Catherine Spader, RN
What is laparoscopy?
Laparoscopy is a surgical technique that allows your surgeon to diagnose and treat many diseases and conditions of the chest, abdomen and pelvis with a laparoscope. A laparoscope is a long, thin camera that transmits pictures of the inside of your body to a video screen viewed by the surgeon. It is inserted through a small incision, typically ½ to 1 cm long. Special surgical tools are inserted through the laparoscope or through other small incisions.
Laparoscopy, also known as laparoscopic surgery, is a type of minimally invasive surgery. This involves making small incisions instead of the large one needed for open surgery. In laparoscopy, surgical tools are threaded through the smaller incisions and around tissues instead of cutting through them. This generally results in a quicker recovery and less pain than open surgery.
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Laparoscopy still has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having a laparoscopy.
Other surgical procedures that may be performed
Your surgeon may perform a biopsy during laparoscopy. A biopsy is the removal of a sample of cells or tissue to test for cancer and other diseases.
You may need open surgery if your surgeon finds an extensive or unexpected problem during laparoscopic surgery. Open surgery is performed by making a longer incision that allows your surgeon to directly view and access the surgical area.
Why is laparoscopy performed?
Your surgeon may recommend laparoscopy to treat diseases and conditions of the chest, abdomen, and pelvis. Your surgeon may only consider a laparoscopy for you if other treatment options that involve less risk of complications have been ineffective. Ask your surgeon about all of your treatment options and consider getting a second opinion before deciding on a laparoscopy.
Your surgeon may recommend a laparoscopy to treat:
Abdominal pain if the underlying cause has not been found through less invasive testing
Endocrine conditions, such as sickle cell disease, lymphoma, leukemia, and pancreatic pseudocyst, tumors or necrosis
Female reproductive system conditions, such as uterine fibroids, endometriosis, ovarian cysts, ectopic pregnancy, pelvic inflammatory disease, infertility, birth control, chronic pelvic pain, and tumors or cancer of the reproductive organs
Hernia, which is when an organ, such as the intestines, bulges or protrudes through a weakness in the muscle
Intestinal conditions, such as appendicitis, colon cancer, diverticulitis, fecal incontinence, rectal prolapse, and inflammatory bowel disease (includes Crohn’s disease and ulcerative colitis)
Liver and gallbladder conditions, such as bile duct injury, liver cancer, gallstones, and cholecystitis (inflammation of the gallbladder)
Lung conditions, such as malignant pleural effusion, recurrent pneumothorax, and lung cancer
Stomach and esophagus conditions, such as gastroesophageal reflux disease (GERD), paraesophageal hernia, or tumors
Trauma, to evaluate the abdomen or chest when injury is suspected to internal organs
Urinary tract conditions, such as prostate cancer, kidney cysts, large ureteral stone, female urinary incontinence, vaginal prolapse, bladder cancer, and kidney cancer
Vascular conditions, such as abdominal aortic aneurysm and blocked arteries
Who performs laparoscopy?
The following specialists perform laparoscopy:
General surgeons and pediatric surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions. Pediatric surgeons further specialize in surgery for infants, children and adolescents.
Obstetrician-gynecologists specialize in women’s health and pregnancy.
Colon and rectal surgeons specialize in the surgical treatment of diseases of the small intestine, colon, rectum, and anus, as well as intestine-related conditions of the liver, urinary tract, and female reproductive system. Colon and rectal surgeons are sometimes called proctologists.
Urologists and pediatric urologists specialize in diseases and conditions of the urinary tract and the male reproductive organs. Pediatric urologists further specialize in treating infants, children and adolescents.
Female pelvic medicine and reconstructive surgeons are urologists or gynecologists who have completed specialized training in women’s pelvic floor disorders.
How is laparoscopy performed?
Your laparoscopy will be performed in a hospital or outpatient setting. Your surgeon will insert the laparoscope through a small incision (cut). More than one incision may be needed to see the surgical area and insert additional instruments.
Laparoscopy is a minimally invasive surgery because only one or few small incisions are made instead of a large incision made in a traditional open surgery. Minimally invasive techniques are sometimes combined with open procedures.
Your surgeon may decide after beginning a minimally invasive technique that you require an open surgery to safely and most effectively complete your surgery.
Types of anesthesia that may be used
Laparoscopy is generally completed using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain.
What to expect the day of your laparoscopy
The day of your surgery, you can generally expect the following:
Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will have.
A surgical team member will start an IV.
The anesthesiologist or nurse anesthetist will start your anesthesia.
A tube will be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
A urinary catheter may be inserted after you are asleep.
The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and during your recovery until you are alert, breathing effectively, and all vital signs are stable.
What are the risks and potential complications of a laparoscopy?
As with all surgeries, a laparoscopy involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.
General risks of surgery
The general risks of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
Bleeding or hemorrhage (heavy bleeding), which can lead to shock
Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can move to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
Infection and septicemia, which is the spread of a local infection to the blood
Potential complications of laparoscopy
Complications of a laparoscopy vary depending on the procedure. General complications include:
Blood vessel damage
Development of a hernia (bulge) at the incision site
Reducing your risk of complications
You can reduce the risk of certain complications by following your treatment plan and:
Following activity, dietary and lifestyle restrictions and recommendations before your procedure and during recovery
Notifying your surgeon immediately of any concerns, such as bleeding, fever, or increase in pain
Participating fully in physical therapy, occupational therapy, and other forms of rehabilitation as recommended by your surgeon.
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my laparoscopy?
You are an important member of your own healthcare team. The steps you take before your procedure can improve your comfort and outcome.
You can prepare for a laparoscopy by:
Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
Completely following all preoperative instructions for specific procedures, such as not eating or drinking before a procedure
Ensuring that your surgeon and care team know if you are nursing or if there is any chance of pregnancy
Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners. Your surgeon will give you instructions for taking your medications and supplements.
Questions to ask your surgeon
Preparing for a laparoscopy can be stressful. It is common for patients to forget some of their questions during a brief surgeon’s office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
It is also a good idea to bring a list of questions to your appointments. Common questions include:
Why do I need a laparoscopy? Are there any other options for diagnosing or treating my condition?
What will happen if you find a condition during the procedure that cannot be treated with laparoscopy? Will you treat it right away with open surgery or will I need another surgery later?
How long will surgery take? When can I go home?
What restrictions will I have after the surgery/ When can I return to work and other activities?
What kind of assistance will I need at home? Will I need a ride home?
How should I take my medications?
How will you treat my pain?
When should I follow up with you?
How should I contact you? Ask for numbers to call during and after regular hours.
What can I expect after my laparoscopy?
Knowing what to expect after a laparoscopy can help you get back to your everyday life as soon as possible.
How long will it take to recover?
You will stay in the recovery room after surgery until you are alert, breathing effectively, and your vital signs are stable. The length of time varies, but generally takes an hour or two. You may have a sore throat if a tube was placed in your windpipe during surgery. This is usually temporary, but tell your care team if you are uncomfortable
If you had an outpatient procedure, you will be discharged home at this point. For more major procedures, a hospital stay is required.
Full recovery after laparoscopy is a gradual process. Recovery time varies depending on the procedure, type of anesthesia, your general health, age, and other factors. For more minor procedures, you may go back to school or work in as little as one to two days. You will generally need to avoid heavy lifting, exercise, and contact sports for a longer period of time.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your laparoscopy. Your surgeon will treat your pain so you are comfortable and can get the rest you need. Call your surgeon if your pain gets worse or changes because it may be a sign of a complication.
You might feel drowsy if you have narcotic pain medications. You should not drive while you are taking narcotics. General anesthesia can also cause drowsiness for a day or so. You may also have some nausea. Tell a care team member if you are nauseated so it can be treated.
When should I call my surgeon?
It is important to keep your follow-up appointments after a laparoscopy. Contact your surgeon for questions and concerns between appointments. Call your surgeon right away or seek immediate medical care if you have:
Breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing
Change in alertness, such as passing out, unresponsiveness, or confusion
Chest pain, chest tightness, chest pressure, or palpitations
Fever. A low-grade fever (lower than 101 degrees Fahrenheit) is common for a couple of days after a major laparoscopic surgery and not necessarily a sign of a surgical infection. However, you should follow your surgeon's specific instructions about when to call for a fever.
Inability to urinate or have a bowel movement
Leg pain, redness or swelling, especially in the calf, which may indicate a blood clot
Pain that is not controlled by your pain medication
Sore throat or hoarseness that lasts longer than expected
Unexpected drainage, pus, redness or swelling of your incision
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