Gynaecologic laparoscopy is an alternative to open surgery. It uses a laparoscope (a slender telescope fitted with a light and video camera) to look inside patient’s abdomen or pelvic area. Whereas, open surgery often requires a large incision (cut).

Laparoscopy generally has a shorter healing time than an open surgery. It also leaves smaller scars.

Laparoscopy can be used for diagnosis, treatment, or both. A diagnostic procedure can sometimes turn into treatment (Operative Laparoscopy).

Diagnostic (investigative) Laparoscopy can determine cause of symptoms or to assess whether you have conditions such as endometriosis or fibroids.

Some of the many reasons for diagnostic laparoscopy are:

• Unexplained pelvic pain

• Unexplained infertility

• A history of pelvic infection

• Taking biopsies

Operative Laparoscopy is used to perform various surgeries, using miniaturised instruments inserted through additional incisions.

Laparoscopy is performed in treatment of following Gynaecological conditions:

• Endometriosis

• Uterine fibroids

• Ovarian cysts or tumours

• Ectopic pregnancy

• Pelvic abscess, or pus

• Pelvic adhesions, or painful scar tissue

• Infertility

• Pelvic inflammatory disease

• Reproductive cancers

Some of many Gynaecological treatments Dr. Joshi performs using Laparoscopy are:

• Hysterectomy, or removal of the uterus

• Removal of the ovaries

• Removal of ovarian cysts

• Removal of fibroids

• Endometrial tissue ablation, which is a treatment for endometriosis

• Adhesion removal

• Vault suspension to treat a prolapsed uterus

Hysterectomy is the removal of the uterus and is a major surgical procedure performed under anaesthesia.

The common reasons for hysterectomy are uterine fibroids, unexplained or irregular menstrual bleeding, prolapse of the uterus, severe endometriosis and adenomyosis, unresolved chronic pain, uterine or cervical or ovarian cancer, to name a few.

Hysterectomy is either performed as abdominal – removal of uterus by a large cut on the abdomen, vaginal or laparoscopic or laparoscopically assisted. The choice of the surgery may depend on the condition of the patient and choice of the surgeon, which the doctor will discuss with you.

Like any surgery, Laparoscopic surgeries come with their own set of complications and associated risks.

Skin irritation and bladder infection are common side effects of this procedure.

Some risks are specific to laparoscopy, few of which are outlined below.
More serious complications are rare. However, they can occur and include the following:

• Damage to an abdominal blood vessel, the bladder, the bowel, the uterus, and other pelvic structures

• Nerve damage

• Allergic reactions

• Blood clots

• Problems when urinating

• Gas embolism- entrapped CO2 bubble travelling to heart or lungs.

Some of above complications are life threatening.

Conditions that increase your risk of complications include:

• Previous abdominal surgery

• Obesity

• Being underweight

• Extreme endometriosis

• Pelvic infection

• Chronic bowel disease

Dr will explain you all the risks. However feel free to ask as many questions as you want, to understand the risks to assist you in the decision-making.

Generally Diagnostic Laparoscopy is a day procedure.

Operative Laparoscopy can require more than a day admission.

Once the procedure is over, nurses will monitor your vital signs. You’ll stay in recovery until the anaesthesia wears off. You will not be released until you are able to urinate on your own. Difficulty urinating is a possible side effect of the catheter use.

Recovery time varies; it depends on what procedure was performed. You may be able to go home just a few hours after surgery or you might also have to stay in the hospital for one or more nights.

After surgery, your belly button might be tender. There may be bruises on your stomach. The gas inside you can make your chest, middle, and shoulders ache. There’s also a chance that you’ll feel nauseated for the rest of the day.

Before you go home, your doctor will give you instructions on how to manage any possible side effects. Your doctor may prescribe pain medication or antibiotics to prevent an infection.

Depending on the surgery, you may be advised to rest for a few days or weeks. It may take a month or more to return to your normal activities.

You should call your doctor if you have:

• Serious abdominal pain

• Prolonged nausea and vomiting

• Fever of 38 °C or higher

• Pus or significant bleeding at your incision site

• Pain during urination

• Pain during bowel movements

• Swollen abdomen

• Increased nausea, vomiting or disoriented feeling

RANZCOG Patient Information Guides

‍https://www.healthdirect.gov.au/laparoscopy

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