A diagnostic laparoscopy is a procedure where the doctor uses a laparoscope to look inside the peritoneal cavity. A laparoscope is a thin tube with a tiny camera and the peritoneal cavity is the space that contains most of the abdominal and pelvic organs. The cavity is filled with gas so that the physician can better see the organs. Laparoscopy

When is laparoscopy used?

The diagnostic laparoscopy is often used in the infertility evaluation. Many times it is possible to treat conditions, such as endometriosis, during the diagnostic laparoscopy. This is the reason that the laparoscopy for infertility should be conducted by an infertility specialist. Laparoscopy is usually indicated in the following situations:

Abdominal pain.
Abnormal fluid in the peritoneal cavity.
An unexplained defect seen on a liver scan.
A possible tubal pregnancy or undiagnosed pelvic mass.

Depending upon the potential causes of infertility, there are alternatives to laparoscopy, which include:

Trying other procedures, such as abdominal surgery.
Having a liver biopsy.
Having x-rays and/or sonograms taken.

How to prepare for a diagnostic laparoscopy?

Plan for help and care during the recovery period after the laparoscopy. Follow the instructions provided by the health-care staff. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. If these instructions are not followed, the procedure will be canceled.

What happens during the laparoscopy?

Patients receive a general anesthetic which eliminates all pain associated with the actual laparoscopy. The peritoneal cavity is filled with carbon dioxide gas inflating it like a balloon, which helps the doctor see the organs. The doctor makes a small cut near the belly button, puts in the gas, and then puts the laparoscope through the cut.

The physician may put other tools through small cuts elsewhere in the abdomen. To look at the pelvis, for example, the doctor puts a tool through a small cut in the lower abdomen. The doctor guides the laparoscope to explore the area and look at certain organs.

If the doctor finds a growth that should not be there, he or she may use the other tool to take a sample of the growth to send to the lab for analysis or the growth might be removed. When finished, the doctor removes the laparoscope and the other tools and sews up the cuts.

What happens after the laparoscopy?

Patients remain in the hospital for several hours, or rarely overnight, to recover from the anesthetic and be observed for any potential post surgical problems. The anesthetic may cause sleepiness or "grogginess" for a while. Patients sometimes have shoulder pain and a "bloated" feeling. There may also be a change in bowel habits for a few days after the laparoscopy. Activities such as heavy lifting should be avoided.

What are the benefits of the laparoscopy?

The laparoscopy helps the doctor make a more accurate diagnosis without extensive surgery. Then further treatment, such as medication or surgery, can be recommended.

What are the risks associated with a laparoscopy?

There is always some risk associated with general anesthesia and surgery and concerns should be discussed with the physician and anesthesiologist.

The abdominal organs, intestines, or blood vessels may be damaged.
The doctor may need to perform abdominal surgery to repair them at the time of the procedure.
The peritoneal cavity may become inflamed.
Infection or bleeding is possible.
There may be some pain after the procedure.

When should the physician be called?

Call the doctor immediately if:

The patient develops a fever.
If there is redness, swelling, pain, or drainage from the small incisions.
If there is dizziness or fainting.
If the patient develops chest pain.
If there is nausea and vomiting.
Presence of shortness of breath.
If there is abdominal pain or swelling that gets worse.

Call the doctor during regular office hours if:

There are questions about the procedure or its results.
To make another appointment.

Robert B. McWilliams, MD

INFORMATION ON LAPAROSCOPIC HYSTERECTOMY

Robert B. McWilliams, MD Reproductive Endocrinology and Gynecology

Laparoscopy