Laparoscopy is a surgical procedure that is done to examine various abdominal organs or female pelvic organs. The procedure is sometimes called as "diagnostic laparoscopy" or "keyhole surgery". This procedure can identify problems such as adhesion, fibroids, infections, and cysts.
The procedure itself is low-risk and minimally invasive. The instrument designed to observe the organs inside the abdomen is called the laparoscope. The laparoscope is a long thin tube with a high-intensity light. The laparoscope comes equipped with a front camera with a very high resolution for better clarity.
Why is it done?
The procedure is done to identify and diagnose the source of abdominal or pelvic pain. When other non-invasive methods fail to produce results, laparoscopy becomes the ideal choice. These methods may include imaging techniques such as CT scans, ultrasound, and MRI. When not enough information can be obtained from these tests, a laparoscopy is performed.
This diagnostic procedure can also be used for taking a biopsy or a tissue sample from a specific abdominal organ. Organs that are typically examined include the appendix, gallbladder, liver, spleen, stomach, reproductive organs, and the pancreas. The instrument will detect liver disease, cancer progression, and abdominal tumors, among others.
How is it done?
An incision is made in the abdominal wall and the laparoscope is inserted through it. As it moves, images are captured by the camera. The images are relayed to an adjacent video monitor, allowing the doctor to internally view your body in real time.
Laparoscopy vs. Open Surgery
Since viewing abdominal organs in real time is made possible, biopsy samples can be obtained during the procedure. It is, therefore, different from an open surgery. There is also minimal blood loss and the pain is bearable. In fact, after the procedure, most patients can go home on the same day of their operation.
Immediate discharge after an open surgery is not always possible as you will have to be monitored and given time for the surgical wounds to heal. Furthermore, there is less scarring associated with laparoscopy as compared to an open surgery.
Before the procedure, it is recommended that you do not drink or eat anything for a period of 6 to 12 hours. However, certain preparations will depend on the type of laparoscopic procedure that is to be carried out. Any current drug prescriptions must be communicated to your doctor, who will advise you on how to use them prior and after the procedure. Having this in mind, the doctor may change the dosage of the medication that he thinks would interfere with the outcome of the process. The common drugs include anticoagulants, vitamin K, dietary supplements, and other drugs that would interfere with blood clotting. Pregnant women are also advised to communicate with their doctor to reduce the risk of harming their unborn baby.
Blood tests, urinalysis, a chest X-ray, and an electrocardiogram will be done. Imaging techniques as mentioned above may also be carried out. All these tests are aimed at assisting the doctor in understanding the defects examined during the procedure. The visual results will act as a guide for the physician to assess what is inside your abdomen.
Since the general anesthesia could make you drowsy after the surgery, you are advised to have someone who will take you home after the procedure. It is not recommended for you to go home alone while dealing with your drowsiness.
The procedure is an outpatient case in nature. General anesthesia is administered, so you will not feel any pain.
During the procedure, a small incision is made just below your belly button and a small cannula tube is then inserted. The cannula tube fills the abdomen with the required amount of carbon dioxide gas to inflate the abdomen. The primary purpose of the gas is to make the abdominal organs clearly visible.
The laparoscope is inserted through the incision and the front camera attached to it relays the images it captures onto an adjacent screen enabling real-time visualization. Tissue samples for biopsy can also be collected using this procedure.
After completion, the instruments are removed and surgical tapes or stitches are used to close the incisions. Bandages are then finally placed as a cover and protection.
Complications are rare in laparoscopic surgeries. However, the most common cases that are associated with a laparoscopy are infection and bleeding. Therefore, you need to be always on the lookout for signs of infection such as:
- Intense stomach pain
- Swelling or redness at the incision site
- Inability to urinate
Ensure that you contact your doctor if any of these symptoms occur.
There is also minimal risk of damage to the abdominal organs. For instance, fluids and blood may find their way into your body when an organ is punctured. Other rare risks include complications from the administered anesthesia, a blood clot, and abdominal wall inflammation.
In the event of the above complications, you will need to undergo further surgery to repair the damage.
Recovery from a Laparoscopy
Upon completion of the procedure, you will be monitored for at least several hours. Your breathing and heart rate will be carefully observed before being released. You will feel drowsy due to the administered anesthesia and will not have a clue as to what happened during the surgery. However, the effect of the anesthesia will wear off after some few hours.
Your release will depend on how your body reacts to the surgery, the type of anesthesia used, and the overall physical condition of your body. The doctor will inform you on how to take care of your surgical wound and give you a schedule for follow-up appointments. Painkillers will also be prescribed to assist you in dealing with the pain caused by the procedure. However, the pain that you experience will only be for a short time.
The carbon dioxide that was used as an inflation gas might remain in your abdomen. As a result, bloating, cramps, shoulder pains, leg swelling, and a stinging sensation when urinating should be expected. Nonetheless, after a few days, they should pass, and weeks after the procedure, your body will have fully recovered.
A pathologist examines the biopsy results. A report that gives the full details of the laparoscopic results will be sent to your the doctor for analysis. Results that are deemed healthy will indicate the absence of intestinal blockages, the lack of abdominal bleeding, and hernias. These results mean that your organs are in good health conditions. Abnormal results, however, will indicate hernias, adhesions, fibroids, cysts or tumors, cancer, injury to particular organs, cholecystitis, endometriosis, and appendicitis, among others.
Your doctor will proceed to schedule an appointment where you will go through the results with him. Appropriate treatment will then be given in the event of a serious medical condition.
Current Trends in Laparoscopy
Robotic-assisted laparoscopy has been recently developed to help with the laparoscopic procedure. It allows for complex procedures to be carried out with utmost precision. The risks of complications associated with this type of laparoscopy are very minimal as compared to the regular laparoscopy or open surgery. As a result, there has been a continued rise in their use by medical institutions.