Laparoscopic Surgery - Procedure, Benefits and Recovery

Laparoscopy is a surgical method that allows your surgeon to examine the organs inside your abdominal and pelvic region. It is a minimally invasive procedure that has minimal incisions or cuts, shorter hospital stays, and smaller scars and helps in faster recovery. 

1. Shorter hospital stay.
2. Fewer internal scars.
3. Smaller external scars.
4. Scars heal faster.
5. Less pain.
6. Quicker return to activities.

Who Needs Laparoscopy?

Your gynaecologist (a doctor specialising in the reproductive health of women) or surgeon may suggest laparoscopy when an X-ray, computed tomography (CT) scan, ultrasound scan , magnetic resonance imaging (MRI) scan, or physical examination does not give clear results.

Why Is Laparoscopy Done?

Laparoscopy is done to check the following in the abdomen:

1. Abdominal injuries and internal bleeding
2. Blockages in the fallopian tubes
3. Unexplained abdominal or pelvic pain 
4. Painful swelling in the appendix (a small pouch that is connected to your intestine)
5. Ectopic pregnancy (a pregnancy that develops exterior to the womb)
6. Fallopian tubes
7. Cysts in the ovary
8. Fibroids (non-cancerous tumours of the uterus)
9. Infections including bacterial infection of the upper genital tract in females
10. A condition where men are born without one or both testicles in the scrotum
11. Cancer in the gallbladder, bile duct, liver, pancreas, or ovary
12. Other than checking the abdominal or pelvic organs, laparoscopy is also used to:
13. Remove gallbladder, a section of intestine, swollen appendix, or fibroids
14. Repair hernia or bleeding or burst ulcers in the stomach
15. Do biopsy (a process to remove a small sample of tissue for testing)
16. Remove a part of or entire organ such as the colon, liver, kidney, bladder, prostate, or ovaries that are affected by cancer[8] 
17. Treat endometriosis (a condition where a tissue that lines the uterus grows outside the uterus)
18. Tie fallopian tubes to prevent future pregnancies
19. Treat ectopic pregnancy (pregnancy that occurs outside the uterus)
20. Check problems associated with the urinary system

Procedure Description

1. For performing laparoscopy, the surgeon uses an instrument called a laparoscope. A laparoscope consists of a small tube with a camera and light source that helps observe images within your abdomen or pelvis. The surgeon observes these images on a television monitor.
2. After you are anaesthetised, the surgeon will perform laparoscopy in the following steps:
3. Make a small cut (1-1.5 cm) just below your belly button and a few more cuts at your pubic hairline to use other surgical tools (if laparoscopy is performed to treat any condition).
4. Insert a tube and pump carbon dioxide inside your abdomen. Carbon dioxide will swell up your abdominal area and make it easy for the surgeon to observe your internal body parts.
5. Insert a laparoscope through the tube and observe the internal body parts with the help of images relayed by the laparoscope on the television.
6. Remove the laparoscope, carbon dioxide, and other surgical tools.
7. Close the surgery site using stitches, clips, surgical staples, or tape.
8. Apply a sterile bandage, adhesive strips, or dressing.
9. If laparoscopy is performed only to observe your internal body parts and diagnose a condition, the procedure will be completed in 30-60 minutes. However, if laparoscopy is performed to remove an organ or treat any conditions, the surgery time will be longer.

What to Expect Before Surgery?

1. Ask you to stop consuming medications that cause blood thinning to prevent too much bleeding during surgery[3,12]
2. Suggest using an oral laxative (stool softener) so that your bowels are empty during the surgery[3]
3. Ask you to stomoking as it delays healing after surgery and increases complications (e.g., infection)[12]
4. Ask you to remove the piercing near your belly button (if any)
5. Ask you to wear loose-fitting clothes and low-heeled shoes on the day of surgery
6. For laparoscopy, your anaesthesiologist will suggest general anaesthesia. General anaesthesia is a medication that makes you unconscious during the surgery so that you do not feel any pain.

What to Expect on the Day of Surgery?

1. On the day of your laparoscopy surgery, you will meet someone from the healthcare team who:
2. May administer an enema in your large intestine and rectum that will help to clean your bowels before the surgery
3. May give you an antibiotic medication[3]
4. Carbon dioxide gas will be inserted into the abdomen to swell it up and make it easier for the surgeon to see organs and other structures.[3,12]

What to Expect During Surgery?

1. The healthcare staff will insert a tube called a urinary catheter that will remove your urine.[3]
2. Position during Surgery:
3. For laparoscopy, you will be kept in a slightly tilted position where your head will be at a lower angle than your feet.[5]
4. Cleaning and draping:
5. A sterile or antiseptic solution will be used to clean your surgical site [3]
6. Other than your surgical site, the rest of your body will be draped to reduce the risk of infection.[13]
7. While under anaesthesia, your anaesthesiologist will constantly check your breathing, amount of oxygen in your blood, heart rate, and blood pressure.[3]