Laparoscopy

By Emma Hitt

(Other terms used for this type of procedure: Peritoneoscopy, Gynecologic Laparoscopy, Pelviscopy, Exploratory Laparoscopy)

Procedure overview

Laparoscopy is a procedure used to examine the organs of the abdominal cavity. Laparoscopy utilizes a laparoscope, a thin flexible tube containing a video camera. The laparoscope is placed through a small incision in the abdomen and produces images that can be seen on a computer screen. A similar procedure can be used to look at the organs of the pelvis (gynecologic laparoscopy or pelviscopy).

The advantage of laparoscopy is that it allows a direct view of the abdominal organs and structures without the need for major surgery. Laparoscopy may also be used to perform biopsies or surgical procedures, such as an appendectomy or cholecystectomy (removal of gallbladder). As laparoscopic techniques improve, more applications are being used. Robotically-assisted laparoscopy may be used for certain procedures. This technique requires specialized equipment and training, but may offer benefits for some patients and conditions. 

Other related procedures that may be used to examine the abdomen include abdominal X-ray, computed tomography (CT scan) of the abdomen, abdominal ultrasound, and abdominal angiogram. Please see these procedures for additional information.

Reasons for the procedure

The abdomen contains organs of the gastrointestinal, urinary, endocrine, and reproductive systems. An abdominal laparoscopy may be performed to assess the abdomen and its organs for tumors and other lesions, injuries, intra-abdominal bleeding, infections, unexplained abdominal pain, obstructions, or other conditions, particularly when another type of examination such as physical examination, X-ray, or CT scan is not conclusive.

Laparoscopy may be used to determine the stage of cancer of the abdominal organs. It may also be used to evaluate abdominal trauma, including the depth and location of injury, and the extent of intra-abdominal bleeding.

Gynecologic laparoscopy may be used to assess pelvic pain and problems, ovarian cysts, and fibroids, and to evaluate the fallopian tubes in women experiencing infertility. Other uses include treating endometriosis and removing an ectopic pregnancy in the fallopian tube.

There may be other reasons for your doctor to recommend a laparoscopy.

Risks of the procedure

As with any surgical procedure, complications may occur. Possible complications of laparoscopy include, but are not limited to, bleeding from the site of insertion and misplacement of the gas used to help visualize the organs.

In certain situations, laparoscopy may be contraindicated. These situations include patients with advanced abdominal wall malignancies, chronic tuberculosis, thrombocytopenia (low blood platelet count) or other bleeding problems, multiple surgical adhesions, and patients taking blood thinning medication.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Certain factors or conditions may interfere with a laparoscopy. These factors include, but are not limited to, the following:

  • Obesity

  • History of multiple surgeries resulting in adhesions that prevent safe access to the abdomen with a laparoscope

  • Blood from an intra-abdominal hemorrhage may prevent visualization with the laparoscope

Before the procedure:

  • Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.

  • You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.

  • In addition to a complete medical history, your doctor may perform a physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood or other diagnostic tests.

  • You will be asked not to eat or drink anything for eight hours before the procedure, generally after midnight.

  • If you are pregnant or suspect that you are pregnant, you should notify your doctor.

  • Notify your health care provider if you are sensitive to or are allergic to any medications, iodine, latex, tape, and anesthetic agents (local and general).

  • Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.

  • Notify your health care provider if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.

  • The area of the abdomen where the incision is to be made may be shaved.

  • A cleansing enema may be given a few hours before the procedure.

  • You may receive a sedative prior to the procedure, depending on the type of procedure being done. If your procedure is to be done on an outpatient basis, you will need to have someone drive you home afterwards because of the sedation given prior to and during the procedure.

  • Based on your medical condition, your doctor may request other specific preparation.


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