Laparoscopy

Definition

Laparoscopy describes a group of operations performed with the aid of a camera placed in the abdomen or pelvis.

The laparoscope allows doctors to perform both minor and complex surgeries with a few small cuts in the abdomen. This technique is known as laparoscopic-assisted surgery.

Laparoscopy may also be done to diagnose a condition. In this case, the procedure is called diagnostic laparoscopy.

For more details about specific laparoscopic surgeries, see:

• Anti-reflux surgery
• Anti-reflux surgery - children
• Appendectomy
• Gallbladder removal - laparoscopic
• Gynecologic laparoscopy
• Hysterectomy
• Inguinal hernia repair
• Laparoscopic gastric banding
• Pelvic laparoscopy
• Radical prostatectomy
• Spleen removal
• Tubal ligation

Alternative Names

How the test is performed

The procedure is usually done in the hospital under general anesthesia. A catheter (a small flexible tube) is inserted through the urethra into the bladder. An additional tube may be passed through the nostril into the stomach (NG tube). The skin of the abdomen is cleaned, and sterile drapes are applied.

After a small cut is made above or below the belly button (navel), a tube is inserted. A tiny video camera passes through the tube. Carbon dioxide gas is injected into the abdomen to lift the abdominal wall, making a larger space in which to work. This allows for easier viewing and moving of the organs.

The laparoscope is then inserted, and the organs of the pelvis and abdomen are examined. Additional small openings are made for instruments that let the surgeon move, cut, stitch, and staple structures during the operation.

After the examination, the laparoscope is removed, all openings are stitched closed, and bandages are applied. Depending on the operation performed, a tube may be left through one of the cuts to let fluids drain.

How to prepare for the test

How the test will feel

With general anesthesia, you will feel no pain during the procedure. However, the stitched cuts may throb and be slightly painful afterward. Your doctor may give you a pain reliever.

You may experience shoulder pain for a few days, because the gas can irritate the diaphragm, the large muscle at the top of the belly. Some of the nerves in the diaphragm also go to the shoulder.

Finally, you may experience an increased urge to urinate, because the gas can put pressure on the bladder.

Why the test is performed

A diagnostic laparoscopy may be done if your doctor cannot tell what type of problem or injury you have based on the results of a physical exam or other tests.

A diagnostic laparoscopy may be done if you have:

• Pain or other symptoms that cannot be explained
• An injury
• Cancer that may have spread (cancer staging)

Normal Values

What abnormal results mean

What the risks are

Special considerations

If you have had pelvic or abdominal surgery in the past, your doctor may not be able to perform laparoscopic surgery on you. Often surgery makes scars form, which may make it difficult or dangerous to pass the instruments into your belly and move them around.

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References

Townsend CM, Beauchamp RD, Evers BM, Mattox KL, Sabiston Textbook of Surgery, 17th ed. St. Louis, Mo: WB Saunders; 2004:445-464.