What is a laparoscopy?

A laparoscopy is a type of keyhole surgery. If you have keyhole surgery your surgeon uses only small incisions (cuts) to get through the skin and other tissues.

Keyhole surgery is different to 'open surgery' where normally one large cut is made. This is why laparoscopy or keyhole surgery are called minimally invasive methods. If you have keyhole surgery, you should recover quite quickly.

A laparoscopy is used to inspect and operate on your organs. Laparoscopy can be used for diagnosis, by viewing the internal organs or taking a biopsy (small tissue sample). It may also be used to treat a problem surgically at the same time.

Laparoscopy is performed under general anaesthesia, so you'll be unconscious during the surgery and won't feel pain.

Laparoscopic surgery has advantages over traditional surgery including:

• much smaller scars
• reduced pain
• more rapid recovery
• a shorter stay in hospital

Who will do my laparoscopy?

Who does the procedure will depend what symptoms or condition you have. A laparoscopy can be done by a:

• general surgeon
• gynaecologist (women's health specialist)
• gastroenterological surgeon (a doctor specialising in treating the digestive system)
• urological surgeon (a doctor who treats problems of the urinary tract, kidneys, and genitourinary system)

Surgeons are specially trained doctors. They are registered with The Royal Australian College of Surgeons and the Medical Board of Australia.

What happens during a laparoscopy?

A laparoscopy is carried out under a general anaesthetic so you will be asleep before any incisions are made.

During a laparoscopy a small cut is made in your abdomen. The cuts are usually 1cm or smaller.

A thin tube containing a light and camera, known as a laparoscope, is inserted to look inside your abdomen and pelvis. The camera sends images to a monitor viewed by your surgeon. Carbon dioxide gas is used to inflate the belly so the surgeon can see the organs properly.

One or more small cuts may be made for other small instruments to be inserted. The surgeon uses these tools to complete your treatment.

After the surgery is finished the gas is let out and the instruments and tubes are removed. The cuts are closed, and dressings are applied.

When is laparoscopy used?

Laparoscopy is used to diagnose conditions or perform surgery in the abdominal and pelvic area.

A laparoscopy can be performed:

• in an emergency — such as removing an inflamed appendix
• as a planned procure — such as investigating the cause of abdominal pain

Laparoscopy for diagnosis

It can be used to:

• assess painful or heavy periods
• assess female infertility
• diagnose endometriosis
• diagnose cysts or examine cancer tissue
• take a biopsy (a small tissue sample) for testing
• search for the causes of abdominal or pelvic pain

Laparoscopic surgery

Many operations can be done via keyhole surgery, including:

• removal of the uterus, fallopian tubes or ovaries
• remove ovarian cysts and tumours
• treat an ectopic pregnancy
• remove the gall bladder
• removal of a kidney
• removal of parts of your intestine, for example, the appendix or fundus (upper part of the stomach)

How to prepare for a laparoscopy

If you have any concerns or questions about the procedure, discuss them with the doctor beforehand.

If you take any medicines (including complementary ones), make sure you tell the doctor early on. Find out if you need to stop taking any of your medicines for the laparoscopy.

If you take blood-thinning medicines such as aspirin or warfarin, this is especially important. The anaesthetist needs to know about your medicines and medical history.

You will be given instructions on how to prepare for your procedure. These will include how long you must fast for (have nothing to eat or drink before your procedure). For some surgeries, you may also be asked to use a bowel preparation to completely empty your bowels.

After the procedure

When you wake from the procedure, you may feel a little sore around the cuts. You may also have some pain in your shoulder — this is caused by pressure from the gas that was in your abdomen.

You may feel sleepy and even nauseous, but these symptoms should not last long. After a few hours in recovery, you are likely to be sent home. For some laparoscopic surgery you may need to stay in hospital for a night or two.

You should not drive home after having a general anaesthetic. It is best to arrange for someone to pick you up or help you get home. Try to have someone with you for the next 24 hours so they can keep an eye on you.

When you go home you will be given some care instructions. Make sure you know:

• if you can eat and drink normally
• how to manage pain
• how to care for any dressings and stiches
• how long to wait before going back to your normal activities
• when to see a doctor for a check up

Complications of a laparoscopy

Like any surgery, laparoscopy can have complications such as:

• bleeding from the incisions
• infection
• damage to an organ or blood vessel
• blood clots in your legs or lung

As with any operation, there is also a small risk of complications associated with general anaesthesia.

Sometimes the surgery becomes difficult to perform as a laparoscopy. The surgical team may decide to make a larger cut (a laparotomy) during the procedure. This lets them properly assess or treat your problem.

Call the hospital or your doctor immediately if you have:

• pain that is worsening or not improving
• increasing pain in your shoulders
• pain or other problems when urinating
• bleeding that is increasing or not settling
• a fever or temperature
• concerns that you are not recovering well
• any other symptoms that you are worried about

Resources and Support

The Gastroenterological Society of Australia (GESA) has information on gallstones and cholecystectomy.

You can read more on preparing for surgery here.

Visit Jean Hailes for Women's Health to read about conditions such as endometriosis and ovarian cysts.

Review your surgeon's registration status at AHPRA.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.