Gynecologic laparoscopy refers to a group of minimally invasive surgical procedures which use a small camera to examine the female reproductive organs.
The first gynecologic procedures involving a laparoscope included exploratory laparoscopy to diagnose ovarian disease such as cysts, torsion, and cancer. Since then, more complex operations have been developed, including laparoscopic removal of a tubal pregnancy, harvest of eggs for in vitro fertilization, and laparoscopic removal of the uterus (hysterectomy) or the ovaries.
The procedure is usually done in the hospital under general anesthesia. A thin tube (catheter) is inserted through the urethra into the bladder. An additional tube, called a nasogastric (NG) tube, may be passed through the nose and into the stomach to empty your stomach.
After cleaning the area, a small surgical cut is made above or below the belly button area. Carbon dioxide gas is injected into the area to raise the abdominal wall, creating a larger space to work in and making it easier for the surgeon to see and work with the organs. The laparoscope is then inserted so that the organs of the pelvis and abdomen can be examined. Additional small cuts may be needed.
After the procedure, the cuts are closed with stitches and covered with bandages. Depending upon the operation, a drain may be placed into one of the areas to drain any fluid that may build up.
Do not eat or drink for 8 hours before the test.
If you are under general anesthesia, you will feel no pain during the procedure, although the surgical cuts may throb and be slightly painful afterward. A pain reliever may be given by your health care provider.
With local anesthesia, you may feel a prick and a burning sensation when the anesthetic is given. Pain may occur at the site of the surgical cut. Afterward, the cuts may throb for several hours and may be slightly painful. A pain reliever will be administered by your health care provider.
Additionally, you may have shoulder pain for a few days, because the carbon dioxide gas used to inflate your abdomen can irritate your diaphragm, which shares some of the same nerves as the shoulder. You may also have an increased urge to urinate, since the gas can put pressure on the bladder.
Depending on the procedure performed, your health care provider may advise you to avoid eating and drinking for a period of time after the procedure.
Gynecologic laparoscopy is performed for the same reasons as open surgery.
Abnormal results are specific to the operation performed.
There is a risk of puncturing an organ, which could cause leakage of intestinal contents or bleeding into the abdominal cavity. This may require more involved surgery. Severe injury may result in infection or the need for blood transfusion.
Women who have had previous abdominal or pelvic surgery may not be able to have laparoscopic surgery. Prior surgery can lead to scarring, which prevents the safe passage of laparoscopic instruments into the area. Scarring may also prevent the abdominal wall from being pushed out of the way properly when the carbon dioxide is injected.
Reviewed By: Audra Robertson, MD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.