E F Nigel Holland
Consultant Gynaecologist and Obstetrician
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What is a Laparoscopy?

A laparoscopy is an operation to find out what is causing your symptoms. It is performed using an instrument called a laparoscope. This is a small, narrow telescope which allows us to see and examine your pelvic organs (womb, ovaries and fallopian tubes).

The operation is usually done under a general anaesthetic (you will be asleep) and takes approximately 15 minutes to do. When you are asleep your adbomen is cleaned with an antiseptic (usually coloured brown). Carbon dioxide gas is passed into the abdomen through a special needle inserted just below your belly-button. The gas helps to protect the pelvic organs.

A small cut is made about a centimetre long and the laparoscope is inserted to see, examine and, if suitable, treat the affected area whether it be adhesions (scar tissue), endometriosis or small ovarian cysts. If treatment can be performed in this way it may be necessary to have one or two more small cuts to accommodate the instruments needed to perform different types of surgery. When the operation is completed the laparoscope is removed and the gas released. A stitch may be put into the cut near your umbilicus.

Why do you need a Laparoscopy?

- To investigate and, if suitable, treat the cause of abdominal or pelvic pain. painful intercourse (deep dyspareunia), painful periods (dysmenorrhoea).
- To examine and/or take samples of any ovarian cysts/ tumours.
- To diagnose an ectopic pregnancy (a pregnancy which develops outside the womb, usually in the Fallopian tube).
- To assess patency of the fallopian tubes by   passing a blue dye   through them as part of infertility investigation (laparoscopy and dye test).

What are the benefits of a Laparoscopy?

- Can be done as a day case.
- Some diagnoses can be treated through the laparoscope, reducing the need for major surgery.

What are the risks of a Laparoscopy?

No operation is without risks. Those associated with laparoscopy are uncommon.
- Damage to the bowel or ureters (the tubes leading from the   kidneys to the bladder).
- Haemorrhage (difficulty in controlling bleeding) may also be caused by accidental damage to nearby blood vessels.
- These risks rarely happen but if they do it may be necessary to make a larger cut in your abdomen to see and repair any damage that may have happened. This operation is called a laparotomy and means you will have to stay in hospital for approximately two to seven days.
- Diagnostic laparoscopy does not answer all the problems and can be reassuringly normal.

Risks associated with a general anaesthetic.
- A general anaesthetic also carries risks. These risks are greater for women who smoke or are overweight. It is advisable if either of these apply to reduce or stop smoking and try to lose some weight. In addition there may be special risks for women with certain medical problems such as heart or lung disease. You will be able to discuss any concerns you may have with your anaesthetist before your operation.

Will you have any pain?

Laparoscopy can produce some discomfort or pain. This may be mild in some patients and more severe in others. The pain that you experience may occur in the abdomen, back or shoulder tip. It is believed that the pain may be due to gas being trapped in the abdomen after the procedure.
There are several ways in which we can manage this pain after your operation.
*Suppository: We may, with your permission, administer a suppository into your back passage. This is a pain killer and has been shown to work very effectively given by this route.
*Tablets: After your operation pain killing tablets are available on request when you return to the ward. It may be advisable to take a short term supply home for a few days.
*Injections:If the tablets and suppository do not control the pain adequately, the nurses may have to administer a pain killing injection.

Will you feel sick after the operation?

Some patients may feel sick from the effects of the anaesthetic and the operation. An anti-sickness injection can be given.

What happens after the operation?

- You may eat or drink when you feel ready.
- When you have had something to eat and drink and have passed urine then you will probably be able to go home. This is usually about 4 hours after your operation, but some patients stay overnight if they do not feel well enough to go home.
- When you are ready for home I will discuss your operation with you. Stitches can take between two to three weeks to dissolve.
- Any further treatment and/or out patient appointments will be arranged. You will be given telephone numbers to contact if you have any queries or problems when you are at home.
- You should arrange for a responsible person to take you home and stay with you for the next 24 hours. They should come to the ward and take you home by either car or taxi.
- If necessary, take your pain killers regularly.
- Rest for 24/48 hours.
- If you work it may be necessary to have up to one week off. A sick note can be provided.
- Do not drink any alcohol for 24 hours.
- Do not drive for 48 hours or until you can stamp your foot on the floor to do an emergency stop, and be able to get in and out of the car and wear a seatbelt. You are advised to check this situation with your insurance company

If you have any further questions please do not hesitate to ask them.

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