Laparoscopy

Laparoscopy, also known as diagnostic laparoscopy, is a surgical medical procedure which is used to examine the organs inside the abdomen. The procedure is conducted with the help of a long, thin tube with a high-intensity light and high-resolution camera, called a laparoscope. It is a type of keyhole surgery performed on the abdomen. It is a minimally invasive procedure which has very low risks and the biggest advantage is that the entire procedure can be conducted with the help of small incisions.

Laparoscopy is initiated by the administration of either local or general anaesthesia to the patient to relieve them from any kind of pain during the surgery. This is done by inserting an intravenous line (IV) in one of the veins. This is followed by the surgeon making an incision below the belly button, and then inserting a small tube, called as a cannula. The cannula helps in inflating the abdomen with carbon dioxide gas in order to enable the doctor to see the abdominal organs more clearly. Once the abdomen is inflated, your surgeon will insert the laparoscope through the incision that was made. A high-resolution camera attached to the laparoscope gives a live-time visual of all the organs on a screen.

Any other instruments required for the procedure is inserted through the other incisions made, which are specific to the type of disease and surgery required. The operation is conducted by a well trained specialised doctor from the outside. After the procedure is performed, the instruments are removed. The incisions are covered with stitches or surgical tape. Bandages may also be placed over the incisions.

The clear cut advantage of laparoscopy over the traditional surgical methods is that large open wounds occurring due to surgery is replaced with small incisions leading to a decreased blood loss, pain and discomfort. Some of the benefits of this procedure are relatively less pain when compared to that of an open procedure, faster span of recovery, smaller incisions and decreased risk of infection.

Some of the risks associated with laparoscopy are as follows:

• Scars due to the surgical incisions
• Hernias
• Inflammation of the intestines, known as appendicitis.
• An abnormal growth in the uterus, known as fibroids.
• Tumors or cysts
• Cancer
• Inflammation of the gall bladder, known as cholecystitis
• Growth of the uterine lining outside the uterus, known as endometriosis.
• Injury to any particular organ.
• Blood clots
• Abdominal Infections

As soon as the surgery is performed, you may experience a moderate amount of pain and throbbing in the region where the incision was made. Your doctor may prescribe you with appropriate medication for the same. Serious complications are rare in case of a laparoscopy, as it is a commonly performed procedure.

Laparoscopy is a type of keyhole surgery usually performed on the abdominal region. It is performed to diagnose and treat several conditions pertaining to the abdominal cavity such as assessment of painful or heavy periods, removal of the uterus or fallopian tubes or ovaries, diagnosis or removal of ovarian cysts, assessment of female infertility, treatment of ectopic pregnancy, removal of gall bladder, collection of biopsy etc. 

While the surgery is being performed, the patient is administered with general anaesthesia, which usually puts the patient to sleep. However, in some cases, local anaesthesia is administered where the patient experiences a feeling of numbness in the region being operated.

After anaesthesia is being administered, a small incision is made in the abdominal region such as below the navel. The laparoscope is inserted through this incision. During the procedure, the abdomen is inflated with carbon dioxide gas with the help of a small tube, called cannula. Filling the abdomen with gas facilitates viewing of a clearer picture of the pelvic reproductive organs to be seen more clearly. The high-resolution camera attached to the laparoscope shows the pelvic organs on an imaging screen. Other small incisions may be made in the abdomen for the insertion of any other surgical instruments that may be required. Another instrument, called a uterine manipulator, may be inserted through the vagina and cervix and into the uterus to move the pelvic organs into view. 

After the procedure, the instruments that were inserted and most of the gas used to inflate the abdomen are removed. The small incisions are closed through stitches and bandages. The patient will be shifted to the recovery room. The patient is asked to rest for a few hours. Some amount of nausea and discomfort may be experienced from the anaesthesia. The patient can usually can go home the same day. However, more complex procedures, such as laparoscopic hysterectomy, may require an overnight stay in the hospital.

Your doctor will let you know when you can resume your normal activities. For minor procedures, it is often suggested that normal activities can be performed after 1–2 days after the surgery. For more complex procedures, such as hysterectomy, it may take longer. Involvement in intense physical activity must be avoided for a few days.

For a few days after the procedure, you may experience fatigue and discomfort. A feeling of soreness may be experienced around the region where the incisions were made in your abdomen and navel. The tube inserted in the throat to facilitate breathing during the surgery may give you a sore throat. Try throat lozenges or gargle with warm salt water. A feeling of pain may be experienced in your shoulder or back. This pain may result from the small amount of gas used during the procedure that remains in your abdomen. It goes away on its own within a few hours or days. If pain and nausea do not go away after a few days or become worse, you should contact your doctor without fail.

A laparoscopy may cost around four lakh rupees in India.