible. Post-operative recovery following a laparoscopic procedure does not take long. Any pain the woman might feel is mild because the incisions are small (1-4 incisions, 5-10mm). It shouldn’t take long for the woman to get out of bed.
A usual symptom is a ‘disturbance’ (mild pain) in the chest, the back or the shoulder blade. This is caused by the gas (CO2) used to inflate the abdomen during laparoscopy. This might persist for 2-3 days. A simple painkiller should be sufficient.
Another symptom due to the gas is bloating, which might persist for3-5 days. Bloating does not affect post-operative recovery. You might also have fever (3-5 days) or some vaginal bleeding due to the procedure. All the above are to be expected and do not affect the outcome of the surgery or the post-operative recovery.
While you are in hospital, you will be taking antibiotics through an intravenous line for the 1st day. On the 2nd day this can be replaced by tablets, which you should continue taking for 4-7 days (depending on how the surgery went).
The stitches are to be removed 7-10 days after the operation (if they are not absorbed).
Having laparoscopy means you should take some days off work. After 3-4 days you should be able to return to your everyday life and your work. In case of a diagnostic laparoscopy, you may start having intercourse again as soon as you feel up to it (provided there is no vaginal discharge). In case of an operative laparoscopy, you should wait 7-14 days.
Possible complications include trauma to a vessel or an organ in the pelvis (such as the intestine or the bladder). Serious complications are rare (1 or 2 in every 1.000 procedures).