A gynaecological laparoscopy is a procedure that allows a surgeon to examine your fallopian tubes, ovaries and womb (uterus). It can be used to either diagnose a condition, or to allow treatment.
You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.
About gynaecological laparoscopy
Gynaecological laparoscopy can be used to:
• diagnose and treat endometriosis
• diagnose and treat pelvic inflammatory disease
• remove scar tissue (adhesions)
• treat an ectopic: pregnancy
• carry out female sterilisation, which is permanent contraception
• remove an ovarian cyst
• remove your womb (hysterectomy) or ovaries (oophorectomy)
• treat fibroids
• remove lymph nodes for cancer treatment
Your surgeon may also suggest a laparoscopy if you have pain in your abdomen because it may help to find out the cause. If you're having problems getting pregnant, you can have a laparoscopy to: see if there are any problems with your ovaries, fallopian tubes or womb.
What are the alternatives?
Gynaecological laparoscopy isn't suitable for everyone. Depending on your symptoms and circumstances. there may be other investigations or treatments available.
Ultrasound can also be used to diagnose some gynaecological conditions such as fibroids. ·1 his investigation uses sound waves to produce an image of the inside of part of your body. There are two types of ultrasound that can be used to diagnose a gynaecological problem. Abdominal ultrasound is when the ultrasound probe is moved over your abdomen. A trans-vaginal ultrasound is where the ultrasound probe is put into your
You may be able to have a CT or MRI scan to investigate symptoms that suggest you have fibroids or endometriosis.
If you need to have a treatment, you may be offered medicines or further surgery. For example, your surgeon may need to make a large cut in your lower abdomen (abdominal hysterectomy) or the top of your vagina
Your surgeon will explain the different procedures and discuss which option is best for you
Preparing for a gynaecological laparoscopy
Your surgeon will explain how to prepare for your procedure. For example, if you smoke you will be asked to stop, as smoking increases your risk of getting a chest infection or wound infection and slows your recovery.
If you're having a 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 have a gynaecological laparoscopy to treat a condition, you may need to stay in hospital overnight. Gynaecological laparoscopy is usually done under general anaesthesia, which means you will be asleep during the procedure. You will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand. However, it's important to follow your gynecologist’s advice.
At the hospital, your nurse may do some tests such as checking your heart rate and blood pressure, and testing your urine. '
You may be asked to wear compression stockings to help prevent blood clots forming in tho veins in your legs. Also, you may need to have an injection of an anticlotting medicine as well as, or instead of, wearing compression stockings.
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure_ This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.
What happens during a gynaecological laparoscopy?
The procedure can take 15 minutes or more depending on what type of examination or treatment you need.
Your surgeon will make a cut in your belly button. He or she will then put a tube through the cut and pump some gas in. 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 your 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. Your surgeon may inject a coloured dye through your cervix (neck of your womb), into your womb and your fallopian tubes. This can show whether your fallopian tubes are blocked.
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 need to rest until the effects of the anaesthetic have passed and may need pain relief to help with any discomfort. General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 24 hours afterwards. If you're in any doubt about driving, contact your 111otor insurer so that you're aware of their recommendations, and always follow your surgeon's advice.
You will usually be able to go when you feel ready, but will need to arrange for someone to take you home. Try to have a friend or relative stay with you for the first 24 hours after your laparoscopy. Your nurse will give you some advice about caring for your wounds, hygiene and bathing and 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 of procedure you had. However, as a general guide, they should usually disappear in seven days. If you have non-dissolvable stitches you will need to have them taken out. Your surgeon will tell you when and where to have them removed.
Recovering from a gynaecological laparoscopy
If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice.
If you have a laparoscopy to diagnose a condition you will need to rest and take it easy for up to one week, though this will depend on the type of procedure you had. If you have treatment during the laparoscopy - for example for endometriosis or a hysterectomy - your recovery will take longer.
Follow your surgeon's advice about contraception and when you can have sex again.
What are the risks?
As with every procedure, there are some risks associated with gynaecological laparoscopy We have not included the chance of these happening as they are specific to you and differ for every per son. Ask your surgeon to explain how these risks apply to you.
Side-effects are the unwanted but mostly temporary affects you may get after having the procedure. For example, you’re likely to feel some pain in your abdomen and you may also have pain in your shoulders. This is caused by the gas used to inflate your abdomen; it usually improves within 48 hours.
You may have some bruising on your abdomen around the areas where the laparoscope and c1ny surgical instruments were put in - this usually gets better without treatment.
This is when problems occur during or after the procedure. The possible complications of any operation include an unexpected reaction to the anesthetic, excessive bleeding or developing a blood clot, usually in a vein in your leg (debt=p vein thrombosis, DVT).
Other complications of having a gynaecological laparoscopy are listed below.
• Other organs in your abdomen, such as your bowel, bladder, womb or major blood vessels, may be damaged during the operation.
• During your laparoscopy, your surgeon may need to change to open surgery, wt1ich involves him or her making a bigger cut on your abdomen. This is done if it's impossible to complete the procedure safely using the laparoscope, or if there is a complication during laparoscopy that requires a larger cut to be made on your abdomen.
• Your wounds may not heal properly or they may become infected.
• You may develop a urine infection.
• You may develop a hernia.
Most women don't have any problems after a gynaecological laparoscopy. However, if you develop any of the following symptoms, contact your doctor.
• Severe pain or pain that gets worse.
• A swollen abdomen.
• A high temperature.
• Red skin around your wound or any discharge.
Speak to your surgeon for more information.
Please contact Mr Aquilina's personal assistant
Lyn Thomsett for any queries
Tel: 0208 504 5381