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Gynaecological laparoscopyPublished by Bupa's health information team, March 2007. This factsheet is for women who are considering having a gynaecological laparoscopy. Your care may differ from what is described here because it is adapted to meet your individual needs.
What is gynaecological laparoscopy?A gynaecological laparoscopy is a keyhole procedure that allows your surgeon to examine the fallopian tubes, ovaries and womb. The procedure is commonly used to:
A laparoscope is a long, thin telescope with a light and camera lens at the tip. It is passed into the abdomen through small cuts. Your surgeon will examine your organs by looking directly through the laparoscope, or at pictures sent to a TV screen. The examination is routinely done under general anaesthesia as a day case. This means you will be asleep during the procedure. What are the alternatives?Depending on your symptoms and circumstances, alternative options may include:
Your doctor will explain your options to you. Preparing for your procedureYour doctor will discuss how to prepare for your examination. You will be asked to follow fasting instructions. Typically, you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand. What to expect in hospitalYour surgeon will talk to you about the procedure and you will be asked to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead. You may be asked to wear compression stockings to help prevent blood clots forming in the veins of your legs (deep vein thrombosis, DVT). About the procedureThe procedure can last from 30 minutes to over an hour, depending on what type of treatment or examination you need. A laparoscopy usually involves two cuts about 5 to 10mm long. The first cut is made just below, or above, your belly button. A hollow needle is inserted. This is then connected to a supply of carbon dioxide gas, which is pumped through the needle and into the abdomen. This lifts the wall of the abdomen away from the organs inside, making it easier and safer to insert the laparoscope and examine the internal organs. The laparoscope is passed through a second cut usually made in the belly button. This means there is less visible scarring. If any treatment or surgery is needed, additional small cuts are made to insert the necessary instruments. Sometimes a special dye may be injected into the fallopian tubes and womb to help tissues show up more clearly. Once the examination is complete, the instruments are carefully taken out and the gas is allowed to escape through the laparoscope. The cuts are closed with two or three dissolvable stitches.
What to expect afterwardsYou will need to rest until the effects of the anaesthetic have passed. If you are sore, you may need painkillers. It's normal to have some vaginal bleeding after the procedure. If a dye was used, you may have a dark vaginal discharge for a day or two. Going homeYou will usually be able to go home once you have made a full recovery from the anaesthetic. However, you will need to arrange for someone to drive you home. You should have someone stay with you for the first 24 hours. Before you go home, you will be given advice about caring for the healing wounds, hygiene and bathing. You may be given a date for a follow-up appointment with your surgeon. Sometimes no further appointments are needed. After you return homeIf you need them, continue taking painkillers as advised by your surgeon. General anaesthesia can temporarily affect your co-ordination and reasoning skills, so you should not drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. You should not drive until you feel you could do an emergency stop without discomfort. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your surgeon's advice. You will need to take it easy for a day or two. You will usually be able to return to work within a couple of days, but this depends on the exact treatment you have. A full recovery can take up to seven days. Follow your surgeon's advice about resuming sexual activity and contraception. Most women experience no problems after having a gynaecological laparoscopy. However, if you develop any of the following symptoms, please contact your GP:
What are the risks?Gynecological laparoscopy is a commonly performed and generally safe procedure. For most women, the benefits in terms of improved symptoms, or having a clear diagnosis, are far greater than any disadvantages. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications. Side-effectsThese are the unwanted but mostly temporary effects of a successful procedure. Afterwards, you are likely to feel some pain in the abdomen as well as "referred pain" in the tips of your shoulders. This usually improves within 48 hours. You may have some abdominal bruising, which usually settles without treatment. ComplicationsComplications are when problems occur during or after the procedure. Most women are not affected. The main complications of any operation are bleeding, infection, an unexpected reaction to the anaesthesia, or developing a blood clot in the veins of one of your legs (deep vein thrombosis, DVT). Complications may require further treatment such as returning to theatre to stop bleeding or antibiotics to deal with an infection. Specific complications of gynaecological laparoscopy are rare, but it's possible that during the operation other organs in the abdomen (such as the bowel, bladder or major blood vessels) may be accidentally damaged. In extremely rare cases, these complications can be fatal. It's also possible that during the operation the womb may be damaged or perforated. This can lead to bleeding and infection, and may require further surgery or, in extremely rare cases, a hysterectomy. There's a chance your surgeon may need to convert your keyhole procedure to open surgery. This means making a bigger cut on your abdomen. This is only done if it's impossible to complete the operation safely using the laparoscope. Ask your surgeon to explain how these risks apply to you. The exact risks will differ for every person and will depend on the type of examination or treatment you are having. Further information
Sources
Related topicsThis information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: March 2007. Expected review date: March 2009.
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