A laparoscopy, also known as keyhole surgery, is an investigation/operation to look inside your abdomen (tummy), using a small telescope. You will be given a general anaesthetic and when you are unconscious, an instrument will be passed through a small cut (5mm) in the abdominal wall usually through the umbilicus (belly button).
A laparoscopy is a diagnostic procedure which allows the surgeon to get a good view of your womb, tubes, ovaries and other parts of the pelvic region. Treatment to scar tissue (adhesions), endometriosis, and removal of ovarian cysts, ovaries and even hysterectomy can be performed through the keyhole (Laparoscopic surgery), in the appropriate patient. Often one or 2 small incisions are made lower down so that operating instruments can be used to gently move things around to obtain a better view and to perform the necessary operation.
Laparoscopy is a safe procedure, but like any other operation, comes with some small risks. There may be a risk of needing an open operation (laparotomy) in the event of a complication such as bleeding, damage to nearby organs, for example bladder or bowel injury. There is a small risk of wound infection, bleeding needing blood transfusion or thrombosis. All precautions are taken to perform the operation as safely as possible. Complications occur in less than one in thousand cases, unless there are other risk factors, such as previous abdominal surgery. After the operation, most women recover usually within a week. If however, you start feeling unwell or have concerns, you must contact the hospital where you were operated, so that you can receive the correct medical advice.
You will be discharged home either the evening of your operation or the following morning – dependent on how you feel. If you have major keyhole surgery, you may stay in the hospital for 2-3 days.
Yes, if you are having a General anaesthetic, no food, even chewing gum for at least 6 hours before your procedure.
Evening Operation: No food or chewing gum after 10 am in the morning. You can drink water up to midday.
Morning Operation: No food or chewing gum after midnight before your procedure. You can drink water up to 6 am of the morning of your procedure. Please take your essential medications as normal with a sip of water, unless advised by nurse or doctor.
You normally should not stop any of your essential medications. Please take your usual essential medications with a tiny sip of water at the regular time. Do remember to bring a list of all your medications to show the nurse at your pre-assessment (if you are having one) and also let your admitting nurse and anaesthetist know all the medications you are on. This is because your medications may influence your anaesthetic and surgery. You should also inform the nurse and anaesthetist of any allergies that you have to foods, metals, drugs etc. Some important notes on certain conditions are listed below.
In general you should not take your insulin injection or your tablet, when you are fasting. For example, if your operation is in the morning, DO NOT TAKE your morning dose or injection as you will be fasting overnight, but do take the previous dose as normal. If your operation is in the evening, take your doses as normal in the morning, but stop injection/tablets if you are taking any at lunchtime (you will fast for 6 hours, usually after 10 am).You can resume your normal regime, once you are eating and drinking normally. If in any doubt, consult your surgeon or anaesthetist.
You will need to stop most blood thinning agents such as Aspirin or Clopidogrel at least 1-2 weeks before your procedure. This is to avoid excessive bleeding at your operation. If you are on Warfarin or Clexane, you will need to liaise with your surgeon and cardiologist. If in any doubt, consult your surgeon or anaesthetist and certainly inform them when you see them, as it may influence your management.
You will have a couple of dissolvable stitches, one in your umbilicus (belly button) and one or two just below, either to the right or left of your abdomen. These will dissolve in approximately 10-14 days. You will not need a dressing, once you take off the ones covering the scars when you leave the hospital.
Following your laparoscopy, the findings and their implications will be discussed with you. Plans will be made for any further treatment and any necessary appointments will usually be made before you leave the hospital. The results of any biopsy taken take about a week to come back. You will usually be seen in clinic for a follow up or have the results communicated to you. If you need further surgery or other treatment, this will be discussed in detail with you, usually in the clinic. Your GP will be sent a letter with the findings from your procedure, and any results. You can be copied into this, if you so wish.
Nitu Bajekal (Consultant Gynaecologist, Feb 2009)