Laparoscopy

March 17 20:15 2019 Print This Article

Exadtination of the abdominal and pelvic organs using a viewing instrument called a laparoscope. Laparoscopy is used to detect tumours and cysts, to investigate subfertility, and to diagnose ectopic pregnancy (pregnancy developing outside the uterus). It is also helpful in diagnosis of other causes of pelvic pain and other abdominal and pelvic symptoms

Laparoscopy is a hospital procedure (often with day-only admission) carried out in the operating theatre with local, spinal or general anaesthesia. A small incision is made in the abdominal wall just below the navel. A needle is inserted, and carbon dioxide is introduced through it into the abdominal cavity. The gas pushes the intestines aside to create a space for better viewing and safer manipulation of the laparoscope. The needle is withdrawn and the laparoscope inserted and angled in all directions to obtain a clear view of organs.

BIOPSY specimens may be obtained and some surgical procedures, such as tubal sterilisation, separation of adhesions, removal of small areas of abnormal tissue, and some minimal access (‘key-hole’) surgery, may be performed through the laparoscope. The procedure generally takes 30 to 45 minutes. If treatment is carried out a second metal tube, through which instruments or a second light can be passed, is usually inserted through a separate incision. After the laparoscope and tube have been removed, most of the gas is allowed to escape from the abdomen and the incisions are closed wiith a stitch or two. There may be some abdominal distension and mild crampy pain for a day or so until all the remaining gas is absorbed.

Laparoscopy is considered to be a very safe pro-cedure. Rare possible complications include bleeding infection, or damage to an organ.

Laparoscopy can be less risky, less stressful, and less costly than laparotomy and can often be done without requiring an overnight stay in the hospital. Laparoscopy results in relatively little pain, and a quick recovery for most patients. Patients sometimes experience aches in the shoulders or chest. Laparoscopy comes from two Greek words. The first is lapara, which means “the soft parts of the body between the rib margins and hips,” or, more simply, the “flank or loin.” The other Greek root is skopein, which means “to see or view or examine.” Laparoscopic surgery is becoming increasingly popular with patients because the scars are smaller and their period of recovery is shorter. The risks of laparoscopy include accidental damage to the bowel or blood vessels within the abdomen or pelvis. Sometimes laparoscopy is performed if a previous test, such as an x-ray or scan, has found a problem in the abdomen or pelvis.

What the risks are?

  • There is a risk of puncturing an organ, which could cause leakage of intestinal contents, or bleeding into the abdominal cavity.
  • Problems with the medication and anaesthetic given can arise.
  • A blood clot could form in your pelvis or leg and possibly cause a pulmonary embolism.
  • The abdomen may become irritated or infected.
  • Severe injury may result in infection or the need for blood transfusion.

How to prepare for the test?

  • You cannot have any food or fluid for 8 hours before the test. An empty stomach will help prevent the nausea that can be a side effect of anesthesia medicines.
  • You will need to sign a consent form giving your doctor permission to perform this test.
  • Before the surgery, you will meet with an anesthesiologist to go over your medical history and to discuss the anesthesia.
  • Shower or bathe the night or morning before the operation.

Why the test is performed?

  • Most laparoscopies are performed as part of the investigation of abdominal or pelvic pain.
  • The most common illnesses diagnosed through laparoscopy are endometriosis, pelvic inflammatory disease, ectopic pregnanc, ovarian cysts and appendicitis.
  • Laparoscopic surgery is becoming increasingly popular with patients because the scars are smaller and their period of recovery is shorter.
  • Pelvic inflammatory disease.
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