DIAGNOSTIC LAPAROSCOPY
|
|
| What is a Diagnostic Laparoscopy? |
| A diagnostic laparoscopy is a procedure
in which the doctor uses a laparoscope to look at the organs
and tissues in your abdomen. A laparoscope is a thin metal tube
with a light and tiny camera. |
|
| Laparoscopy literally means ‘to look
inside the abdomen’. It is a surgical procedure sometimes
referred to by patients as ‘belly-button surgery’.
The procedure involves placing a telescope-like instrument through
a small, usually ½ inch, incision in the abdomen. |
|
| The laparoscope is then attached to a high-resolution
TV monitor so that the surgeon and their assistants can complete
the procedure. Laparoscopy is usually performed on an outpatient
basis, which means that the patient can go home a few hours
after the surgery. In addition, recovery times are much shorter
than when large abdominal incisions are performed. |
|
| What is the purpose of Diagnostic
Laparoscopy? |
| Diagnostic laparoscopy may be recommended
to look at the outside of the uterus, fallopian tubes, ovaries,
and internal pelvic area. Many infertile patients require laparoscopy
for a complete evaluation. Generally, the test is performed
after the basic infertility screening tests, although the presence
of pain, history of past infection or an abnormal ultrasound
may signal the need to perform diagnostic laparoscopy sooner
in the evaluation. In some women the fallopian tubes are blocked.
This can prevent sperm and egg from coming together, causing
infertility. With laparoscopy, a simple test confirms this possibility.
A colored fluid is injected through the uterus. If the tubes
are open the fluid will flow out the ends of the tubes into
the abdomen. The surgeon can see this through the laparoscope. |
|
| This procedure also allows us to determine whether
there are any defects such as scar tissue
adhesions, endometriosis,
ovarian
cysts, ectopic pregnancy, tubal disease, genital tuberculosis,
fibroid tumors and other abnormalities of the uterus. If any
defects are found then they can often be corrected with operative
laparoscopy which involves placing instruments through ports
in the scope and through additional, narrow (5 mm) ports which
are usually inserted at the top of the pubic hair line in the
lower abdomen. |
|
| What are the benefits of Diagnostic
Laparoscopy? |
| More accurate diagnosis.This minor surgical
procedure may help the doctor make a more accurate
diagnosis about the cause of infertility. |
|
| No stitches.The incision required is
very small. It does not even need a stitch. |
|
| Therapeutic benefit.The doctor may be
able to treat the cause during the laparoscopy. |
|
| Shorter recovery time.Your stay at the
hospital and time needed to recover will be much shorter
than with more extensive abdominal surgery. |
|
| Fewer post-op complications.Most need
little or no pain medicine. |
|
| Less scarring.The incisions for most
kinds of laparoscopic surgery heal without noticeable
scars. |
|
| How do I prepare for Diagnostic
Laparoscopy? |
| Eat a light meal, such as soup or salad,
the night before the procedure. Do not eat or drink
anything after midnight or the morning before the procedure.
Do not even drink coffee, tea, or
water. |
|
| You will need to shave your private
parts prior to the procedure. |
|
| You need to be accompanied by your spouse
or another relative to help you in your post-op
recovery period. |
|
| What kind of anesthesia is used
for Diagnostic Laparoscopy? |
| Laparoscopy is usually performed as an outpatient
procedure, under general anesthesia, and with minimal discomfort. |
|
|
| How is Diagnostic Laparoscopy performed? |
| After anesthesia, a needle is inserted through
the navel, and the abdomen is filled with carbon dioxide gas.
As the gas enters the abdomen, it creates a space inside by
pushing the abdominal wall and the bowel away from the organs
in the pelvic area allowing a view of the reproductive organs.
The laparoscope is then inserted through the same incision.
It is connected to a tiny camera that sends images to a television
monitor. While looking at the monitor, the surgeon can see the
uterus, fallopian tubes, ovaries, and nearby structures. A small
probe is inserted through another incision just above the pubic
region to move the organs into clear view. A device called a
uterine manipulator may be placed in the uterus through the
vagina to move the uterus during the procedure. |
|
| The monitor makes the images larger and
easier for the doctor to see. These images are recorded for
later viewing and a copy of the same will be given to you on
a compact disc.The doctor uses the laparoscope to see the following
parts of the body. |
|
| Uterus |
|
| Fallopian tubes |
|
| Ovaries |
|
| Bladder |
|
| Intestines |
|
| Liver |
|
| Spleen |
|
| Appendix |
|
| Surfaces of the abdominal cavities themselves |
|
| Additionally, a blue solution is injected
through the cervix to determine if the fallopian tubes are open.
The procedure usually takes about 15 to 20 minutes. |
|
| If no abnormalities are noted at this time,
the instruments are removed and the gas released (If defects
or abnormalities are discovered, one can proceed to operative
laparoscopy).The cuts are then closed without stitches, using
an adhesive dressing. You are kept in a recovery room for one
to three hours while anesthesia wears off. In a few hours, you
can go home. |
|
|
| What happens after a Diagnostic
Laparoscopy? |
| The anesthetic may cause sleepiness or grogginess
for a while. You are allowed liquids after 4 hours and soft
diet in the evening. The most common complaints after laparoscopy
include |
|
| Mild nausea from medication/anesthesia |
|
| A sore throat if a breathing tube was
used during anesthesia |
|
| Discharge like menstrual flow for a
few days |
|
| Shoulder pain, caused from gas that
has built up under the diaphragm |
|
| Bloated feeling |
|
| Pain at the incision sites |
|
| Cramping |
|
| Constipation |
|
| Most symptoms usually improve within 24
to 48 hours after surgery. |
|
|
|
| What are the risks associated with
Diagnostic Laparoscopy? |
| Complications after laparoscopic surgery
are rare. The incidence is about 3 of every 1,000 women who
have diagnostic laparoscopy. However, the risks may be greater
for people who are obese, smoke cigarettes, or have additional
health problems. |
|
| There may be some soreness near the
incisions, especially when twisting or stretching the
body. |
|
| Since a breathing tube is used for the
anesthesia, some patients may have a mild sore throat. |
|
| Laparoscopy requires general anesthesia
which carries certain risks. Modern general anesthesia,
however, is safe and reactions are rare. You must be sure
to tell the doctor if you have had
a bad reaction to anesthesia in the past, or if a close family
member has experienced such a reaction. |
|
| There may be discomfort in the abdomen,
upper chest, shoulders, and neck area due to the
carbon dioxide used to inflate the abdomen, but this disappears
quickly. |
|
| The abdominal organs, glands, intestines,
or blood vessels may be damaged. The doctor may
perform abdominal surgery to repair them at the time of the
laparoscopy. |
|
| The lining of the abdominal wall may
become inflamed. |
|
| A blood clot may break off, enter the
bloodstream, and clog an artery in the lung, pelvis, or
legs. Rarely, a clot may break off and clog an artery in the
heart or brain, causing a heart attack
or stroke. |
|
| You may have infection or bleeding. |
|
| You may have some pain after the procedure. |
|
| You may have an allergic reaction to
the fluid used during the procedure. |
|
| Most people recover quickly and resume their
normal activities without problems. |
|
|
|
| When should I call the doctor? |
| Call the doctor right away if |
|
| You develop a fever over 100°F (37.8°C) |
|
| You become dizzy and faint |
|
| You experience nausea and vomiting |
|
| You become short of breath, have chest
pain or leg pain |
|
| You have abdominal pain or swelling
that gets worse |
|
| An incision begins to bleed or leak
fluid |
|
| An incision becomes red, swollen or
feels warm |
|
| Call the doctor during office hours if |
|
| You have questions about the procedure
or its result |
|
| You want to make another appointment |
|
|
Global Service