LAPAROSCOPY

General Information

DEFINITION--Procedure that allows visual examination and some treatments of the pelvic and abdominal organs. Surgery is performed with a laparoscope, a fiber-optic instrument.

BODY PARTS INVOLVED--Abdomen and all its contents.

REASONS FOR SURGERY

• Diagnosis of reasons for infertility in women.
• Minimal endometriosis.
• Complications from pelvic disease.
• Masses or cysts in the pelvis.
• Undiagnosed pelvic pain.
• Fibroid tumors of the uterus.
• Voluntary sterilization.
• For diagnosis and treatment for a variety of abdominal disorders.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Heart or lung disease.
• Advanced pregnancy.
• Previous abdominal surgery, especially hernias.
• Use of drugs such as: antihypertensives; antiarrhythmics; diuretics; or beta-adrenergic blockers.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon; obstetrician-gynecologist; gastroenterologist; specially trained family doctors.

WHERE PERFORMED--Outpatient surgical facility or hospital.

DIAGNOSTIC TESTS--Before surgery: Blood studies.

ANESTHESIA

• General anesthesia by injection and inhalation with an airway tube placed in the windpipe.
• Local anesthesia (sometimes).

DESCRIPTION OF OPERATION

• A small incision is made in or below the patient's navel. A needle is inserted to inflate the abdomen with carbon dioxide.
• The operating table is tilted to allow the bowel and carbon dioxide to float up toward the chest. The laparoscope is used to examine the abdomen visually.
• The laparoscope is used to perform surgeries, if necessary.
• The laparoscope is removed, and the carbon dioxide is allowed to escape from the abdomen.
• Small sutures under the skin and an adhesive bandage are used to close the wound.

POSSIBLE COMPLICATIONS--Perforation of the bowel or liver (rare).

AVERAGE HOSPITAL STAY--0 to 2 days.

PROBABLE OUTCOME--Expect full recovery without complications. You may experience slight discomfort for 24 to 48 hours. You may have aches in your shoulders and chest from the carbon dioxide that was used to inflate your abdomen. No treatment is necessary. Allow 6 days for full recovery from surgery.

Postoperative Care

† Ask your doctor about contraception methods. If surgery was for sterilization and you were taking birth-control pills, finish your present package; then you no longer need birth--

control methods.

• Use sanitary pad (not tampons) to stop slight vaginal bleeding, which may occur after surgery. > Sit in a hot tub of water for 10 to 15 minutes at a time to relieve discomfort.

MEDICATION---Your doctor may prescribe pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Resume driving 24 hours after recovery from surgery. > Resume sexual relations in 2 or 3 days after recovery from surgery.

DIET

• Avoid carbonated beverages for 48 hours after surgery.
• No special diet.

Call Your Doctor If

† You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.

• You have excessive bleeding or discharge from either the surgical area or the vagina.
• You experience abdominal swelling or pain.