Laparoscopic Surgery: Purpose, Diagnosis, and Benefits

Laparoscopy is a type of surgery that helps a surgeon look inside your body without making a large cut (incision). It is used to both diagnose and treat conditions that have developed in the belly or pelvis.

What is Laparoscopic Surgery?

The term laparoscopy is derived from the name laparoscope, which is a slender tool that has a tiny video camera and a light at the end. The surgeon makes a small cut in your body (measuring half an inch or less) and inserts the laparoscope into your body. With the help of the video camera, the surgeon can observe what is happening inside your body. Without making a large opening, these instruments enable a doctor to observe what is happening inside the body. Laparoscopic surgery is also called keyhole surgery.

Why is Laparoscopic Surgery Done

Laparoscopic surgery is used for various surgeries like:

• Adrenal gland removal 
• Removal of cysts, polyps, fibroids, and stone
• Removal of small tumours
• Biopsies
• Tubal ligation and reversal
• Ectopic pregnancy
• Endometriosis surgery
• Urethral or vaginal reconstruction surgery
• Orchiopexy or testicle correction surgery
• Rectopexy or rectal prolapse repair
• Hernia repair surgery
• Esophageal anti-reflux surgery
• Gastric bypass surgery
• Gallbladder removal
• Appendix removal
• Prostate and kidney removal
• Removal of a part of the liver, bowel, or stomach
• Cancer

Diagnostic Laparoscopy

A laparoscopy can diagnose the cause of symptoms that you experience in the belly or pelvis. Sometimes, X-rays, ultrasounds, and MRI scans do not provide enough information to confirm a diagnosis.  A diagnostic laparoscopy can be used to figure out the stage of cancer for an abdominal organ. In the case of an abdominal injury, it can be used to find out where and how deep the injury is.

It is used to check on tumors or other growths in the belly or pelvis. It is used when there is bleeding or pain that cannot be explained, infections, blockages, or other conditions. Pain can be caused by appendicitis, adhesions, intra-abdominal scar tissue, pelvic infections, abdominal bleeding, and, less frequently, cancer. Sometimes, a tumor can be felt or seen on X-ray, but they require a diagnosis before treatment or therapy can be recommended. Laparoscopy can enable the physician to look directly at the mass, obtain tissue, and discover the diagnosis.

In women, diagnostic laparoscopy can be used to examine pelvic pain, ovarian cysts, fibroids, and fallopian tube issues. It is used to diagnose and treat endometriosis.

Sometimes, there is the presence of a fluid in the abdominal cavity called ascites. The cause of this cannot be understood without looking inside the abdominal cavity which can be easily done with laparoscopy.

At other times, an ultrasound, MRI, or CT scan can reveal a mass inside or on the surface of the liver. A liver biopsy may be required for diagnosis. Laparoscopy is a safe and accurate way to accomplish this.

A “second look” or cancer staging is done with laparoscopy. Before performing a formal exploration of the abdomen or doing treatments like chemotherapy or radiation therapy, laparoscopy is used.

Benefits of Laparoscopic Surgery

Laparoscopy has a lot of benefits over traditional surgery methods. This is because it involves less cutting. The benefits are:

•       Smaller scars
•       Early discharge from hospital
•       Less pain and scars heal faster
•       You can resume normal activities very quickly
•       Less internal scarring
•       Reduced risk of wound infection
•       Reduced risk of hemorrhage and lower blood loss
•       Less pain medication

In traditional surgery, for intestinal surgery, you may spend a week or more in the hospital. Your total recovery may take 4 to 8 weeks. When you have laparoscopic surgery, you will stay only two nights at the hospital and recover in 2 or 3 weeks. A shorter stay at the hospital means a lower cost.

Procedure

Before the procedure, you may have to take imaging or blood and urine tests. You will receive fluid through an IV inserted into your vein. Pain medications and anesthesia will also be administered through this. Doctors may insert a breathing tube to keep your airway open. A urinary catheter may be used.

Your skin will be cleaned with a disinfecting solution, and then the surgeon will make the necessary cuts in your pelvic area. Tubes will be placed for the camera and tools. A drain may also be placed. In some cases, the doctor may use a device that lets them reach inside with a hand. This is called “Hand-assisted” laparoscopy. This is used for the liver and other organs.

Next, carbon dioxide will be pumped in to separate your abdominal wall from your organs. This helps the surgeon see your organs easily. Now the doctor puts a camera and tools through the tube or tubes and complete the procedure using images on a video monitor.

Once the surgery or biopsy is complete, the surgeon will let the gas out of your body and close the incisions. A diagnostic laparoscopy procedure takes between 30 minutes to an hour. If the condition is very complicated, a surgery could take up to 3 hours. At any point, if the surgeon feels that cannot complete the surgery laparoscopically, they will switch to a traditional open procedure with a larger incision.

After surgery, you’ll stay in a recovery room for about an hour while healthcare providers monitor your vital signs until you wake up. You may have pain after the surgery both from gas left in the body or from the incisions or surgery itself. Pain medication can help relieve these symptoms.

Recovery

As you recover, you may experience any of the following:

• Nausea: You will be asked to drink clear liquids till the nausea disappears. Avoid carbonated beverages for a few days after the surgery. Your doctor will tell you when you can resume eating soft foods and your regular diet.
• Shoulder pain: The carbon dioxide used to inflate your abdomen may cause shoulder pain. The gas presses on a nerve that directs pain in the shoulder. This may take about two days to reduce.
• Incision pain: Your doctor will tell you how to care for the incisions once you leave the hospital. If the wounds become red, swollen, painful, have discharge or bleeding, you must call your doctor at once. If the doctor has placed a drain, then you may need to empty the collected fluids many times in a day to keep the tube clear.
• Abdominal or pelvic pain: These get better after a few days. However, if they get worse, call the doctor immediately.
• Constipation, tiredness, and trouble sleeping: If you are bothered by any of these, contact the doctor, and they will help you with medication.

Conclusion

Laparoscopy is a very efficient surgery that allows doctors to see what is happening inside your body without opening you up. A lot can be done through these tiny holes but everything cannot be done. Larger problems may require to be addressed using traditional surgical methods. However, many issues can be treated using this minimally invasive procedure. 

Frequently Asked Questions