Catherine Spader, RN
What is pelvic laparoscopy?
Pelvic laparoscopy is a type of surgery that allows your doctor to see and treat organs and tissues inside your pelvis with a laparoscope. A laparoscope is a long, thin camera that is inserted through a small abdominal incision, typically ½ to 1 cm long. The camera transmits pictures of the inside of your body to a video screen viewed by your doctor as he or she performs your surgery.
Many different diseases and conditions can be treated during pelvic laparoscopy. These include uterine conditions, ovarian cysts, and appendicitis. Surgeons also perform laparoscopic tubal ligation for permanent birth control.
Pelvic laparoscopy is a type of minimally invasive surgery. This involves making small incisions instead of the larger one needed for open surgery. Surgical tools are threaded through the smaller incisions and around tissues instead of cutting through them. This generally results in quicker recovery and less pain than open surgery.
A pelvic laparoscopy is a common but major surgery with serious 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 pelvic laparoscopy.
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Other surgical procedures that may be performed
Your doctor may perform other procedures in addition to a pelvic laparoscopy. An open surgical procedure may be needed if a problem is found during laparoscopy that must be treated using open surgery. Open surgery involves making a longer incision that allows your doctor to directly view and access the surgical area.
There are many surgeries that may be performed during pelvic laparoscopy. Common procedures include:
Hysterectomy is the removal of the uterus.
Laparoscopic robotic surgery is laparoscopic surgery that is assisted by a computerized surgical robot.
Removal of abnormal tissue can include removal of a pelvic mass, scar tissue, uterine fibroids, diseased ovaries or fallopian tubes, and endometrial tissue, which is uterine tissue that grows outside the uterus.
Tissue biopsy is the removal of samples of tissue to be examined for disease or malignancy.
Tubal ligation is a form of birth control in which the fallopian tubes are closed. This is considered permanent.
Why is pelvic laparoscopy performed?
Your doctor may recommend a pelvic laparoscopy to treat certain diseases and conditions of the pelvic organs. These include the bladder, rectum, prostate, and female reproductive organs.
Your doctor may only consider pelvic laparoscopy for you if other treatment options that involve less risk of complications have been ineffective. Some conditions may require open surgery. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on a pelvic laparoscopy.
Your doctor may recommend a pelvic laparoscopy to treat:
Appendicitis, which is an inflammation and possibly infection of the appendix
Cancer of the rectum, prostate, bladder or a woman’s reproductive organs or a man’s prostate
Chronic pelvic or lower abdominal pain that is unexplained through less invasive testing or does not improve with other treatments
Ectopic pregnancy, which is a pregnancy that grows in the fallopian tube instead of in the uterus
Endometriosis, which is an abnormal growth of uterine tissue outside the uterus
Fecal or urinary incontinence. Pelvic laparoscopy is used to identify the underlying cause and treat several types of urinary incontinence as well as fecal incontinence.
Infertility. Pelvic laparoscopy may be used to diagnose and treat the underlying cause of infertility.
Ovarian cysts, which are cysts that grow on the ovaries
Ovary torsion, in which an ovary has twisted into a position that cuts off circulation to the ovary
Pelvic inflammatory disease or tubo-ovarian abscess, which is an infection of a woman’s reproductive organs, often due to a sexually transmitted disease
Rectal or vaginal prolapse, which is a dropping of the rectum or vagina out of it normal position
Uterine fibroids, which are benign tumors of the uterus
Who performs pelvic laparoscopy?
The following specialists perform pelvic laparoscopy:
Obstetrician-gynecologists specialize in medical and surgical care of women’s health and pregnancy.
General surgeons specialize in the surgical treatment of a wide variety of diseases, disorders and conditions.
Colon and rectal surgeons specialize in the surgical treatment of diseases of the small intestine, colon, rectum, and anus, as well as related conditions of the liver, urinary tract, and female reproductive system.
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 pelvic laparoscopy performed?
Your pelvic laparoscopy will be performed in a hospital or outpatient surgical setting. It involves inserting surgical instruments through small incisions in the abdomen. Other details of your surgery vary depending on your diagnosis, symptoms, and other factors. Your surgery may be either an outpatient procedure or a major surgery requiring a hospital stay.
Types of anesthesia that may be used
Laparoscopies are performed using general anesthesia. General anesthesia uses a combination of intravenous (IV) medications and gases that are used to 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 pelvic laparoscopy
The day of your surgery, you can generally expect to:
Talk with a preoperative nurse who will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and make sure that you sign the surgical consent.
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 have had anesthesia.
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 pelvic laparoscopy?
As with all surgeries, a pelvic 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
Risks and potential complications of surgery include:
Anesthesia reaction, such as an allergic reaction and problems with breathing
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 travel 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 pelvic laparoscopy
Complications of pelvic laparoscopy include:
Blood vessel damage
Development of a hernia (bulge) at the incision site
Injury to the intestines or surrounding organs
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 doctor immediately of any concerns, such as bleeding, fever, or increase in pain
Taking your medications exactly as directed
Telling all members of your care team if you have any allergies
How do I prepare for my pelvic laparoscopy?
You are an important member of your own healthcare team. The steps you take before your surgery can improve your comfort and outcome.
You can prepare for a pelvic 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.
Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific surgery. Preoperative testing may include a chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
Losing excess weight before the surgery through a healthy diet and exercise plan
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.
Questions to ask your doctor
Preparing for a pelvic laparoscopy can be stressful. It is common for patients to forget to ask about some of their concerns during a doctor’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. Questions can include:
Why do I need a pelvic 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 during the pelvic laparoscopy? Will you treat it right away with an open procedure or will I need to have another surgery later?
How long will the procedure take? When can I go home?
What restrictions will I have after the surgery? When can I return to work and other activities? When can I resume sexual activity?
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 pelvic laparoscopy?
Knowing what to expect after a pelvic laparoscopy can help you get back to your everyday life as soon as possible.
How long will it take to recover?
After the surgery, you will stay briefly in the recovery room until you are fully alert, breathing effectively, and your vital signs are stable. The length of time varies depending on your age, general health, and the type of procedure, but generally takes an hour or two. If you had an outpatient procedure, you will likely be discharged home at this point. A hospital stay is required for more major procedures.
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.
Full recovery after pelvic 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, such as a tubal ligation, you may go back to school or work in one to two days. You will generally need to avoid heavy lifting, strenuous exercise, and contact sports for about a month.
Will I feel pain?
Pain control is important for healing and a smooth recovery. There will be discomfort after your pelvic laparoscopy. Your doctor will treat your pain so you are comfortable and can get the rest you need. Call your doctor if your pain gets worse or changes because it may be a sign of a complication.
You might be 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 doctor?
It is important to keep your follow-up appointments after a pelvic laparoscopy. Contact your doctor for questions and concerns between appointments. Call your doctor 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 doctor'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 incisions
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