Laparoscopy

How is laparoscopy performed?

Laparoscopy is usually carried out under general anesthesia administration which makes you asleep through the procedure and eases away any pain during the procedure. Anesthesia is administered through an intravenous line (IV) in one of the veins.

In some cases, local anesthesia is used instead of general anesthesia. This will numb the area of the incision, so if you don't feel asleep also, you won’t feel any pain.

It is done as an outpatient procedure which means patients will be able to go home the same day after laparoscopy. It may be performed in a hospital and also in an outpatient surgical center.

The surgeon makes one or more tiny incisions (1 to 1.5 cm) in the abdomen, usually near the belly button, and then inserts a small tube called a cannula. This cannula is used to inflate the abdomen with carbon dioxide gas which allows the surgeon to see abdominal organs in real-time.

After the abdomen is inflated, the laparoscope is inserted through the incision, the camera attached to the laparoscope displays the images on a video monitor screen, which allows the surgeon to view the organs in real-time.

In general, the number and size of the incision to be made depends upon the specific disease or organs your surgeon is attempting to confirm or find out. In laparoscopy usually, one to four incisions are made, each between 1 to 2 centimeters in length. These incisions allow other instruments to be inserted if required (biopsy for further evaluation of the tissues).

After the procedure is done, the gas is let out from the abdomen, and the incisions are closed using stitches (dissolvable thread) and dressing is applied, bandages can be placed in the stitched area if required.

Laparoscopic surgery is far less traumatic for the body than the traditional type of surgery with a larger incision.

Patients felt less pain, less discomfort, and quicker recovery times. One can go home on the same day after laparoscopy, depending on your conditions.

What type of disease or conditions can be diagnosed using Laparoscopy?

Many conditions can be diagnosed using an Ultrasound scan, computerized tomography(CT) scan, or magnetic resonance imaging (MRI) scan.

However, the only way to give positive confirmation of the diagnosis is by directly studying the affected part of the body in real-time, using laparoscopy. Laparoscopy today are widely used to diagnose many different conditions, investigate or treat certain symptoms, such as:

• Pelvic inflammatory disease(PID) of females.
• Endometriosis in females.
• Ectopic pregnancy.
• Ovarian cysts.
• Fibroids.
• Female infertility.
• Undescended testicles.
• Appendicitis.
• Abdominal pain
• Certain types of cancers for biopsy.
• Diagnosed cancer by laparoscopy (liver, pancreatic, ovarian, bile duct, gallbladder).

What type of conditions can be treated using Laparoscopy?

Laparoscopy can be used to treat several different conditions, such as:

• Removing an inflamed appendix.
• Treat digestive conditions, remove a section of the intestine (Crohn’s disease or diverticulitis).
• Remove the gallbladder, often treating gallstones.
• Repair hernias.
• Repair burst or bleed (stomach ulcers).
• Treat weight loss surgery.
• Treat ectopic pregnancy by removing the embryo.
• Treat fibroids (remove).
• Hysterectomy (remove womb).
• Sometimes treat PID, endometriosis, heavy periods, or painful periods.

Laparoscopic surgery Recovery

The recovery time after laparoscopy is individually different, depending on one’s health conditions and problems (whether laparoscopy was used to diagnose or to treat a condition).

• If it was used to diagnose then one can start normal activities within 5days or a week.
• If it was used to treat a condition minor surgery such as appendix removal (normal activities can be resumed within 3 weeks) or major surgery such as removal of ovaries or kidneys due to cancer, recovery time is longer up to 12 weeks and more.

Generally, after the laparoscopy is performed, you will be monitored thoroughly for several hours, until you are fully awake and able to eat, drink, and pass urine before releasing you from the hospital. One could feel groggy and disoriented as it recovers from the anesthetic. Some people may feel sick or vomit, which is a common side effect of the anesthetic, and recover quickly. In some cases, one may spend overnight in the hospital for monitoring.

The timing to release you from the hospital vary, depending on your following conditions:

• Your overall physical condition
• Type of anesthesia used
• Your body’s reaction to the surgery

Before release from the hospital, you will be instructed on how to keep your wounds clean and when to come back for a follow-up appointment or to remove your stitches clean.

For some or a few days, you'll feel some moderate pain and discomfort in the incision area. You may also feel a sore throat if a breathing tube is used. Any pain and discomfort should be improved within a few days. To relieve the pain, medicine is prescribed by the Doctor.

It is also common to have pain due to the use of carbon-dioxide gas for inflating your abdomen:

• Shoulder pain
• Irritate diaphragm
• Bloating
• Cramps

This pain and discomfort are not to worry about, it should go away within a couple of days, once the body has absorbed the remaining carbon dioxide gas.
One can usually resume all the daily activities within a week.
You have to attend a follow-up appointment with your doctor about two weeks, after the laparoscopy

To ensure smoother recovery, one can follow up these activities

• Start light activity as soon as you are able, to reduce the risk of blood clotting.
• Get more sleep hours than you normally sleep.
• Wear loose-fitting clothes.

Potential risk factor of laparoscopy and when to seek a doctor or helpline

It is recommended to seek medical advice or a doctor or contact NHS111 if you experience any of these risk factor symptoms after laparoscopy, during recovery:

• A high body temperature of 38℃ and above.
• Chills
• Severe and continuous vomiting.
• Severe abdominal pain.
• Bleeding or discharge around the incision. Or redness, pain, and swelling around the wound.
• Abnormal vaginal discharge or vaginal bleeding.
• Pain and swelling in either of the legs.
• A burning or stinging sensation when urinating.

Getting pregnant after Laparoscopy: what you have to know?

Laparoscopy is often used to identify or treat infertility issues. The use of laparoscopy in reproductive medicine has become a common procedure because it is quite rare to adversely affect a woman's fertility. In many infertility cases, it can truly improve the odds of conception.

Many women face troubles conceiving a child because of their physical problems within the pelvis and reproductive tract which keeps them away from getting pregnant, commonly known as “pelvic factor infertility”.

There can be many factors that cause pelvic factor infertility (which affects women's reproductive function systems) such as:

• Scar tissues from infections.
• Injuries or previous surgeries.
• Endometriosis problems.
• Ovarian cysts.
• Polyps or fibroids in the uterus wall.

Laparoscopy is used to diagnose such issues which often cannot be diagnosed in ultrasound. This enables the surgeon to treat or repair those problems even during the laparoscopy procedure.

What are the advantages of laparoscopy surgery?

Laparoscopic surgery is one of the surgical methods which have evolved tremendously over time which is much newer, safer, and better than have increased the quality of life for surgical patients because of its extreme advantages, such as:

• Very small negligible scars.
• Very short recovery period and shorter hospitalization (stay) than the traditional method.
• Less tissue cutting.
• Less pain, lesser use of pain medication.
• Resume normal activities faster.
• Very quick healing of the scar.
• Reduced risk of infection (internal organs).

What are the disadvantages of laparoscopy surgery?

Though laparoscopy surgery is of great, there are few disadvantages of laparoscopy, such as:

• The surgeon will have to access a limited range of movement from a tiny keyhole.
• Poor depth perception.
• Surgeons face difficulty feeling tissues, so unable to judge the force that needs to be applied.
• It is a non-intuitive motor skill that is difficult to learn.