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laparoscopy

Laparoscopy is a keyhole surgery technique for examining the exterior of the uterus (womb) and the fallopian tubes. While this surgical procedure is often performed as a diagnostic examination, it can also be used for the treatment of blocked tubes, endometriosis, adhesions, ovarian cysts, ectopic pregnancies or fibroids. Hydrosalpinx, a disorder whereby fluid collects in the fallopian tubes, can also be diagnosed and sometimes treated with laparoscopy.

how it works

A laparoscope is a telescopic instrument that is inserted into the abdomen through a small incision just below the navel. Carbon dioxide is then introduced into the abdomen. A second, smaller cut is made just above the pubic hair in order to insert surgical instruments. Laparoscopy is sometimes called ‘band-aid’ surgery, as the incisions are extremely small and can normally be covered with a plaster. Using the laparoscope, the doctor can literally see the reproductive organs of a woman and correct any abnormalities such as a blockage, endometriosis, or adhesions (scar tissue) with the help of laser surgery or electrocauterisation. (For women with serious fallopian tube disorders, it appears to generally not be worthwhile to try to address the disorder using laparoscopy. They are generally advised to move directly onto IVF treatment.)

If the disorders are more extensive than expected during keyhole surgery, it might be necessary for treatment to be performed through an abdominal operation (laparotomy) either there and then or at a subsequent date. If there is a chance of immediate surgery, it will be discussed with the woman beforehand.

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risks

A woman will be put to sleep for this operation, which requires a day in hospital. The following side effects may occur:

  • Abdominal pains after the operation, sensitivity of and bruising to the abdomen.
  • Shoulder and abdominal pains as a result of the carbon dioxide.
  • Nausea or headaches as a result of the anaesthesia.

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possible complications

Serious risks include

  • Venous thrombosis or pulmonary embolism
  • Death
  • Return to theatre
  • Trauma to bowel, bladder or ureter

Frequent risks include

  • Infection
  • Bruising
  • Scaring
  • Adhesions
  • Bleeding
  • Urinary frequency / loss of control
  • Anaemia
  • Fatigue

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results

The success of laparoscopy can vary dramatically, depending on the reason for the procedure.

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