Test Overview

Laparoscopy is a surgery that uses a thin, lighted tube put through a cut
(incision) in the belly to look at the
abdominal organs or the
female pelvic organs. Laparoscopy is used to find problems such as
cysts,
adhesions,
fibroids, and infection. Tissue samples can be taken
for
biopsy through the tube (laparoscope).

In
many cases laparoscopy can be done instead of laparotomy surgery that uses a
larger incision in the belly. Laparoscopy can be less stressful and may have
less problems and lower costs than laparotomy for minor surgeries. It can often
be done without needing to stay overnight in the hospital.

Why It Is Done

Laparoscopy is done to:

  • Check for and possibly take out abnormal
    growths (such as tumors) in the belly or pelvis.
  • Check for and
    treat conditions such as
    endometriosis,
    ectopic pregnancy, or
    pelvic inflammatory disease (PID).
  • Find
    conditions that can make it hard for a woman to become pregnant. These
    conditions include cysts, adhesions,
    fibroids, and infection. Laparoscopy may be done after
    initial infertility tests do not show the cause for the
    infertility.
  • Do a biopsy.
  • See whether cancer in another
    area of the body has spread to the belly.
  • Check for damage to
    internal organs, such as the spleen, after an injury or
    accident.
  • Do a
    tubal ligation.
  • Fix a
    hiatal hernia or an
    inguinal hernia.
  • Take out organs, such as the
    uterus,
    spleen,
    gallbladder (laparoscopic cholecystectomy),
    ovaries, or
    appendix (appendectomy). Partial removal (resection)
    of the colon also can be done.
  • Find the cause of sudden or ongoing
    pelvic pain.

How To Prepare

Tell your doctor if you:

  • Have allergies to any medicines, including
    anesthesia.
  • Take a blood thinner, or if you have had bleeding problems.
  • Are or might be pregnant.

Before laparoscopy:

  • Follow the instructions exactly
    about when to stop eating and drinking, or your surgery may be canceled. If
    your doctor has instructed you to take your medicines on the day of surgery,
    please do so using only a sip of water.
  • Leave your jewelry at home. Any jewelry you wear will
    need to be taken off before the laparoscopy.
  • Remove your glasses,
    contacts, and dentures or a removable bridge before the laparoscopy. These will
    be given back to you as soon as you wake up after the
    surgery.
  • Arrange for someone to drive you home after the
    laparoscopy.

You may be asked to use an
enema or suppository several hours before or the day before the
surgery to empty your colon.

The hospital or surgery center may
send you instructions on how to get ready for your laparoscopy or a nurse may
call you with instructions before your surgery.

You will be asked to sign a consent
form that says you understand the risks of the test and agree to have it done.

Talk to your doctor about any concerns you have
about the need for the surgery, its risks, how it will be done, or what the
results will mean. To help you
understand the importance of this test, fill out the
medical test information form (What is a PDF document?).

How It Is Done

Laparoscopy is done by a
surgeon or a doctor of women’s health (gynecologist).
General anesthesia is generally used, but other types
of anesthesia, such as
spinal anesthesia, may be used. Talk with your doctor
about what choice is best for you.

About an hour before the
surgery, you will empty your bladder. You will get fluids and medicine through
an
intravenous (IV) in a vein in your arm. You may get a
medicine (sedative) to help you relax.

Several
procedures may be done after you get your anesthesia and are relaxed or
asleep.

  • An airway will be placed in your throat to help
    you breathe if you get general anesthesia.
  • A thin flexible tube
    (urinary catheter) may be put through your
    urethra into the bladder.
  • Some of your
    pubic hair may be shaved.
  • Your belly and pelvic area will be washed
    with a special soap.
  • For women, your doctor may do a
    pelvic exam before putting a thin tube (cannula)
    through your vagina into the uterus. The cannula lets your doctor move your
    uterus and ovaries to get a better look at the belly organs.

During laparoscopy, a small incision is made in the belly.
More than one incision may be made if other tools will be used during the
surgery. A hollow needle is put through the first incision and gas (carbon
dioxide or nitrous oxide) is slowly put through the needle to inflate the
belly. The gas lifts the abdominal wall away from the organs inside so your
doctor can see clearly.

A thin, lighted tube (laparoscope) is then
put through the incision to look at the organs. Other tools can be used to take
tissue samples, fix damage, or drain cysts. A laser may be attached to the
laparoscope to help with the surgery.

After the surgery, all the
tools will be removed and the gas will be released. The incisions will be
closed with stitches and covered with a bandage. The scar will be very small
and will fade over time.

Laparoscopy takes 30 to 90 minutes,
depending on what is done, but can take longer if a condition (such as
endometriosis) is found and treated. After the laparoscopy, you will go to the
recovery room for 2 to 4 hours. You can usually do your normal activities the
next day, but do not do any strenuous activity or exercise for about a
week.

How It Feels

If general anesthesia is used, you will
be asleep and feel nothing. After you wake up, you will feel sleepy for several
hours. You may be tired and have some pain for a few days after a laparoscopy.
You may have a mild sore throat from the tube in your throat to help you
breathe. Use throat lozenges and gargle with warm salt water to help your sore
throat.

If you have other types of anesthesia, you may have pain
for a few days when the initial numbness wears off.

Risks

There is a small chance for problems from a
laparoscopy.

  • Bleeding from the
    incisions
  • Infection
  • Damage to an organ or blood vessel.
    This may cause more bleeding that needs another surgery to repair.

A laparoscopy may not be done because of a higher chance
for problems if you have:

  • Abdominal cancer.
  • An abdominal
    hernia.
  • Had abdominal surgeries in the past.

After the surgery

Right after surgery, you will be
taken to a recovery room where nurses will care for and watch your vital signs
(temperature, blood pressure, oxygen level, and heart rate). You will stay in
the recovery area for 2 to 4 hours, and then you will go home. Your nurse will
explain any special instructions from your doctor. You will probably go home
with a sheet of care instructions and who to call if you have a problem.

You may have some bloating. There may be bruising around the incisions
for a few days. You may have some pain around the incisions. Do not drink
carbonated beverages for 1 to 2 days after the laparoscopy to lower your chance
of gas pains and vomiting.

The gas used during the laparoscopy
can irritate your
diaphragm for a few days. You may have some pain or
achiness in your shoulder for a couple of days after the laparoscopy.

Some of the gas in your belly may leak into your skin and cause a
crackling sound if you rub the skin surrounding the stitches. This is not
serious and will go away in a few days.

Call your doctor
immediately if you have:

  • A large area of redness or swelling around
    the incisions.
  • Bleeding or drainage from the
    stitches.
  • Fever.
  • Severe belly
    pain.
  • Hoarseness in your voice that lasts more than a few days or
    gets worse.

Results

Laparoscopy is a surgery that uses a
thin, lighted tube put through a cut (incision) in the belly to look at the
abdominal organs or the
female pelvic organs. Your doctor may talk to you about the surgery once you
are fully awake. He or she may call you at home later to talk to you about the
results. Results of any lab tests on tissue samples may not be available for
several days.

Laparoscopy

Normal:

The organs are normal in size,
shape, and position.

Adhesions,
cysts, or abnormal growths, such as tumors, are not seen.

No signs of disease (such as
endometriosis), inflammation (such as appendicitis),
or infection are seen.

Abnormal:

An organ may be abnormal in
size, shape, or position.

Adhesions, cysts, or abnormal
growths, such as tumors, may be seen.

Signs of disease, such as
endometriosis, or infection may be seen.

An
ectopic pregnancy may be present.

Inflammation of an internal
organ may be present, such as
appendicitis,
cholecystitis, or
pelvic inflammatory disease (PID).

Scar tissue may be seen on an
internal organ, such as the
fallopian tubes.

What Affects the Test

Reasons you may not be able to
have the surgery or why the results may not be helpful include:

  • If you are obese, which may make the
    laparoscopy harder to do.
  • If you have scar tissue from another
    surgery or an injury.
  • If a tissue sample is taken for a biopsy, but
    the results are not clear about what the problem is.

What To Think About

  • People who are obese or who have had other
    belly surgeries may need to have a larger incision in the belly for the
    surgery. This is called open laparoscopy.

References

Other Works Consulted

  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

Credits

ByHealthwise Staff
Primary Medical Reviewer Sarah Marshall, MD – Family Medicine
Martin J. Gabica, MD – Family Medicine
E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer Deborah A. Penava, BA, MD, FRCSC, MPH – Obstetrics and Gynecology

Current as ofOctober 6, 2017