What is laparoscopy?

Laparoscopy (say "lap-uh-ROSS-kuh-pee") is a type of surgery that uses very small cuts. These cuts are called incisions.

The doctor puts a lighted tube through incisions in your belly. This tube is called a scope. Then the doctor puts special tools through the tube to do the surgery.

The surgery may be done to diagnose a condition, repair or remove an organ, or see if cancer has spread.

For some surgeries, you can usually go home the same day.

The incisions from the surgery usually leave several scars about half an inch long.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• Avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
• You may also have some shoulder or back pain. This pain is caused by the gas your doctor used to inflate your belly to help see your organs better. The pain usually lasts about 1 or 2 days.
• You may drive when you are no longer taking pain medicine and can quickly move your foot from the gas pedal to the brake. You must also be able to sit comfortably for a long period of time, even if you do not plan to go far. You might get caught in traffic.
• You may need to take a few days to a few weeks off work. It depends on the type of work you do and how you feel.
• You may shower 24 to 48 hours after surgery, if your doctor okays it. Pat the cut (incision) dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.

Diet

• If your stomach is upset, try bland, low-fat foods such as plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids to prevent dehydration. Choose water and other clear liquids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• You may notice that your bowel movements are not regular right after your surgery. This is common. Avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Incision care

• If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.

Laparoscopy usually takes about 30 to 90 minutes, depending on what is done. But it can take longer in certain situations.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to empty your colon with an enema or laxative. Your doctor will tell you how to do this.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

There is a small chance of problems from laparoscopy, such as:

• Bleeding from the incisions.
• Infection.
• Damage to an organ or blood vessel. This may cause more bleeding that needs another surgery to repair.

A laparoscopy may not be done because of a higher chance for problems if you have:

• Abdominal cancer.
• An abdominal hernia.
• Had abdominal surgeries in the past.

Results of any lab tests on tissue samples may not be available for several days.

If general anesthesia is used, you will be asleep and feel nothing. After you wake up, you will feel sleepy for several hours. You may be tired and have some pain for a few days after a laparoscopy. You may have a mild sore throat from the tube in your throat to help you breathe. Use throat lozenges and gargle with warm salt water to help your sore throat. After a laparoscopy, you may have shoulder pain. This is caused by the air your doctor put in your belly to help see your organs better. The pain may last for a day or two.

If you have other types of anesthesia, you may have pain for a few days when the initial numbness wears off.

After laparoscopic surgery, you are likely to have pain for the next several days. You may have a low fever and feel tired and sick to your stomach. This is common. You should feel better after 1 to 2 weeks.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery may take about 1 to 4 hours. It depends on what needs to be done. Hernia surgery may take 1 to 2 hours. But surgery to remove the spleen or part of the bowel may take 3 to 4 hours.

Laparoscopy is done by a surgeon or a doctor of women's health (gynecologist). General anesthesia is most often used. But other types of anesthesia, such as spinal anesthesia, may be used. Talk with your doctor about what choice is best for you.

About an hour before the surgery, you will empty your bladder. You will get fluids and medicine through an intravenous (I.V.) in a vein in your arm. You may get a medicine (sedative) to help you relax.

Several procedures may be done after you get your anesthesia and are relaxed or asleep.

• An airway will be placed in your throat to help you breathe if you get general anesthesia.
• A thin flexible tube (urinary catheter) may be put through your urethra into the bladder.
• Some of your pubic hair may be shaved.
• Your belly and pelvic area will be washed with a special soap.
• For women, your doctor may do a pelvic exam before putting a thin tube (cannula) through your vagina into the uterus. The cannula lets your doctor move your uterus and ovaries to get a better look at the belly organs.

During laparoscopy, a small incision is made in the belly. More than one incision may be made if other tools will be used during the surgery. A hollow needle is put through the first incision. Then air is slowly put through the needle to inflate the belly. The air lifts the abdominal wall away from the organs inside so your doctor can see clearly.

A thin, lighted tube (laparoscope) is then put through the incision to look at the organs. Other tools can be used to take tissue samples, fix damage, or drain cysts. A laser may be attached to the laparoscope to help with the surgery.

After the surgery, all the tools will be removed and the air will be released. The incisions will be closed with stitches and covered with a bandage. The scar will be very small and will fade over time.

After the laparoscopy, you will go to the recovery room. How long you stay will depend on why you had the surgery.

Laparoscopy is done to:

• Check for and possibly take out abnormal growths (such as tumors) in the belly or pelvis.
• Check for and treat conditions such as endometriosis, ectopic pregnancy, or pelvic inflammatory disease (PID).
• Find conditions that can make it hard for a woman to become pregnant. These conditions include cysts, adhesions, fibroids, and infection. Laparoscopy may be done after early infertility tests do not show the cause for the infertility.
• Do a biopsy.
• See if cancer in another area of the body has spread to the belly.
• Check for damage to internal organs, such as the spleen, after an injury or accident.
• Do a tubal ligation.
• Fix a hiatal hernia or an inguinal hernia .
• Take out organs, such as the uterus, spleen, gallbladder (laparoscopic cholecystectomy), ovaries, prostate, or appendix (appendectomy). Partial removal (resection) of the colon also can be done.
• Find the cause of sudden or ongoing pelvic pain.