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Gynaecological Laparoscopy

About gynaecological laparoscopy

Gynaecological laparoscopy is a procedure used to look inside your abdomen (tummy) and examine your fallopian tubes, ovaries and womb. Laparoscopy can be used either to diagnose a condition or to treat a condition.

Gynaecological laparoscopy can be used to:

  • diagnose and treat endometriosis, a condition where the lining of your womb grows outside your womb
  • diagnose and treat pelvic inflammatory disease - inflammation of your ovaries, womb or fallopian tubes
  • diagnose and remove scar tissue (adhesions)
  • treat an ectopic pregnancy, a condition where a fertilised egg implants outside your womb
  • carry out female sterilisation, which is permanent contraception
  • remove an ovarian cyst
  • remove your womb or ovaries (hysterectomy)
  • treat fibroids - non-cancerous growths on or inside your womb
  • remove lymph nodes for cancer treatment

Preparing for a gynaecological laparoscopy

If you're having gynaecological laparoscopy to diagnose a condition, you will usually have it done as a day-case procedure. This means you have the procedure and go home the same day. If you need to have a gynaecological laparoscopy to treat a condition, you will usually need to stay overnight. You will be invited to a pre-operative appointment with the nurse a few days before your procedure.

If you're having a laparoscopy to diagnose your condition or because you have abdominal pain, your surgeon may go on to treat your condition during the procedure. He or she will talk to you about any possible treatment before your operation, and you will be asked to sign a consent form that includes the possible treatments.

What happens during a gynaecological laparoscopy

‍Your surgeon will make a cut in your belly button. He or she will put a tube through the cut and pump in some gas. This expands your abdomen, separates your organs and makes it easier for your surgeon to look at your organs with the laparoscope. If you need any treatment, or if your surgeon needs to move some of the organs to get a good view, he or she will make some small cuts lower down on your abdomen. Any surgical instruments that are needed for treatment can be inserted through these cuts.

At the end of the procedure, your surgeon will carefully take the instruments out of your abdomen and allow the gas to escape through the laparoscope. He or she will close the cuts with stitches.

What to expect afterwards

You will usually be able to go home when you feel ready. Your nurse will give you some advice about caring for your wounds, hygiene and bathing before you go home. You may be given a date for a follow-up appointment.

Your surgeon may use dissolvable stitches. The length of time your dissolvable stitches will take to disappear depends on what type you have. However, for this procedure they should usually disappear in seven days. If they cause skin irritation, then your doctor can remove them after this time.

Recovering from a gynaecological laparoscopy

If you have a laparoscopy to diagnose a condition you will need to rest and take it easy for two or three days. If you have had treatment during the laparoscopy - for example, if you have had treatment of endometriosis or a hysterectomy, your recovery will take longer. It usually takes about one to four weeks to make a full recovery from a gynaecological laparoscopy, but this varies between individuals and procedures, so it's important to follow your surgeon's advice.

What risks or complications can occur?

Gynaecological laparoscopy is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

  • Complications of Anaesthesia

These are problems associated with a general anaesthetic, which will be discussed with you prior to your operation.

  • Pain

This occurs after any operation. There will be mild tenderness around your wound sites and possibly some shoulder tip pain which usually settles after 2-3 days. Severe pain is very uncommon and should be discussed with the doctor.

  • Damage to internal organs

There is a small risk that other organs, such as the bowel may be injured when placing instruments in the abdomen during the operation. This is rare and carries a risk of 3 in 1000 cases. This risk becomes higher if you have had previous abdominal surgery or if you are particularly overweight. If an injury does occur then a laparotomy may be required to repair the injury. A laparotomy is an incision across the abdomen, which will require a stay in hospital for approximately 4-5 days.

  • Bleeding

There may be some internal bleeding but this does not normally cause a problem/ there may be a small amount of bleeding from the wound sites or a small collection under the wound. This is not usually serious and will often settle on its own. There may be some vaginal bleeding and during this time tampons should not be used.

  • Infection

This can occur with any operation and can usually be treated with antibiotics. An infection may develop at the wound sites after you have gone home.

All operations carry a small risk of death which is 3-8 women for every 100,000 laparoscopies.

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