What is laparoscopy in gynecology?

Laparoscopy is a technique that is used to diagnose and treat gynecological conditions.
Laparoscopy is a technique that is used to diagnose and treat gynecological conditions.

Laparoscopy in gynecology (gynecological laparoscopy) is a less invasive alternative to open surgery. The procedure involves using a laparoscope (a long, thin tube with a light connected to a camera) to look inside the pelvic area to diagnose gynecological disorders or to perform surgery to treat gynecological conditions. A small incision is made over the abdomen through which the laparoscope is inserted. Two to three other small incisions may be made to insert specialized surgical instruments. Open surgery is more invasive and usually requires a large incision. Healing is also generally faster with laparoscopic procedures.

Why is laparoscopy in gynecology done?

Laparoscopy in gynecology may be performed for diagnosis, treatment or both.

Indications for diagnostic laparoscopy include

Gynecological conditions that may be diagnosed by performing a laparoscopy include

Laparoscopy may be used in the treatment of the following gynecological conditions

  • Removal of the uterus (hysterectomy)
  • Removal of tumors from the ovary or uterus
  • Endometriosis (presence of endometrial tissue, the tissue that lines the inside of the uterus, at sites outside the uterus)
  • Removal of adhesions and scar tissue
  • Tubal sterilization (permanent sterilization)
  • Surgery to treat prolapsed uterus (when the internal supports of the uterus become weak making it descend towards or outside the vagina)

How is laparoscopy in gynecology performed?

During the procedure

Laparoscopy is usually performed under general anesthesia. Hence, there is no pain during surgery. This means you will be unconscious for the procedure. A needle is inserted into the abdomen to fill the abdomen with carbon dioxide gas. The gas widens the abdominal cavity by allowing a clearer view of the organs, keeps the abdominal wall away from the organs and reduces the risk of injury to the abdominal organs. The surgeon makes a small incision below the umbilicus (belly button) through which the laparoscope is inserted. The camera attached to the laparoscope transmits the video to a screen giving a clear and magnified view of the pelvic structures. The video can also be recorded for future reference. If the procedure is being performed only to make a diagnosis, only one incision is required to insert the laparoscope. If a surgical procedure is to be performed, additional small incisions would be required through which the surgical instruments would be inserted. Once the procedure is over, the incisions are sutured (stitched) and dressed.

After the procedure

After the procedure, the patient would have to stay in the hospital until the anesthesia wears off, but the patient needs to have someone drive them home. Patients are usually discharged on the same day or 24 to 48 hours after the procedure, depending on what was done. Patients can resume their daily activities in 1 to 2 days but are advised to avoid straining, heavy lifting, sports, exercise and other specific activities until the surgeon allows it. Recovery time depends on the procedure performed. It varies from a few days to a few weeks. Patients may experience pain, swelling and bruising, which usually resolves in a few days. Painkillers and antibiotics are usually prescribed. Recovery following laparoscopic procedures is faster than recovery after open surgery.

What are the complications of laparoscopy in gynecology?

Serious complications of laparoscopic procedures are rare. Some possible complications include

The risk of complications increases in the following cases

  • Previous history of major pelvic or abdominal surgery
  • History of pelvic infections
  • Bowel disease
  • Chronic smoking
  • Adhesions
  • Obesity
  • Poor nutritional status
  • Diabetes and other major systemic illnesses

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Medically Reviewed on 10/29/2020
References
Medscape Medical Reference

Advanced Gynecologic Endoscopy