Laparoscopy

To diagnose certain problems, a doctor needs to look directly into the abdomen and at the reproductive organs. This can be done with laparoscopy.

The word laparoscopy comes from the Greek words that mean “look into the abdomen.” A laparoscope is a small telescope that is inserted into the abdomen through a small incision (cut). It brings light into the abdomen so the doctor can see inside.

Uses of Laparoscopy
There are several reasons why laparoscopy may be recommended. Laparoscopy may be used if you have problems with infertility or if you want to be sterilized. It is also used to check for ectopic pregnancy, causes of pelvic pain and masses.

Diagnosis and Surgery
Laparoscopy is often used to diagnose causes of abdominal pain. If the doctor finds that he or she can treat the condition during the procedure, diagnostic laparoscopy can turn into operative laparoscopy. This procedure is used to treat many health problems.

Endometriosis. Tissue like endometrium (the lining of the uterus) sometimes grows in places outside of the uterus. One way to be certain that endometriosis is present is by laparoscopy.

Adhesions. Sometimes tissues in the abdomen stick together and form scar tissue called adhesions. Adhesions can cause pain. They often can be separated during laparoscopy.

Fibroids. Fibroids are growths that form on the inside, outside or within the wall of the uterus. Laparoscopy can diagnose some fibroids.

Ovarian cysts. Ovaries sometimes develop cysts (fluid-filled sacs). These cysts may be harmless, causing only mild pain.

Hysterectomy. The laparoscope can be used to assist in a vaginal hysterectomy (removal of the uterus through the vagina). The laparoscope is used to help the doctor see inside the abdomen during part of the surgery.

Infertility and Sterilization

Women who have trouble getting pregnant may have laparoscopy to find problems like endometriosis or cysts.

Laparoscopy is also used for sterilization. In this operation, the doctor uses the laparoscope as a guide to block the fallopian tubes by cutting, clipping or burning them.

Ectopic Pregnancy
When a woman has pain in her lower abdomen during early pregnancy, the doctor may suspect an ectopic pregnancy. An ectopic pregnancy is one that may be located in the tube instead of the uterus. It may rupture the tube and cause abdominal bleeding that may require emergency surgery.

Benefits of Laparoscopy
In the past, most surgery involving reproductive organs was done by laparotomy. Now, many of these same procedures are done through the laparoscope. There are many benefits to laparoscopy — a shorter hospital stay, smaller incisions and a shorter recovery.

The Procedure
The anesthesia used depends on the type of procedure, your doctor’s advice, and your personal choice. General anesthesia is usually used so that you will not be awake.

After the anesthesia is given, a small cut is made below or inside the navel. A gas, such as carbon dioxide or nitrous oxide, is usually put into the abdomen. The gas swells the abdomen so the pelvic reproductive organs can be seen more clearly.
The laparoscope is placed through the cut. Another cut is often made above the pubic region. Through this cut, an instrument is used to move the organs into view.

Other surgical instruments can be inserted through the scope or through another small cut.

After the procedure, the instruments are removed and the gas released. The cuts are then closed, usually with stitches that dissolve. In a few hours you can go home. You should plan to have someone take you home and stay with you, at least for awhile.

Possible Problems
Although problems seldom occur with laparoscopy, there can be some complications. You may have some bleeding, reactions to the anesthesia, or injury to other organs.

Recovery
The recovery time from laparoscopy is much shorter than that from regular surgery. It is safe to resume normal activities as soon as you feel up to it, usually within a few days. If you are sexually active, talk with your doctor about when you can have sex again.

Finally …
Laparoscopy can be useful in diagnosing and treating many gynecologic problems. It has taken the place of surgery in some cases and offers the benefits of fewer problems and shorter recovery.

This excerpt from ACOG’s Patient Education Pamphlet is provided for your information. It is not medical advice and should not be relied upon as a substitute for visiting your doctor. If you need medical care, have any questions, or wish to receive the full text of this Patient Education Pamphlet, please contact your obstetrician-gynecologist.

To ensure the information is current and accurate, ACOG titles are reviewed every 18 months

Copyright © April 1998 The American College of Obstetricians and Gynecologists