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A laparoscopy is any surgical procedure that uses a laparoscope. A laparoscope is a thin tube attached to a light source that is inserted through a small incision in the belly button. With it, a healthcare professional can see the pelvic and abdominal organs.

Who is a candidate for the procedure?

The goal of laparoscopy is to find the cause of a problem without making a big cut (incision) in the abdomen. If a pelvic or abdominal ultrasound has shown something abnormal, laparoscopy is often used to confirm or treat the findings.

A woman may need a laparoscopy for many reasons. Some symptoms that may lead to the procedure include:

• chronic pelvic pain that is suspected to result from a pelvic infection
• endometriosis, a condition where tissue from the lining of the uterus grows outside the uterus, resulting in pain, infertility, and/or ovarian cysts
• infertility, the inability to become pregnant

A healthcare professional may also use laparoscopy to remove these organs or growths:

• hernia
• gallbladder
• appendix
• small fibroids, which are benign (non-malignant) tumors of the uterus
• uterus
• tubes
• ovaries or ovarian cysts

A healthcare professional may use this procedure to diagnose, evaluate, or treat these conditions:

• a hole, tear, or puncture in the uterus that occurred after a dilatation and curettage. This is a procedure in which the inside lining of the uterus is scraped with a special instrument.
• a hole, tear, or puncture in the uterus from hysteroscopy, which is a procedure where a thin tube with a light source is inserted through the vagina in order to see inside the uterus
• a hole, tear, or puncture in the uterus from placement of a birth control device called an IUD
• endometriosis, which is the growth of uterine tissue outside of the uterus
• small growths in the ovaries called cysts
• unruptured ectopic pregnancy, which occurs when a baby implants and grows outside the uterus
• the presence of fluid in the abdomen, which could be due to blood, ascites, or cancer cells
• a pelvic mass
• an unexplained abnormal liver scan

A healthcare professional may also use this procedure for these reasons:

• to follow-up after surgery for ovarian cancer
• to aid in a sterilization procedure called tubal ligation, which keeps the woman from becoming pregnant
• to treat scar tissue, called adhesions, in the pelvic area

How is the procedure performed?

First, the woman receives general anesthesia. This relaxes the abdominal muscles and causes complete loss of consciousness during which the woman feels no pain and has no awareness of the operation.

Then, the healthcare professional makes a small cut below her belly button and puts the laparoscope through the cut.

Then, the abdominal cavity is inflated with 2 to 5 liters of carbon dioxide gas. This helps the examiner see the organs in the region. Next, the examiner makes one to three smaller cuts, usually on the lower abdomen. These are used for instruments that might be needed to hold an organ, to take a biopsy sample, or to apply a laser to any lesions.

The healthcare professional can also use the laparoscope to see:

• the uterus
• fallopian tubes
• ovaries
• bladder
• intestines
• liver
• spleen
• appendix
• the surfaces of the abdominal cavities themselves

After the healthcare professional has viewed or removed what is needed, the cuts are closed with stitches or with a special glue. Stitches may heal by themselves or may need to be removed in the healthcare professional's office a week later. The procedure usually takes about an hour.

The woman stays in a recovery room for one to three hours while the anesthesia wears off. Sometimes, the woman may need to stay overnight in the hospital if she has trouble waking up or if there are any complications.

What happens right after the procedure?

The healthcare professional will discuss the findings and treatment options after the procedure.

What happens later at home?

• shoulder pain, caused from gas that has built up under the diaphragm
• feeling bloated
• pain at the incision sites
• cramping
• constipation

These symptoms usually improve within 24 to 48 hours after surgery.

What are the potential complications after the procedure?

Because sharp instruments are used during surgery, trauma may occur to any organ within the abdomen. Other complications include:

• problems related to the anesthesia, such as reactions to medicines or having trouble breathing
• a bloody swelling, called a hematoma, around the cut
• infection of the cut
• bleeding in the abdomen