Laparoscopy

A laparoscopy allows your physician to look directly at your reproductive organs using an instrument called a laparoscope. This procedure is diagnostic, in that it allows the doctor to see problems that could not be seen with a pelvic exam, X-Rays, or Ultrasound. Many times the problem can also be treated during the procedure. You can usually go home the same day the procedure is performed.

What is a Laparoscope?
A laparoscope is a long, narrow tube with a fiberoptic light at one end. It is inserted into the abdomen through an incision in or under the navel. It can be maneuvered in any direction to allow views of the internal organs. Generally two other small incisions will be made below the bikini line to allow surgical instruments or a laser to be inserted into the lower abdomen.

When is the Laparoscope Used?

Adhesions
When tissues in the abdomen stick together, and this forms scar tissue, called adhesions, the laparoscope may be used. Adhesions can result from infection, previous pelvic surgery, or endometriosis. They can be a cause of pelvic pain. The tissues can be separated during a laparoscopy.

Endometriosis
Sometimes uterine tissue (endometrium) is found outside the uterus. This is called endometriosis. This tissue bleeds each month with the menstrual cycle. This can result in pelvic pain and adhesions. Endometriosis is diagnosed by laparoscopy and many times can be treated through the laparoscope.

Infertility
If a woman is having trouble conceiving, the physician may perform a laparoscopy to look for endometriosis and to look at the fallopian tubes. If the tubes are blocked, the egg and the sperm cannot meet.

Ectopic Pregnancy
An ectopic pregnancy is a pregnancy that has implanted outside of the uterus. Most of the time, it has implanted in a fallopian tube. A laparoscopy can be used to diagnose, and many times treat, an ectopic pregnancy.

Ovarian Cysts - An ovarian cyst is a pouch containing fluid or solid material attached to or around the ovary. These cysts may be painful. Often the cyst will resolve on its own, but when it doesn't, it can often be treated through the laparoscope.

Fibroids
Fibroids are tumors made up of fibrous tissue that can grow inside, outside, or within the walls of the uterus. Sometimes a laparoscope is used to diagnose fibroids.

What Happesn During a Laparoscope?
A laparoscopy is usually an "outpatient" procedure, which means that you will arrive and go home on the same day. Most of the time the procedure is performed under general anesthesia, so you will be asked not to eat or drink anything for at least 8 hours before the surgery. Sometimes a regional anesthesia can be used.

The surgeon will make a one inch incision just below or inside the navel, and then will insert a needle and inject carbon dioxide gas into the abdomen. This harmless gas will lieft the abdominal wall away from the internal organs, creating a space to allow the surgeon to see the organs. The needle will be removed and the laparoscope will be inserted into the incision. Other incisions may be made above the pubic area to allow other insruments or a laser to be inserted. Usually, the laparoscope projects the images onto a television screen. This makes the images larger and easier for the surgeon to see. Sometimes pictures are taken during the surgery or a video is made.

After the procedure is over, the instruments will be removed and the gas released. The incisions are usually closed with a few dissolvable stitches. You will be sent to the Recovery Room until you are awake and alert.

Following the surgery, it is not unusual to have some abdominal cramping or shoulder discomfort due to the carbon dioxide gas. This will gradually go away over the next few days.

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