1. What is Laparoscopy?

Laparoscopy is an operation to look at the pelvic organs, including the uterus, tubes and ovaries, using a small telescope.

2. Who needs it? When Is Laparoscopy recommended?

• Women having difficulty in getting pregnant
• To investigate the cause of lower abdominal pain and painful periods
• To investigate the cause of pain during sexual intercourse.
• To perform the Dye Test to check if the fallopian tubes are open
• To diagnose gynaecological conditions such as tubal disease, genital tuberculosis,fibroids, ovarian cysts etc. They can often be corrected with operative laparoscopy
• To see and treat conditions such as endometriosis and adhesions (scar tissue) that are difficult to see on ultrasound scan
• To obtain tissue for biopsy in suspected cases of the abdominal mass or Tuberculosis.
• To remove damaged tubes before commencing IVF, to increase the success rate
• To remove the fallopian tube in case of ectopic pregnancy
• For women who do not wish any more children – Laparoscopic Sterilisation

3. What happens during Laparoscopy?

This procedure is done under anaesthesia and women are advised to admit an hour before the surgery. Procedure altogether takes about 45-60 minutes.
A small cut (1 cm) is made near the belly button (Umbilicus) and an instrument is inserted to inflate the abdominal cavity with gas (carbon dioxide). A further hole (0.5 cm) is usually made in the ‘bikini’ line or on the left hand side of the lower abdomen, to insert additional instruments and operate safely and effectively. At the end of the operation the gas and instruments are removed and the small holes are closed with skin glue or sometimes stitches.
A picture of the inside of the womb will be seen on the TV screen which is connected to the camera.

What does the dye test involve?

A special instrument is inserted into the cervix (neck of the womb). The dye is injected, which passes through the cervix, uterine cavity and down the Fallopian tubes. This helps to find out if your tubes are open, although it might not be entirely conclusive if the function of the tube is normal because it may depend on other causes that affect the inside of the tubes

4. Are there any side-effects or complications?

The complications of laparoscopy are rare.

Common complications include

• Pain – After a laparoscopy it is common to have some pain in the shoulders due to a small amount of gas staying in the tummy. The body usually absorbs the gas naturally over the next 24 hours, which will ease the symptoms. Pain killers are advised for 5 days
• Infection – in the skin wound and urine infection. To prevent this, antibiotics are commenced before the procedure.

Rare complications include

• Bleeding –May occur during or any time after the operation. This rarely needs a blood transfusion or another operation.
• Blood clots – In the legs or lungs(thrombosis/embolus), causing breathing difficulties, very rarely leading to death. This is more common in long duration surgery, heavy weight, not mobilising after the surgery. In high-risk cases, a blood thinning injection will be prescribed to reduce the risk of blood clots.
• Damage to internal organs – Such as bowel and bladder. The risk is higher in patients who have previously had surgery to the abdomen including Caesarean Section. Utmost care is taken to avoid such risk and if an injury does occur, open surgery is done and the damage repaired.
• Developing a hernia – Near one of the cuts used to insert the instruments. This is prevented by using deeper stitching techniques to close the cuts. This happens few months after the surgery
• Failed procedure – Very rarely, it is not possible to place the laparoscope inside the abdominal cavity. This happened in cases of old tuberculosis or pelvic infection.

5. When do I get the results?

Most of the time, findings will be explained soon after the operation. Next steps of fertility management will also be discussed before discharge.

6. Are there any alternatives

Unfortunately, No! No substitute to looking inside with camera.

7. Answers to Frequently asked questions FAQs

You will be discharged home 2-4 hours after surgery
You can return to your place of work after 24 hours.
This procedure cannot be done during periods