|What Is Laparoscopy?
It is a minimally invasive method of performing abdominal surgery. Laparoscopy is also called keyhole surgery, bandaid surgery and minimally invasive surgery (MIS). During the procedure a small incision is made in the belly and a thin lighted tube is inserted through it. This tube (laparoscope) has a camera attached so it allows the surgeon to view the abdominal organs. Other surgical tools can be inserted through the laparoscope, or through other incisions to carry out treatment. In such a way, laparoscopy can be used both to diagnose and treat conditions.
Laparotomy or Laparoscopy?
Laparotomy is a more invasive method of abdominal surgery that involves a larger incision in the tummy. The advantage of laparotomy is that it allows surgeons a direct view of the internal organs (particularly useful if a disease is not confined to one area, such as cancer). Many routine surgeries that were once performed by laparotomy in the past, are now performed by laparoscopy. Laparoscopy is less stressful and healing time is faster.
Why Is It Done?
To diagnose and treat:
• Ovarian cysts
• Pelvic inflammatory disease (PID)
• Adhesions (scar tissue)
• Ectopic pregnancy
• Blocked fallopian tubes (and so is an important diagnostic tool for infertility)
• Cancer of the reproductive organs such as fallopian tube cancer or ovarian cancer. Laparoscopy in this instance is more likely to be exploratory, or for staging purposes. Treatment usually requires more direct access (laparotomy).
It is also:
• Done to remove an IUD device which has perforated the uterus.
• Done to sterilize a woman by tubal ligation (tying her tubes).
• Used during some vaginal hysterectomies.
• To insert a Lap-Band as part of obesity surgery (Laparoscopic Adjustable Gastric Banding (LAGB)).
• Used for egg retrieval surgery, a fertility treatment.
How Is It Performed?
Laparoscopies are usually done in hospital as day surgery - you get to go home the same day. General anesthesia is usually given which means you are completely unconscious. About an hour before surgery you will be asked to empty your bladder and an IV drip is then attached to your arm. You will receive fluids and the anesthetic through this.
• When you are sleeping some or all of the following may be done:
• An airway inserted into your throat to help you breathe.
• A urinary catheter (thin flexible tube) placed through your urethra into your bladder.
• A thin tube called a cannula is inserted through your vagina and into the uterus. This tube allows the surgeon to move your womb and ovaries to the side so that he can get a better look at the abdominal organs.
• Some of your pubic hair may be shaved.
Once the anesthesia has taken effect, a small incision is made just below the belly button. If other tools need to be used, more than one incision will be made. Next a long thin needle is inserted through the incision and gas is pumped in. The gas lifts the intestines and exposes the pelvic organs lying beneath. The laparoscope is inserted and the surgeon can now inspect the organs. If surgery is being performed to fix a problem other tools may be used - for example to cut a sample of tissue for biopsy, to drain cysts or remove scar tissue. A laser may be attached to the laparoscope to assist surgery.
Once the procedure is over, the incision(s) are closed with stitches. It takes about 30 to 90 minutes to perform, but it can be longer, depending on what needs to be done. Endometriosis surgery for example can take much longer. You will be returned to the recovery room for 2 to 4 hours.
What Is The Recovery Time?
If you have no complications, you can return home after 4 or 5 hours. You can resume all normal activities (including sex) after a day. You may feel some shoulder pain for a few days, this is a side effect of the gas used during surgery.
This woman has 3 laparoscopic incisions
What Are The Risks?
Laparoscopy is a relatively safe procedure, although in rare cases it can result in complications. These include organ damage from surgical instruments used, abscess formation and inflammation of the lining of the abdomen. Additionally there are the associated risks of general anesthesia. All of these risks can be minimized in the hands of an experienced surgeon.
How Much Does Laparoscopy Cost?
Without insurance, the cost of laparoscopy averages between $1,700 and $5,000. The difference in price depends on whether it is performed for diagnostic or treatment purposes.