• Laparoscopy

    (Surgery With Keyhole Incisions)

    Click here to view an animated version of this procedure.

    Definition

    Laparoscopy is a type of surgery done through several small incisions in the abdomen. Small tools and a laparoscope (tiny camera) are placed through the incisions to allow the surgeon to see inside the belly and perform surgical tasks. This type of surgery is very popular, as it usually shortens recovery time. It also leaves only very small scars in most cases.
    Laparoscopic Instruments Being Placed in the Abdomen
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    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    Many types of surgery can now be done with a laparoscope. Some examples include:
    It can also be done to help make a diagnosis.

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have a laparoscopy, your doctor will review a list of possible complications, which may include:
    • Infection
    • Bleeding
    • Damage to blood vessels or organs
    • Problems related to anesthesia
    • The need for open surgery rather than laparoscopic surgery
    Factors that may increase the risk of complications include:
    • Smoking
    • Obesity
    • Heart or lung condition
    • Previous abdominal surgery
    • Diabetes

    What to Expect

    Prior to Procedure

    Depending on the reason for your surgery, your doctor may do the following:
    • Physical exam and review of medicines
    • Blood tests (such as, pregnancy test, liver function, electrolyte status)
    • Urinalysis to detect urinary tract infection and diabetes
    • Ultrasound—a test that uses sound waves to visualize the inside of the body
    • CT scan—a type of x-ray that uses a computer to make pictures of the inside of the body
    • MRI scan—a test that uses magnetic waves to make pictures of the inside of the body
    In the days leading up to your procedure:
    • Depending on the type of surgery, you may need to take a laxative or use an enema.
    • Arrange for a ride home.
    • The night before, eat a light meal. Unless told otherwise by your doctor, do not eat or drink anything after midnight.
    Talk to your doctor about the medicines you are taking. Up to one week before the procedure, you may be asked to stop taking some medicines such as:
    • Aspirin or other anti-inflammatory drugs
    • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

    Anesthesia

    Most commonly, you will have general anesthesia—You will be asleep.

    Description of the Procedure

    After you are asleep and do not feel any pain, a needle will be inserted to inject carbon dioxide into your abdomen. The gas will make your abdomen expand. This will make it easier to see the organs. The laparoscope will then be inserted through a small hole that is cut in the skin. The laparoscope lights, magnifies, and projects an image onto a video screen. The area will then be inspected.
    If necessary, several other incisions will be made in the abdomen. Tiny tools will be inserted to take biopsies or do surgery. The incisions will be closed with stitches or clips.

    How Long Will It Take?

    This varies greatly depending on the procedure

    Will It Hurt?

    Anesthesia will prevent pain during the procedure. You may have soreness for a couple of days during recovery. Ask your doctor about pain medicine to help manage pain. You may also feel bloated or have pain in your shoulder from the gas. This can last up to three days.

    Post-procedure Care

    Once home, follow your doctor's instructions, which may include:
    • Remove the dressing the morning after surgery.
    • Avoid heavy lifting.
    • Do not drink carbonated beverages for two days.
    Ask your doctor about when it is safe to shower, bathe, or soak in water. You should be able to go back to regular activities in about one week. If the procedure was done to help diagnose a condition, your doctor will suggest treatment options. Biopsy results may take up to a week to come back.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occur:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
    • Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
    • Pain that you cannot control with the medicines you have been given
    • Headache, muscle aches, feeling faint or dizzy
    • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
    • Difficulty urinating or having a bowel movement
    • Cough, shortness of breath, or chest pain
    In case of an emergency, call for medical help right away.

    RESOURCES

    National Library of Medicine http://www.nlm.nih.gov

    Society of American Gastrointestinal Endoscopic Surgeons http://www.sages.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Women's Health Matters http://www.womenshealthmatters.ca

    References

    Laparoscopy. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/publications/patient%5Feducation/bp061.cfm. Published 2009. Accessed July 21, 2009.

    Patient information for diagnostic laparoscopy. Society of American Gastrointestinal Endoscopic Surgeons website. Available at: http://www.sages.org/publication/id/PI02/. Published 2004. Accessed July 22, 2008.

    Surgery and other procedures for cancer treatment. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated June 2007. Accessed July 22, 2008.

    6/2/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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