Laparoscopy: Purpose, Risk, Preparation, Procedure, Recovery Time, Results and Benefits

Updated: September 28, 2019

Laparoscopy is a surgical diagnostic procedure used to examine the organs inside the abdomen. It is a low risk, minimally invasive procedure that requires only small incisions. It is also known as diagnostic laparoscopy.
An instrument called a laparoscope is used in this procedure to look at the abdominal organs. A laparoscope is a long, thin tube with a high intensity light and a high resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. The camera sends images to a video monitor as the tube moves along. Biopsy samples can also be obtained during this procedure. Laparoscopy allows your doctor to see inside your body in real time, without open surgery.

Purpose of a Laparoscopy:

The main purpose of laparoscopy is to identify and diagnose the source of pelvic or abdominal pain. This minimal invasive procedure is usually performed when noninvasive methods are uncertain with diagnosis. Laparoscopy is performed when imaging techniques such as ultrasound, CT scan or MRI scans do not provide enough information or insight for a diagnosis. The procedure may also be used to take a biopsy, or sample of tissue, from a particular organ in the abdomen.
The following organs can be examined using a laparoscopy:

• appendix
• gallbladder
• pancreas
• liver
• spleen
• stomach
• small intestine and large intestine (colon)
• pelvic or reproductive organs

Laparoscopy is useful in detecting:

• an abdominal mass or tumor
• fluid in the abdominal cavity
• liver disease
• the effectiveness of certain treatments
• the degree to which a particular cancer has progressed

Immediately after diagnosis, your doctor may be able to perform an intervention to treat your condition.

Risks of Laparoscopy:

The most common risks associated with laparoscopy are bleeding, infection, and damage to organs in your abdomen. However, these are rare occurrences. It is important to watch for any signs of infection after the procedure. Contact your doctor if you experience:

• fevers or chills
• continuous nausea or vomiting
• abdominal pain that becomes more intense over time
• redness, swelling, bleeding, or drainage at the incision sites
• lightheadedness
• persistent cough
• shortness of breath
• inability to urinate

There is a small risk of damage to the organs being examined during laparoscopy. Blood and other fluids may leak out into your body if an organ is punctured. Other surgery will be required to repair the damage in such case.
Less common risks include:

• complications from general anesthesia
• inflammation of the abdominal wall
• a blood clot, which could travel to your pelvis, legs, or lungs

People who have had prior abdominal surgeries, has increased risk of forming adhesions between structures in the abdomen. Performing laparoscopy in the presence of adhesions will take much longer and increases the risk of injuring organs.

Preparation for Laparoscopy:

Any prescription or over the counter medications that you are taking should be informed to your doctor. As they could affect the outcome of laparoscopy, your doctor may change the dose of any medications and will tell you how they should be used before and after the procedure.
These medications include:

• anticoagulants, such as blood thinners
• nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin or ibuprofen
• other medications that affect blood clotting
• herbal or dietary supplements
• vitamin K

You should also tell your doctor if you are pregnant or think you might be pregnant. This will reduce the risk of harm to your fetus. Certain blood tests, urinalysis, electrocardiogram (EKG or ECG), and chest X-ray may be done before laparoscopy. Your doctor might also perform certain imaging tests, including an ultrasound, CT scan, or MRI scan. These tests can help your doctor better understand the abnormality being examined during laparoscopy. The images also give your doctor a visual guide to the inside of your abdomen which can improve the effectiveness of laparoscopy.
You will probably need to do fasting for at least eight hours before laparoscopy. During this period you can drink only water. Avoid eating and drinking anything else. As Laparoscopy is often performed using general anesthesia, which can make you drowsy and unable to drive for several hours after surgery, you should also arrange for a family member or friend to drive you home after the procedure.

Procedure for Laparoscopy:

Laparoscopy is usually done as an outpatient procedure in a hospital or an outpatient surgical center. You will be able to go home the same day as your surgery. You will likely be given general anesthesia for this type of surgery so that you won't feel any pain during the procedure. An intravenous (IV) line is inserted in one of your veins to receive general anesthesia as well as special medications. Through this IV you will be also provided hydration with fluids. Sometimes local anesthesia is used instead which numbs the area. Even though you will be awake during the surgery, you won't feel any pain.
The surgeon makes an incision below your belly button, and then inserts a small tube called a cannula during laparoscopy. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows your doctor to see your abdominal organs more clearly. Then  the laparoscope will be inserted through the incision once your abdomen is inflated. The images on a screen will be displayed by the camera attached to the laparoscope, allowing your organs to be viewed in real time. The number and size of incisions depends upon the specific diseases that your surgeon is attempting to confirm or rule out.
Usually, one to four incisions that are each between one and two centimeters in length are made. These incisions also allow other instruments to be inserted, such as another surgical tool to perform a biopsy. A small sample of tissue will be taken from an organ to be evaluated during a biopsy. The instruments are removed after the procedure is done. Your incisions are then closed with stitches or surgical tape. Bandages may be placed over the incisions.

Recovery Time for Laparoscopy:

Before you are released from the hospital, you will be under observation once the surgery is over. Your breathing and heart rate, will be monitored closely. Any adverse reactions to the anesthesia or the procedure will also be checked. Hospital staff will also monitor for prolonged bleeding.
The timing of your release will vary. It depends on:

• your overall physical condition
• the type of anesthesia used
• your body's reaction to the surgery
• You may have to remain in the hospital overnight in some cases.

As the effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure. Therefore to be on the safer side a family member or friend will need to drive you home if you received general anesthesia.
You may feel moderate pain and throbbing in the areas where incisions were made in the days following laparoscopy. Usually you will have shoulder pain after your procedure as a result of the carbon dioxide gas used to inflate your abdomen to create a working space for the surgical instruments. The gas can irritate your diaphragm, which shares nerves with your shoulder. It may also cause some bloating. The discomfort and pain should go away within a couple of days.
Medication are prescribed to relieve the pain. Usually you can resume all normal activities within a week. However, you will need to attend a follow-up appointment with your doctor about two weeks after laparoscopy.
For a smoother recovery you can follow the below things:

• Begin light activity as soon as you are able, in order to reduce your risk of blood clots.
• Get more sleep than you normally do.
• Use throat lozenges to ease the pain of a sore throat.
• Wear loose fitting clothes.

Results of Laparoscopy:

A pathologist is a doctor who specializes in tissue analysis will examine the sample if a biopsy was taken. A report detailing the results will be sent to your doctor.
Normal results from laparoscopy indicate the absence of abdominal bleeding, hernias, and intestinal blockages, which also mean that all your organs are healthy.
Abnormal results from laparoscopy indicate the below conditions:

• adhesions or surgical scars
• hernias
• cysts or tumors
• cancer
• appendicitis, an inflammation of the intestines
• fibroids, or abnormal growths in the uterus
• injury or trauma to a particular organ
• cholecystitis, an inflammation of the gall bladder
• endometriosis, a disorder in which the tissue that forms the lining of the uterus grows outside the uterus
• pelvic inflammatory disease, an infection of the reproductive organs

An appointment will be scheduled with you by your doctor to go over the results. He will discuss appropriate treatment options with you if a serious medical condition was found. You both can work together to come up with a plan for addressing that condition.

Benefits of a Laparoscopy:

The procedure has several advantages compared with traditional surgery. Because it involves less cutting you:

• have smaller scars.
• get out of the hospital quicker.
• will feel less pain while the scars heal, and they heal quicker.
• get back to your normal activities sooner.
• may have less internal scarring.

With traditional methods, you might spend a week or more in the hospital for intestinal surgery, and your total recovery might take four to eight weeks. If you have laparoscopic surgery, you might stay only two nights in the hospital and recover in two or three weeks. And a shorter hospital stay generally costs less.