Laparoscopy

What is laparoscopy?

If you’re experiencing pain or your doctor identifies a suspicious area in the abdominal region on imaging, a diagnostic procedure called a laparoscopy may be recommended. During laparoscopy, your surgeon will make a very small incision near the belly button through which a camera can be inserted. The inside of your abdomen will be examined with a laparoscope, a small telescope designed for medical use that has a light and video camera on the end. Using this device, your surgeon can view the inside of your abdomen and pelvis to identify abnormalities. If needed, biopsies of suspicious areas may be taken using additional tools.

Why laparoscopy is performed

Your doctor may recommend diagnostic testing if you’re experiencing issues in the abdomen and pelvis, such as:

• Pain
• Swelling (fluid retention)
• An abnormal area, such as a mass
• Concern for metastatic disease

Your doctor will likely recommend imaging studies first, such as a computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or ultrasound. Doctors prefer to use these tools as an initial step because they are noninvasive and don't require anesthesia or more invasive surgical procedures. Sometimes, more invasive procedures are required to determine whether a mass is cancerous. You'll typically be evaluated for a biopsy procedure by an interventional radiologist or gastroenterologist. When this procedure isn't possible or if these prior biopsies are not diagnostic in nature, you may be referred to a surgeon for a laparoscopy. During a laparoscopy, a surgeon will take tissue samples, or biopsies, of suspicious areas that will be sent to a lab for testing.

Laparoscopy is one option to diagnose and treat small tumors linked to the following cancers:

• Liver cancer
• Ovarian, endometrial and cervical cancer
• Pancreatic cancer
• Gallbladder cancer
• Bile duct cancer
• Colon cancer
• Kidney cancer

How to prepare for laparoscopy

Prior to your procedure:

• Discuss any medications, vitamins, herbs and other supplements you’re taking with your doctor.
• Tell your doctor about any known allergies.
• Several days before your scheduled laparoscopy, stop taking any blood thinners, including aspirin, as directed by your care team.
• Follow the specific pre-surgery instructions provided by your doctor. These instructions will tell you when to stop eating and drinking prior to the surgery, as well as what to wear and personal hygiene guidelines for the day of surgery.
• Ask your doctor if you’ll be able to go home after the procedure. If so, you may need to make arrangements to have someone drive you home.

What to expect when you have laparoscopy

During surgery:

• You will be given an IV prior to surgery so that your care team can administer medicine.
• General anesthesia will be administered before surgery.
• Once you’re asleep, you’ll be connected to a breathing machine via a tube inserted into your throat.
• After making a small incision near your belly button, a laparoscope is inserted into the abdomen. This allows your surgeon get a better look at the organs being investigated. Your abdomen will be filled with gas to make it easier for the surgeon to get a clear look at your organs. If surgery to take a biopsy or remove a cancerous tumor is being performed, other cutting tools will be used, and other small incisions may be made.
• After the procedure is finished, the excess gas will be removed, the cuts will be closed, and the breathing tube taken out.

The procedure typically takes between 30 to 90 minutes.

After surgery:

• You will be monitored by your care team while the anesthesia wears off to ensure there are no complications from surgery.
• You feel sleepy or confused for several hours because of the anesthesia.
• You may be nauseous, and your mouth may be numb. Your throat may be hoarse or sore for one to two days after surgery due to the breathing tube, and you may feel pain or numbness at the incision sites.
• If there is any remaining gas inside of your body after the procedure, you may experience abdominal or shoulder pain until it dissipates.
• If you have outpatient surgery, you can leave when you’re able to stand up without any help and after you’ve emptied your bladder, but you’ll likely need someone to drive you home.
• If you have inpatient surgery, you’ll remain at the hospital until your care team discharges you.

In both instances, biopsy and surgical results will likely be shared with you when they are available, likely at your next outpatient appointment.

Laparoscopy risks and benefits

There are many benefits of laparoscopy versus open surgery, including less pain, a faster recovery time and a lower risk of infection. The amount of time you have to stay in the hospital is typically shorter when you have laparoscopic surgery, and because the incisions made to perform a laparoscopy are so small, your scars may be much less noticeable.

While laparoscopy is less invasive than open surgery, it can take longer to perform. The longer you’re under anesthesia, the greater the risk of complications, which can take weeks after surgery to show up. Complications of either a laparoscopy or open surgery may include:

• Bleeding or a hernia (bulging of an organ or tissue) at the incision site
• Internal bleeding (which would require repeated procedures or another operation)
• Infection at the incision site (pain, redness, oozing)
• Pneumonia (lung infection)
• Blood vessel damage
• Injury to nearby organs

If you experience signs of serious complications such as chest pain, breathing difficulties, a fever that won’t go away, or you’re coughing up blood, contact your care team immediately.