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LAPAROSCOPY

What is laparoscopy?

 

Laparoscopy is a way of doing surgery without making a large cut on your abdomen (tummy area). A long, thin telescope (called a laparoscope) is inserted into the abdomen through a small cut. A camera is attached to the telescope to let your doctor see your pelvic organs. To do the surgery, long instruments are inserted through other small cuts on your abdomen. Usually, there are a total of 4 small cuts.

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Why is laparoscopy done?

 

There are reasons you would have a laparoscopy. You might have this procedure if you have:

  • Abnormal vaginal bleeding

  • Fibroids

  • Endometriosis

  • Ovarian cysts

  • Cancer of the uterus, ovary, cervix

  • Ectopic pregnancy (a pregnancy in the fallopian tubes)

  • Pelvic prolapse

  • Urinary incontinence

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My doctor says I need a laparoscopy. What should I expect?

 

Depending on why you are having surgery, you might go home the same day or need 1 overnight stay in the hospital. Ask your doctor how long you will need to be in hospital for.

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Once you are in the operating room:

  • You will be given a general anesthetic. This means that you will be asleep the entire surgery.

  • A tube will be placed in your throat to help you breathe.

  • A catheter will be inserted into your bladder. Depending on your surgery, it might be removed at the end of the procedure or the next day.

  • Your doctor will then make a small cut at your umbilicus (belly button) or just under your left rib cage. The laparoscope is then inserted through this cut.

  • During the procedure, the abdomen is lled with carbon dioxide gas to let your doctor see your organs more clearly.

  • Your doctor then makes 3 more small cuts to insert instruments to perform the surgery. Sometimes an instrument is inserted through the vagina into the cervix to move the uterus and help your doctor bring the organs into view.

  • Once the surgery is completed, all the instruments, including the one in the vagina, are removed.

  • The small cuts are closed with stitches or tape. There will be small scars that will usually fade over time.

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Who will be involved in my surgery?

 

On the day of surgery, you will meet the surgical team. This will include:

  • Your doctor

  • Surgical assistants: these are usually trainees supervised by your doctor. They can include:

    • Fellows (doctors who are licensed obstetricians and gynecologists and are doing extra training to perform minimally invasive surgery)

    • Residents (doctors are training to become obstetricians and gynecologists)

    • Medical students (these are students learning to become doctors)

  • Nurses

  • Anesthesiologist (doctors who put you to sleep during surgery)

 

 

What do I need to do to get ready for surgery?

 

Bowel Preparation

Your surgery might require that your bowels be cleaned of all solid material. There are different types of cleanses for your bowels. All of them will likely give you loose stools. Your doctor’s office will talk about this with you. When you do your bowel preparation, it is very important that you drink lots of fluids and stay well hydrated.

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Clear Fluid Diet Until 4 Hours Before Your Surgery

On the day before surgery, you can only drink clear fluids (any fluid that you can see-through).

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Allowed​

  • Water

  • Clear broths

  • Juices

  • Clear soda

  • Tea (no milk, creamer, or honey)

  • Coffee (no milk or creamer)

  • Clear Gatorade

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Not Allowed

  • Milk

  • Cream

  • Orange juice

  • Tomato Juice

  • Creamy soups

  • Solid foods

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How long will it take me to recover?

 

After you wake up from the general anesthetic, you will feel sleepy. Some women might feel sick and vomit. You will need someone to drive you home.

  • For smaller procedures, most women will recover by 1 to 2 weeks.

  • For larger procedures, most women will recover within 2 to 4 weeks.

  • For a few days after the surgery, you might feel tired and have some discomfort.

  • You should still move around at home.

  • You will be sore around the cuts in your abdomen.

  • You will be given pain medication.

  • You might have a sore throat from the tube put in your throat during surgery. You can try throat lozenges to help with the sore throat.

  • You might also have some pain in your shoulders or back. This is from the carbon dioxide gas used during surgery. It will go away on its own within a few hours up to 1 to 2 days.

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What can I do after surgery?

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  • You can shower 2 days after surgery.

  • Your doctor will let you know when you can get back to regular activities.

  • Usually, your doctor will recommend to avoid heavy activity for 4 to 6 weeks and may recommend to avoid sexual intercourse for 2-4 weeks.

  • Do not drive until you are no longer taking narcotic pain medication and you can move around.

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When should I be concerned?

 

While it is normal to have some pain and bleeding after surgery, you should see your doctor or go to the emergency room immediately if you have the following:

  • Abdominal pain that is getting worse

  • Heavy vaginal bleeding (changing 2 to 4 pads over 2 hours)

  • Fever

  • Chest pain or difficulty breathing

  • Severe pain, swelling and redness in on or both legs

  • Unable to urinate

  • Severe nausea (feeling sick to the stomach) and vomiting

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What are the benefits of laparoscopy?

 

The alternative to laparoscopy is a laparotomy. This is a single large cut on the abdomen. Laparoscopy has many benefits over laparotomy. These are:

  • Smaller cuts

  • Shorter hospital stays

  • Shorter recovery period

  • Quicker return to normal activities

  • Less pain

  • Lower risk of bleeding and infection

 

 

What are the risks of laparoscopy?

 

Laparoscopy is a safe procedure, but there is a risk of the following complications:

  • Bleeding at the cut sites on the skin

  • Hernia at the cut sites on the skin (a bulge caused by intestines pushing through the deeper layers of the abdominal wall)

  • Internal bleeding, rarely needing a blood transfusion

  • Infection

  • Injury to blood vessels, nerves, or other organs (like the stomach, intestines, bladder, ureters). You might need additional procedures to fix these injuries.

  • Temporary di culty emptying the bladder

  • Blood clots in the veins of the legs or lungs

  • Injury to the nerves in the legs from the positioning or the nerves of the abdominal wall causing pain in the future

  • Problems from the anesthesia

     

It is also important to know that in some cases, your doctor might decide during the surgery that a laparoscopy cannot be done to complete the surgery. In these cases, a laparotomy (large cut on the abdomen) will be made instead. If this happens, you might need to stay in the hospital for 2 to 3 days and you will have a longer recovery (usually 6-8 weeks).

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Who do I contact if I have questions?

If you have any questions or concerns, please call your gynecologist’s office.

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Sunnybrook Health Sciences Centre

2075 Bayview Avenue Toronto, ON M4N 3M5

Telephone: 416.480.6100

www.sunnybrook.ca
PR 47191 (MAR 2016)

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