A laparoscopy is a procedure that allows your doctor to look inside your abdomen using a thin telescope with a light source, called a laparoscope. The laparoscope is inserted through a small cut, usually just under the belly button, allowing the doctor to examine the organs inside your abdomen.

A laparoscopy is used as a diagnostic procedure to try and find the cause of your symptoms.

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How is a laparoscopy performed?

The procedure is carried out under a general anaesthetic.

• A small cut is made, usually just under your belly button.
• Carbon dioxide gas is pumped into your abdomen. This gas is harmless and is used to inflate the abdomen and separate the organs so they can be seen more easily.
• If required, further small cuts may be made to allow other instruments to be passed into the abdomen.

Any potential minor treatments that might be carried out at the time of your laparoscopy will be discussed with you in clinic before you are placed on the waiting list.

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Can anyone have this operation?

Most people can have a laparoscopy, provided they have not had problems with anaesthetics in the past and are fit for surgery.
Before the operation, you will attend a pre-operative assessment appointment. This may include:

• A medical examination
• Blood tests
• Further investigations such as a heart tracing or X-rays, if required

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What are the advantages of laparoscopic surgery?

Compared to traditional (open) surgery, laparoscopic surgery usually offers:

• Less pain following the procedure
• A shorter hospital stay
• A quicker recovery time
• Smaller scars

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Are there any risks associated with this operation?

A laparoscopy may not always identify an obvious cause for your symptoms. Some risks are increased in women with a raised body mass index or those who have had previous abdominal surgery.

Serious but uncommon risks include:

• Overall risk of serious complications: approximately 1 in 500
• Damage to the bowel, bladder, uterus, or major blood vessels, which may require immediate repair by laparoscopy or open surgery
• Up to 15% of bowel injuries may not be diagnosed at the time of laparoscopy
• Failure to gain entry to the abdominal cavity or complete the procedure
• Hernia at the site of entry
• Death: between 3 and 8 women in every 100,000 undergoing laparoscopy (very rare)

More common risks include:

• Wound bruising
• Shoulder-tip pain
• Wound gaping
• Wound infection

If the operation cannot be carried out safely using the laparoscope, the surgeon may convert to an open procedure. This happens in around 3–5% of cases. Additional surgery may be required if complications occur.

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What should I expect after my laparoscopy?

General anaesthetic

When you wake up, you may feel drowsy and slightly uncomfortable. Pain relief will be provided if required. You will need someone to drive you home and stay with you overnight.

Hospital stay

• Diagnostic laparoscopy: usually discharged the same day
• Operative procedure: may require an overnight stay

Pain and discomfort

You can expect some lower abdominal discomfort for a few days. Simple painkillers are recommended and will be provided.

Scars

• Incisions are about 1cm in size
• Closed with stitches (some dissolve, others are removed after 5–7 days)
• Dressings can be removed after 24 hours

Vaginal bleeding

A small amount of vaginal bleeding for 1–2 days is normal.

Eating and drinking

You will be offered a drink and a light snack once you are awake.

Driving

Do not drive for 24 hours after your anaesthetic. Check with your insurance company, as conditions may vary.

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Returning to work

When you can return to work depends on your job.

• After a diagnostic laparoscopy or simple procedure, you may feel able to return within one week
• Take it easy for the first 48 hours

If you are off work for less than one week, you can usually complete a self-certification form.

You should feel better day by day. If you continue to feel unwell, contact the gynaecology ward.