Laparoscopy

Diagnostic and operative laparoscopy

Diagnostic laparoscopy is performed when it is necessary to find the cause of pelvic problems that cannot be diagnosed by gynecological examination, ultrasound or related examinations. It can be performed in cases of acute and chronic pain, suspected ectopic pregnancy, and it is an especially important examination method in the treatment of infertility.

Operative laparoscopy is a common method in ovarian cyst surgery (cystectomy), tubal ligation (sterilization), diseased fallopian tube extraction (salpingectomy), and fibroid extraction (myomectomy). Additionally in cases where the pregnancy is in the fallopian tube, ectopic pregnancy surgery with (salpingectomy) or without extraction (salipingotomy) of the altered fallopian tube.

Diagnostic

Laparoscopy is a method of examination of the abdominal cavity, i.e. endoscopic surgery that is performed under general anesthesia through small openings, 5– 10 mm in size, on the skin of the abdomen. Before the procedure, the anesthesiologist will inform you about the details and risks of anesthesia.
The bladder is emptied before the procedure by introducing a catheter through the urethra. The catheter usually remains in the bladder for a few hours after the procedure.

After washing and disinfecting the operative field, the doctor begins the procedure with an incision, 5–10 mm in size, under the navel. First, a needle is introduced through the incision in which the abdomen is filled with carbon dioxide for better examination of the pelvic organs. Through the same incision, a special type of telescope (laparoscope) with a video camera is introduced. Other instruments are introduced into the pelvic cavity through equally small incisions on the skin just above the pubic hairs. In the case of operative laparoscopy, the extracted cyst or other formation is removed from the abdomen through the same incision and is then placed in a solution of 10 % formaldehyde and sent to the pathologist for histopathological analysis. The gas is released at the end of the operation, and the openings in the skin are closed with surgical sutures. In particularly complicated cases, a plastic tube is placed through a side incision to drain secretions and blood before closing the abdominal openings on the skin.

Postoperative recovery after laparoscopy

After the procedure, the patient may experience pain in the shoulders and ribs due to a small amount of gas residual under the diaphragm, muscle pain, pain in the area of the operative wound, discomfort or fatigue in the following days, and a certain degree of nausea. Some women may experience several days of menstrual pain accompanied by vaginal discharge. If necessary, pain can be suppressed with analgesics.

When the symptoms disappear and you feel better, you can resume your usual physical and sexual activities, but not earlier than 2 weeks after the procedure.

You will be notified of the outcome of the laparoscopy before being discharged from the hospital. Although the patient can usually leave the hospital on the second day after the procedure, sometimes it is necessary to stay for several days. It depends on how complicated the procedure is and how the postoperative recovery proceeds. The doctor thoroughly informs the patient about all the details.

Stitches are usually removed 7 days after the procedure when a check-up is scheduled.