Laparoscopy

Laparoscopy (keyhole surgery) is a low risk, minimally invasive surgical procedure used to help diagnose a wide range of conditions that develop inside of the abdomen and pelvis without having to make large incisions.  A doctor may use a laparoscope (camera) to assess your lower abdomen including your uterus, fallopian tubes, bladder, bowel and ovaries.

Laparoscopy Dye Test

A laparoscopy dye test is a procedure that will help to diagnose why you may be having difficulty getting pregnant.  The dye will show whether your fallopian tubes are blocked whilst the laparoscopy will help identify endometriosis, certain types of cancers, ovarian cysts and other medical conditions.  A laparoscopy is most commonly used in:

• Gynaecology – the medical practise dealing with and treating conditions affecting the female reproductive system
• Gastroenterology – the branch of medicine focused on the diagnosis and treatment of conditions affecting the digestive system
• Urology – the branch of medicine that focuses on the study and treatment of conditions that affect the urinary system

Why are They Performed?

It is possible to diagnose a condition using non-invasive techniques, such as an ultrasound scan, CT scan or an MRI scan. However, occasionally it is necessary to use a laparoscope to study and confirm the diagnosis of the affected area.

Laparoscopic surgery can be requested for the diagnosis of a wide range of conditions.  Examples of conditions that might require a laparoscopy include:

Endometriosis

A condition where tissue starts to grow in other places, such as the ovaries and fallopian tubes causing pelvic pain, severe period pain and pain during or after sex.

Ectopic Pregnancy

When a fertilised egg imbeds itself outside of the womb, typically in one of the fallopian tubes, causing abdominal pain and vaginal bleeding.

Female Infertility

Failing to conceive despite having regular unprotected sexual intercourse.

Pelvic Inflammatory Disease

Infection of the upper genital tract resulting in pain around the pelvis, discomfort when urinating, heavy and painful periods. Mainly affecting sexually active women between 15 and 24.

Fibroids

Irregular growths that develop on a woman’s uterus causing heavy periods and severe abdominal pain.

Ovarian Cysts

Developing on an ovary, they are very common and rarely show symptoms.

Appendicitis

A painful swelling of the appendix. With on and off pain starting at the centre of the abdomen and then moving to the right hand side, intensifying and remaining constant.

Undescended Testicle

A condition in which one or both of the testicles have not moved down into their usual place in the scrotum.

Unexplained Pelvic or Abdominal Pain

Any symptoms that cannot be diagnosed a one of the above conditions.

A laparoscopy is performed when other tests do not provide enough information to confirm a diagnosis.  The technique may also include surgical procedures such as removing a damaged organ or taking a sample of tissue from a particular organ for further testing.

How is a Laparoscopy Performed?

Laparoscopy is carried out in an outpatient setting under general anaesthetic (meaning you will not feel any pain) and usually takes between 30-60 minutes (depending on the type of procedure being carried out).

The doctor will make an incision in the abdominal wall, generally around the belly button, and will use carbon dioxide to gently inflate your abdomen, making it easier to see.  They will insert an instrument called a laparoscope (a flexible, thin tube with a light and camera at the tip) through the incision to inspect the abdominal organs; the camera then sends images to a monitor for assessment.  After the procedure, your doctor will let the gas out of your abdomen, close the cuts with stitches or glue and apply a dressing. 

You will be observed for several hours following the procedure before you are allowed to go home.  In most cases, you can go home the same day following your laparoscopy; however, you will need to arrange transport, as you will be advised not to drive for 24 hours after the procedure.

A laparoscopy dye test is performed using a similar procedure except the doctor will inject the dye, which will then pass through the cervix and down the fallopian tubes, highlighting any blockages and helping to confirm a diagnosis.

Laparoscopy vs. Traditional Open Surgery

Advantages

• A shorter stay in hospital
• Faster recovery time
• Reduced discomfort and bleeding following the operation
• Less scarring
• Less likely to develop an infection

Disadvantages

• Cannot be performed on everyone (if you have previously undergone abdominal operations there may be too much scar tissue to operate safely)
• Not suitable for complicated surgeries as the images provided are 2 dimensional
• There may be the need for a second open surgery if any complications occur during the procedure

Complications and Risks with Laparoscopy

If you have previously undergone abdominal surgery, your doctor may think the risk of a laparoscopy outweighs the benefits. This is due to the areas of scar tissue increasing the length of the procedure and the risk of injury to abdominal organs. As with any surgery, there is always the risk of:

• Pain
• Sickness
• Bleeding and blood clots
• Infection to the wound
• Scarring

Specific complications of a laparoscopy/gynaecological laparoscopy/dye test:

• Damage to your internal organs such as your bladder or bowel
• A hernia developing near one of the incisions
• Reaction to the anaesthetic
• Failure to diagnose the problem
• Surgical emphysema (subcutaneous emphysema)
• Infection of the gynaecological organs or bladder
• A small amount of bleeding or excessive bleeding from your vagina
• Pain and discomfort in your abdomen
• Bruising around the wound
• Urine infection

If a complication arises, your surgeon may need to change to open surgery.

Although it is quite common to feel a little unwell for the first couple of days following the laparoscopy procedure, you should feel better soon after.  If you continue to feel unwell and are suffering from complications, contact your doctor for advice.

Following the procedure, some of the gas used to inflate your abdomen can remain inside which can cause bloating, cramps and shoulder pain (the gas can irritate your diaphragm and the nerve endings in your shoulder).  Once your body has absorbed the remaining gas, these symptoms should pass and are nothing to worry about.

Recovery from Laparoscopy

The length of time it takes to recover from the procedure depends on the person, the treatment and if any complications develop.

If you underwent a laparoscopy to diagnose a condition, you will probably be able to return to your normal daily activities within a week; this includes going back to work.  After minor surgery, such as an appendix removal, you may be able to return to your regular day-to-day activities within 3 weeks whereas major surgery, such as your kidneys or ovaries being removed due to cancer, could take up to 12 weeks following the procedure to get back to normality.

If you were given dissolvable stitches or glue to close your incisions, they will dissolve on their own.  If you have non-dissolvable stitches, you will need to have them taken out after about 5-7 days.

In the days and weeks following the procedure you are likely to feel more tired than usual, be experiencing pain and discomfort where the incisions were made as well as a possible sore throat if a breathing tube was used.  Your body is using a lot of energy to heal itself so rest and take regular naps are necessary.  It is a good idea to keep moving around as it will help avoid problems later, such as blood clots in your legs or lungs.  Your doctor may also advise you to wear compression stockings or have blood thinning injections for a while following your procedure.  If you require pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen.

Need Help?

At One Healthcare we can book you in to see a specialist consultant surgeon, usually within 48 hours, for an initial consultation.  Laparoscopy is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Laparoscopy treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at One Hatfield Hospital.

Why One Hatfield

• Modern purpose-built hospital opened in December 2017
• 0% and low finance options**
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• Private, spacious, en-suite rooms
• Specialist physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

Contact us and find out more

If you are based in and around Hertfordshire, St Albans, Stevenage, Watford, Barnet, North London, Welwyn or Bedfordshire and would like to visit the One Hatfield Hospital please click here.