Gynecologic laparoscopy

• Alternative Names

  Exploratory laparoscopy - gynecologic; Laparoscopic tubal ligation; Laparoscopic oophorectomy; Laparoscopic hysterectomy; Laparoscopic egg harvest

• How the test is performed

  The procedure is usually done in the hospital under general anesthesia. A thin tube (catheter) is inserted through the urethra into the bladder. Another tube, called a nasogastric (NG) tube, may be passed through the nose and into the stomach to empty your stomach.

  After cleaning the area, a small surgical cut is made above or below the belly button area. Carbon dioxide gas is injected into the area to raise the abdominal wall. This makes a larger space to work in and makes it easier for the surgeon to see and work with the organs.

  The laparoscope is then inserted so that the surgeon can examine the organs of the pelvis and abdomen. Other small cuts may be needed.

  After the procedure, the cuts are closed with stitches and covered with bandages. Depending upon the operation, a drain may be placed into one of the areas to drain any fluid that may build up.

• How to prepare for the test

  Do not eat or drink for 8 hours before the test.

• How the test will feel

  If you are under general anesthesia, you will feel no pain during the procedure. However, the surgical cuts may throb and be slightly painful afterward.

  If you get a local anesthetic, you may feel a prick and a burning sensation. You may have pain at the site of the surgical cut. Afterward, the cuts may throb for several hours and may be slightly painful.

  Your health care provider may give you a pain reliever.

  You may also have shoulder pain for a few days, because the carbon dioxide gas used to inflate your abdomen can irritate your diaphragm, which shares some of the same nerves as the shoulder. You may also have an increased urge to urinate, because the gas can put pressure on the bladder.

  Depending on the procedure you have done, your health care provider may advise you to avoid eating and drinking for a period of time afterward.

• Why the test is performed

  Gynecologic laparoscopy is done for the same reasons as open surgery.

  Laparoscopy can be used to:

  • Harvest eggs for in vitro fertilization
  • Remove a tubal pregnancy
  • Remove the uterus (hysterectomy) or the ovaries
• What abnormal results mean

  Abnormal results vary based on the type of procedure.

• What the risks are

  There is a risk of puncturing an organ. This could cause the contents of the intestines to leak, or lead to bleeding into the abdominal cavity. This may need more involved surgery. Severe injury may result in infection or the need for a blood transfusion.

• Special considerations

  Women who have already had surgery to the abdomen or pelvis may not be able to have laparoscopic surgery.

  Surgery can lead to scarring, which prevents laparoscopic instruments from safely passing into the area. Scarring may also prevent the abdominal wall from being pushed out of the way properly when the carbon dioxide is injected.

Review Date: 2/19/2008

Reviewed By: Peter Chen, MD, Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.