Laparoscopy is a surgical procedure that allows your physician to directly view the peritoneal cavity, ovaries, and the outer surfaces of the fallopian tubes and uterus.
A slender instrument with a tiny camera and fiber optic light, called a laparoscope, is inserted through a small incision just below the navel to illuminate and view the inside of the abdomen.
Carbon dioxide gas is injected into the abdominal cavity, through a special needle inserted into the incision. The gas inflates the abdomen, creating space between the various organs and making it much easier for the physician to view the reproductive organs. Note: The gas is removed at the end of the procedure.
Even smaller incisions are made near the pubic hair line. A second instrument—a tool used to reposition organs for better viewing—is inserted here. The physician may also insert other instruments; for example, tools to take tissue samples for laboratory analysis, or even a tiny laser to remove fibroids, endometriosis, or scar tissue. Laparoscopy is often employed to open blocked fallopian tubes, and can even be used to perform a hysterectomy.
Microlaparoscopy is a new minimally invasive diagnostic surgical procedure that uses telescopes and instruments that are much smaller than previously available. If this procedure is appropriate for your condition, the resulting incisions are smaller, which may in turn reduce any postoperative abdominal tenderness.
Please refer to your outpatient surgery center folder for specific information such as date, time, location, contact phone numbers and preparation instructions.
Arrange for someone to attend to your needs at home for at least 48 hours after surgery. Also, you will need a quiet, peaceful environment when you return home. If you have children, you should arrange child care outside the home for the day of surgery and possibly the following day.
It’s a good idea to have the following items on hand before your surgery, to avoid the person attending you having to leave you alone during trips to the store:
- prescription pain medication
- over-the-counter pain medication (Advil®, Aleve®, Motrin®, Tylenol®, aspirin, etc.)
- feminine pads
- heating pad
- light food items such as bread, fruit, ice cream, oatmeal, rice, saltine crackers, soup, steamed vegetables, yogurt
- loose, comfortable clothing
- movie video(s)
- that great book you’ve been meaning to read
- throat lozenges
- writing materials
Do not eat, drink, smoke or chew gum after midnight on the evening before your surgery. Ask you doctor if you should stop taking any prescribed medications.
You may be given instructions for bowel preparation during your preoperative office visit. Bowel preparation is usually recommended for patients with endometriosis, pelvic adhesions or pelvic pain. Preparing the bowel with a purging agent like Magnesium Citrate or Go-lyte® is often followed by an oral antibiotic and enemas. While unpleasant, this procedure minimizes the risk of surgical complications from bowel injury. Generally, no vaginal prep is required.
You must shower or bathe the night prior to your surgery. Nail polish, make-up and jewelry should be removed. Wear loose-fitting clothes to prevent any unnecessary pressure on the umbilicus the day of your surgery.
After you check in at the outpatient surgery center, a nurse will call you into the changing room. You will take off all your clothing and put on a patient gown. Eyeglasses, contact lenses, dentures and all jewelry should be removed. Valuables should be left at home, or entrusted to the person who accompanies you.
The nurse will ask you several questions about medications you take, allergies, your health status, and other information before your surgery. Please feel free to ask any questions and express any concerns you may have.
You will be asked to empty your bladder. A nurse will insert your IV and may provide you with a medication that makes you feel relaxed and drowsy.
The anesthesiologist or a nurse will walk you into the operating room. The nurse anesthetist or anesthesiologist will place four adhesive tabs on your back or chest to monitor your heart rate. While watching the monitor, do not be alarmed about sudden changes in your heart rate or pattern. These changes may be caused by electronic interference and are not related to your heart activity.
You will be given medication that will make you drowsy and may blur your vision. You will then drift off to sleep.
You will wake up in the recovery room after your surgery. A nurse will check your blood pressure, pulse and temperature several times. He or she will also check your dressing and intravenous. Ask for an extra blanket if you are cold. You may be given a cup of ice chips to moisten your mouth, instead of a drink. The nurse or physician will tell you when you may drink something.
While policies on allowing family members into the recovery area vary for each facility, you may have visitors as soon as you are transferred from the recovery area. This is usually about an hour after surgery. You may not remember conversations during this time, and it will not be unusual for you to ask your visitors the same question or questions repeatedly. These are normal effects of anesthesia and last for only an hour or two.
Your physician will discuss the findings with your family immediately after the surgical procedure is completed. Family members should let the receptionist know how they can be contacted if they leave the waiting area.
Medication will be available for pain or nausea. Do not hesitate to ask your nurse for medication if you are uncomfortable. Medication will be administered through your IV until you are able to drink. Once you are able to drink, your medication will be changed to pills. Additional pain medication is usually allowed every three to four hours. Additional nausea medication is usually allowed every four to six hours.
Laparoscopy patients typically remain in the outpatient surgery center for about three to four hours after the procedure. You will be allowed to go home after you are able to empty your bladder. An overnight hospital stay is considered for any patient who experiences severe nausea or is unable to empty her bladder. If additional medications are required, you will be given prescriptions before you leave.
Care for your incisions. You will typically have a half-inch incision just below your navel. This incision will have one suture that will dissolve. You will also have two to four tiny incisions—one quarter inch or smaller—near the pubic hair line. These incisions are made for the various instruments used during the surgery. These incisions—because they are so small—may not have a suture. Each will be covered with small adhesive strips, which may be removed two to three days after surgery.
The incisions may produce a watery, pinkish color drainage for a day or two. This is normal and typically lasts less than 48 hours. You may reinforce or change your dressings if they become saturated. You may remove the dressings 48 hours after surgery if you wish; however, it’s still a good idea to cover your incisions with a light dressing for the first week or so, to protect your clothes and keep the fabric from irritating your incisions.
With microlaparoscopy, you will not have any sutures. Your bandaids can be removed the next morning.
Diet. You may receive dietary instructions before you leave the hospital. Generally, stick to clear liquids (bottled water, fruit juices, Jello) until you pass gas from your rectum or have a bowel movement. You may then start to advance your diet, sticking to light, easily digested foods during the first few days.
If you have not passed gas by the morning after surgery and you are not experiencing nausea, you may try a piece of toast, crackers or something else light. If you are able to tolerate this, you may start advancing your diet. However, take it slow. If you do experience nausea at this time, please call our office.
Gas pain. You may experience pain in your shoulders, or sharp pain under your diaphragm. This pain is caused by some residual carbon dioxide gas not expelled from your abdomen at the end of the procedure. The pain usually disappears after a day or two. Getting up and moving around while you are experiencing this pain is helpful. You may also find heat, massage, and drinking hot water or hot tea with fresh lemon therapeutic for this pain.
Infection. Take your temperature every morning for one week, and please call our office if you experience any of the following symptoms:
- temperature above 101 degrees
- unusual dizziness or a fainting spell
- increasing redness, swelling, unusual drainage or pain from your incisions
- frequent urination or burning with urination, or spasmodic pain in the lower abdomen above the pubic bone, which may indicate a bladder infection
Pain medication. It is important to understand that your pain medication may give you a false sense of wellness. Remember that the function of pain medication is to mask pain. So, even though you may feel fine during the first few days following surgery, understand that your body is still recovering.
Eat and drink carefully, as choking or coughing is not a pleasant experience following this type of surgery. Laughing, crying, sneezing and shivering from cold may also cause discomfort. Find a comfy spot and take it easy.
Physical activity. You can expect to feel sore and drained of energy for a few days. Make an effort to get out of bed or off the sofa and move around, even through you may not feel like doing so. Increase your activity gradually. You may tire easily even after the slightest physical effort for a week or two. You should not engage in any strenuous activity until after your first post-op visit to our office.
Also, please be sure to discuss any post-operative travel plans with your physician before you undergo surgery. And if you must take an unexpected trip for any reason during the first week after your surgery, please let us know beforehand.
Sexual activity. You may resume sexual activity within two to three days following your surgery, unless you are given other instructions. On the other hand, be careful. Please do not have sexual intercourse until any pain, vaginal bleeding or discharge has subsided.
Sore throat. You may experience a sore throat. This soreness is caused by a tube placed into your throat (trachea) during anesthesia. Any throat irritation usually lasts for just a few days and can sometimes be relieved by throat lozenges.
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This information is not a substitute for medical advice from a physician. You should consult your physician in health matters, especially if you experience symptoms that may require diagnosis or medical attention.