Laparoscopy
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What is the
test?
Laparoscopy is a surgery that allows your doctor
to see and operate on the organs inside your
pelvis and abdomen through very small incisions
in the abdominal wall. Many types of abdominal
surgery can be done with laparoscopy, including
diagnosis and treatment of infertility or pelvic
pain, gallbladder or appendix removal, and tubal
ligation for preventing pregnancies.
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How
do I prepare for the test?
Discuss the specific procedures planned during
your laparoscopy ahead of time with your doctor.
Laparoscopy is done by either a surgeon or a
gynecologist-obstetrician. You will need to sign
a consent form giving your doctor permission
to perform this test.
If you take aspirin, nonsteroidal anti-inflammatory
drugs, or other medicines that affect blood clotting,
talk with your doctor. It may be necessary to
stop or adjust the dose of these medicines before
your test.
You will be told not to eat anything for at
least eight hours before the surgery. An empty
stomach will help prevent the nausea that can
be a side effect of anesthesia medicines. You
should arrange for a ride home from the hospital
if your doctor plans on sending you home on the
same day.
Before the surgery (sometimes on the same day),
you will meet with an anesthesiologist to go
over your medical history (including medicines
and allergies) and to discuss the anesthesia.
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What
happens when the test is performed?
Laparoscopy is done in an operating room. You
wear a hospital gown. You have an IV (intravenous)
line placed in your arm so that you can receive
medicines through it.
You have general anesthesia for this test, which
puts you to sleep so you are unconscious during
the procedure. For general anesthesia, you breathe
a mixture of gases through a mask. After the
anesthetic takes effect, a tube may be put down
your throat to help you breathe.
During laparoscopy, a tiny camera is inserted
through a very small incision (less than an inch
long), usually in or just below your navel. A
gas such as carbon dioxide or nitrous oxide is
pumped into your abdomen to help lift your abdominal
wall off of your pelvic and abdominal organs
so that the camera can view them clearly. If
you are having any procedure more complicated
than inspection of the pelvis or abdomen, your
doctor makes one or more additional incisions
to allow other instruments to reach into your
abdomen. For pelvic surgeries, it is common for
the additional incision to be just below the
pubic hair line. You should ask your surgeon
where you might expect to have incisions as part
of your laparoscopy.
A wide variety of instruments are useful in
laparoscopy. These include instruments that can
cut and place clips onto internal structures,
burn away scar tissue or painful areas in the
pelvis, or remove small biopsy samples or even
whole internal organs (often in pieces so that
larger incisions are not necessary). Your doctor
can see the work he or she is doing by watching
a television screen.
At the end of the surgery, the instruments are
withdrawn, the gas is removed, and the incisions
are stitched closed. Your anesthesia is stopped
so that you can wake up within a few minutes
after your laparoscopy is finished.
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What
risks are there from the test?
It is easier for patients to recover from laparoscopy
compared with regular abdominal surgery (often
called "open" surgery) because the wounds from
the incisions are so small. You will have a small
straight scar (less than an inch long) wherever
the instruments were inserted.
Sometimes a small amount of the gas used to
expand the abdomen will remain after the surgery
for a day or two, before it dissolves away. This
can cause some shoulder pain. Depending on the
type of operation your laparoscopy involved,
you might also have some cramping in the pelvis
or abdomen. Some laparoscopy procedures in the
pelvis normally cause a small amount of bleeding
through the vagina. Some patients experience
some nausea from the medicines used for anesthesia
or anxiety.
General anesthesia is safe for most patients,
but it is estimated to result in major or minor
complications in 3%-10% of people having surgery
of all types. These complications are mostly
heart and lung problems and infections. For laparoscopy,
the risk of complications from anesthesia are
smaller than average, because most surgeries
done with laparoscopy are fairly simple and do
not require you to have anesthesia for much longer
than an hour.
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Must
I do anything special after the test is over?
You will be watched for a few hours after your
surgery to make sure that you are recovering
well. You may be asked to sit up and drink liquids.
For many laparoscopic procedures, you can go
home the same day. You should not drive or drink
alcohol the day of your test.
You should contact your doctor if you develop
a fever over 101° F, strong pain, or bleeding
from the vagina that is heavier than expected.
You will have a follow-up visit with your doctor
to remove stitches if needed and to make sure
you are recovering well.
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How
long is it before the result of the test is
known?
If your laparoscopy was done to look for a cause
of pain or other diagnosis, your doctor can tell
you right after the surgery what was seen during
the test. If a biopsy sample is removed, you
may have to wait several days for the report.
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