Laparoscopy

What is laparoscopy?

Laparoscopy is a procedure a doctor uses to look inside the abdomen (belly) and pelvis. This is done with a laparoscope, a thin, flexible tube with a light and a small video camera on the end. The tube is put in a small cut made through the abdominal wall near the navel (belly button). A second or third incision may also be made in other parts of the belly to put in other instruments. Laparoscopy is also known as minimally invasive surgery or keyhole surgery.

Why do you need a laparoscopy?

There are a few reasons you might need a laparoscopy:

You are having problems in your abdomen (belly) and pelvis

This test is used to look for the causes of problems such as pelvic pain or to look at an abnormal area seen on an imaging test (such as a tumor in the pelvis).

You have a suspicious area that might be cancer

Laparoscopy can be used to remove or take biopsy samples of lymph nodes in the pelvis or abdomen. It is commonly used for people with gynecologic cancers (cervical cancer, ovarian cancer, and endometrial cancer).

To treat a small cancer

Laparoscopy can be used to treat small gynecologic cancers (ovarian, endometrial, cervical) as well as cancers of the colon or kidney.

What’s it like to have a laparoscopy?

This is a general outline of what typically happens before, during, and after a laparoscopy. But your experience might be a little different, depending on why you’re having the test, where you’re having the test done, and your overall health. Be sure to talk to your health care provider before having this test so you understand what to expect and ask questions if you’re not sure about something.

Before the test

Be sure your health care provider knows about any medicines you are taking, including vitamins, herbs, and supplements, as well as if you have allergies to any medicines.

You might be asked to stop taking blood-thinning medicines (including aspirin) for several days before the test. You might also be asked not to eat or drink anything for at least several hours before the procedure. Your doctor or nurse will give you specific instructions. Be sure to follow them, and to ask questions if there’s anything you don’t understand.

Getting the test

Laparoscopy may be an outpatient (you don’t need to stay overnight in a hospital) or inpatient (you need to stay in the hospital overnight or a few days) procedure depending on what is being done.

For this test, you will be given drugs through an intravenous (IV) line to put you in a deep sleep (general anesthesia). A tube will be put into your throat and hooked up to a breathing machine while the procedure is being done. A small cut is made through the abdominal wall near the belly button where the laparoscope is inserted. A small amount of gas is introduced into the abdomen to expand it so the organs are easy to see. Other small cuts may be made in the lower part of the belly to put in different cutting tools to remove or biopsy abnormal areas which are then checked in the lab. The laparoscope, cutting tool, and most of the gas will then be removed and the small cuts will be closed. Once the procedure is complete, you will be gently woken up and taken off the breathing machine. 

The procedure can take between 30-90 minutes, but possibly longer, depending on what’s being done.

After the test

After the procedure, you will be watched closely to make sure you don’t have any problems. As the anesthesia wears off you may be groggy or confused for a few hours. Your mouth and throat will probably be numb for a few hours. You won't be allowed to eat or drink until the numbness wears off. Once the numbness is gone, you may have a sore throat, cough, or hoarseness for the next day or so. You may have pain or numbness in the sites where the cuts were made. You might also have abdominal or shoulder pain from the left-over gas that may take a few hours or days to get better.

If you had the procedure as an outpatient, you will most likely be able to go home after a few hours, but you will probably need a ride home because of the medicines or anesthesia you received. Many centers will not discharge people to go home in a cab or a ridesharing service, so you might need someone to help you get home. If transportation might be a problem, talk with your health care provider about the policy at your hospital or surgery center for using one of these services. There may be other resources available for getting home, depending on the situation.

Your doctor or nurse should give you specific instructions on what you can and can’t do in the hours after the test.

If biopsies were done as part of the procedure, the results will typically be ready within a few days, although some tests on the biopsy samples might take longer. You will need to follow up with your doctor after the procedure to get your results.

Possible complications of laparoscopy

Laparoscopy risks include:

• Bleeding
• Needing to have a laparotomy, where the abdomen is opened with a larger cut, because the procedure could not be done with the smaller cuts used by laparoscopy
• Injury to nearby organs (especially the bowel and bladder)
• Pneumonia (infection in the lung)
• Infection of the incisions (cuts)

Your doctor or nurse should give you specific instructions on when you might need to call the doctor’s office (for problems such as chest pain, trouble breathing, coughing up blood, or a fever that doesn’t go away). Be sure you understand when you should call.