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Laparoscopy, also known as diagnostic laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen. It’s a low-risk, minimally invasive procedure that requires only small incisions.
Laparoscopy uses an instrument called a laparoscope to look at the abdominal organs. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.
Laparoscopy allows your doctor to see inside your body in real-time, without open surgery. Your doctor also can obtain biopsy samples during this procedure.
Before this system came along, a surgeon who operated on his patient’s belly had to make a cut that was 6-to-12 inches long. That gave them enough room to see what they were doing and reach whatever they had to work on.
In laparoscopic surgery, the surgeon makes several small cuts. Usually, each one is no more than a half-inch long. (That’s why it’s sometimes called keyhole surgery.) They insert a tube through each opening, and the camera and surgical instruments go through those. Then the surgeon does the operation.
Laparoscopy is often used to identify and diagnose the source of pelvic or abdominal pain. It’s usually performed when noninvasive methods are unable to help with diagnosis.
In many cases, abdominal problems can also be diagnosed with imaging techniques such as:
Laparoscopy is performed when these tests don’t provide enough information or insight for a diagnosis. The procedure may also be used to take a biopsy, or sample of tissue, from a particular organ in the abdomen.
Your doctor may recommend a laparoscopy to examine the following organs:
By observing these areas with a laparoscope, your doctor can detect:
As well, your doctor may be able to perform an intervention to treat your condition immediately after diagnosis.
You should tell your doctor about any prescription or over-the-counter medications you’re taking. Your doctor will tell you how they should be used before and after the procedure.
Your doctor may change the dose of any medications that could affect the outcome of laparoscopy. These drugs include:
You should also tell your doctor if you’re pregnant or think you might be pregnant. This will reduce the risk of harm to your developing baby.
Before laparoscopy, your doctor may order blood tests, urinalysis, electrocardiogram (EKG or ECG), and chest X-ray. Your doctor might also perform certain imaging tests, including an ultrasound, CT scan, or MRI scan.
These tests can help your doctor better understand the abnormality being examined during laparoscopy. The results also give your doctor a visual guide to the inside of your abdomen. This can improve the effectiveness of laparoscopy.
You’ll probably need to avoid eating and drinking for at least eight hours before laparoscopy. You should also arrange for a family member or friend to drive you home after the procedure. Laparoscopy is often performed using general anesthesia, which can make you drowsy and unable to drive for several hours after surgery.
Laparoscopy is usually done as an outpatient procedure. This means that you’ll be able to go home the same day as your surgery. It may be performed in a hospital or an outpatient surgical center.
You’ll likely be given general anesthesia for this type of surgery. This means that you’ll sleep through the procedure and won’t feel any pain. To achieve general anesthesia, an intravenous (IV) line is inserted in one of your veins. Through the IV, your anesthesiologist can give you special medications and well as provide hydration with fluids.
In some cases, local anesthesia is used instead. A local anesthetic numbs the area, so even though you’ll be awake during the surgery, you won’t feel any pain.
During laparoscopy, the surgeon makes an incision below your belly button and then inserts a small tube called a cannula. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows your doctor to see your abdominal organs more clearly.
Once your abdomen is inflated, the surgeon inserts the laparoscope through the incision. The camera attached to the laparoscope displays the images on a screen, allowing your organs to be viewed in real-time.
The number and size of incisions depend upon what specific diseases your surgeon is attempting to confirm or rule out. Generally, you get from one to four incisions that are each between 1 and 2 centimeters in length. These incisions allow other instruments to be inserted. For example, your surgeon may need to use another surgical tool to perform a biopsy. During a biopsy, they take a small sample of tissue from an organ to be evaluated.
After the procedure is done, the instruments are removed. Your incisions are then closed with stitches or surgical tape. Bandages may be placed over the incisions.
When the surgery is over, you’ll be observed for several hours before you’re released from the hospital. Your vital signs, such as your breathing, and heart rate, will be monitored closely. Hospital staff will also check for any adverse reactions to the anesthesia or the procedure, as well as monitor for prolonged bleeding.
The timing of your release will vary. It depends on:
In some cases, you may have to remain in the hospital overnight.
A family member or friend will need to drive you home if you received general anesthesia. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure.
In the days following laparoscopy, you may feel moderate pain and throb in the areas where incisions were made. Any pain or discomfort should improve within a few days. Your doctor may prescribe medication to relieve the pain.
It’s also common to have shoulder pain after your procedure. The pain is usually a result of the carbon dioxide gas used to inflate your abdomen to create a working space for the surgical instruments. The gas can irritate your diaphragm, which shares nerves with your shoulder. It may also cause some bloating. The discomfort should go away within a couple of days.
You can usually resume all normal activities within a week. You’ll need to attend a follow-up appointment with your doctor about two weeks after laparoscopy.
Here are some things you can do to ensure a smoother recovery:
If a biopsy was taken, a pathologist will examine it. A pathologist is a doctor who specializes in tissue analysis. A report detailing the results will be sent to your doctor.
Normal results from laparoscopy indicate the absence of abdominal bleeding, hernias, and intestinal blockages. They also mean that all your organs are healthy.
Abnormal results from laparoscopy indicate certain conditions, including:
Your doctor will schedule an appointment with you to go over the results. If a serious medical condition was found, your doctor will discuss appropriate treatment options with you and work with you to come up with a plan for addressing that condition.