Laparoscopy

A laparoscopy is a surgical procedure that involves looking directly into your abdomen and pelvis using a small camera that is placed through an incision in your umbilicus. This allows us to evaluate and potentially treat gynaecological problems such as scar tissue (adhesions), endometriosis, and ovarian cysts that may affect fertility.

For this operation you will require a general anaesthetic (you will be asleep), but in most cases you will go home the same day. After the incision is made (usually next to the navel), the laparoscope is inserted into the abdominal cavity. Either carbon dioxide or nitrous oxide gas is then passed into the cavity to separate the abdominal wall from the underlying organs. This makes examination of the internal organs easier. Anywhere between one and three more incisions are made to allow access to other surgical instruments, for example, a laser. Once a diagnosis is made or the problem is removed (or both), the instruments are taken out, the gas allowed to escape and the incisions sewn shut. The stitches may need to be removed at a later stage or else they will dissolve by themselves.

Most women experience bloating, abdominal discomfort and/or back and shoulder tip pain for 24-48 hours after surgery. This is normal and is related to the gas used to distend your abdomen during the surgery. This pain should not be severe and should gradually improve over 24-48 hours. You may also feel abdominal bloating, nausea, abdominal cramps, or constipation.

Most patients are able to resume normal activities within a few days to one week. We recommend that you do not engage in any strenuous physical activity for about a week or so. Following a pelvic laparoscopy, we recommend you use sanitary towels instead of tampons to cope with any vaginal bleeding or discharge.

Problems diagnosed or treated by laparoscopy

Some of the many problems that may be diagnosed or treated by laparoscopy include:

• Female infertility – laparoscopy allows us to check for problems such as scar tissue, endometriosis and fibroid tumours, and to see if the uterus, fallopian tubes and ovaries are abnormal in any way.
• Other problems of the female reproductive system – including pelvic floor and vaginal prolapse. Some types of hysterectomy can also be performed using laparoscopic surgery.
• Ectopic pregnancy – the embryo lodges and grows within the fallopian tube. The developing embryo will eventually rupture the fallopian tube unless it is surgically removed.
• Adhesions – the presence of scar tissue within the pelvic cavity.