Laparoscopy investigation and treatment

What is laparoscopy?

A gynaecological laparoscopy is an examination of your reproductive organs (the fallopian tubes, the ovaries and the womb) using a narrow, tube-like telescope called a laparoscope. The instrument is inserted through small cuts on your abdomen.

Laparoscopes measure about 5 to 10mm in diameter and have a light and camera lens attached to the tip. The camera lens sends pictures of your internal organs to a video screen. Your surgeon will view these to find out what is causing your gynaecological symptoms (diagnostic laparoscopy).

The technique can also be used to perform certain operations (operative laparoscopy), such as ovarian biopsies, removal of ovarian cysts, treatment for endometriosis or ectopic pregnancy.

Laparoscopy treatment is normally carried out as a day-case procedure, requiring no overnight stay, and is usually performed under general anaesthesia. This means you will be asleep during the procedure.

Your doctor will explain the benefits and risks of having a gynaecological laparoscopy investigation, and will also discuss the alternatives to the procedure.

About the operation

Your surgeon will make one or two small cuts on the skin, above, or just below, your belly button (navel). Using a hollow needle, carbon dioxide gas is pumped into the abdomen. This creates more room for your surgeon to work in and makes it easier to see the internal organs.

The laparoscope is then inserted into the cut. Your surgeon will examine the internal organs by looking directly through the laparoscope, or at pictures it sends to a video screen.

Another instrument may be inserted through a second cut. This instrument is used to move internal structures so that your surgeon can see around them.

If any laparoscopy treatment or surgery is performed (operative laparoscopy), additional small cuts are made in order to insert the necessary instruments.

Afterwards, the instruments are removed and the gas is allowed to escape through the laparoscope. The skin cuts are closed with two or three dissolvable stitches.

A laparoscopic procedure can last from 30 minutes to over an hour, depending on what the surgeon needs to do.

After the procedure, you are likely to feel some pain in the abdomen as well as “referred pain” in the tips of your shoulders – caused by the gas used to inflate the abdomen. This usually disappears within 48 hours or so. You may have some abdominal bruising, which usually settles without treatment.

Gynaecological laparoscopy is commonly performed and generally safe. For most women, the benefits in terms of improved symptoms, or from having a clear diagnosis, are much greater than any disadvantages. However, all surgery carries an element of risk.

Specific complications of laparoscopy are uncommon but can include accidental damage to other organs in the abdomen (such as the bowel, bladder or major blood vessels) requiring further surgery to repair the damage. In extremely rare cases, these complications can be fatal.

Very rarely, the womb is perforated or damaged during the laparoscopy. This can lead to bleeding and infection, and may require further surgery or, in very few cases, a hysterectomy.

Your surgeon will be experienced at performing laparoscopies, but even so, occasionally a laparoscopy is not completed successfully and may need to be repeated.

The chance of complications depends on the exact type of operation you are having and other factors such as your general health. Ask your surgeon to explain in more detail how any risks apply to you.

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