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Gynaecological laparoscopy

A gynaecological laparoscopy is a procedure that allows a surgeon to look inside your pelvis, for example at your fallopian tubes, ovaries and uterus (womb). It can be used either to diagnose a condition or for treatment. 

Gynaecological laparoscopy can be used to:

  • diagnose and treat endometriosis
  • remove adhesions (scar tissue)
  • treat an ectopic pregnancy
  • carry out female sterilisation (surgery on your fallopian tubes to prevent future pregnancy)
  • remove an ovarian cyst
  • remove your womb (hysterectomy) or ovaries (oophorectomy)
  • treat fibroids
  • investigate cancer or remove lymph nodes for cancer treatment

Your surgeon may take a biopsy during your procedure. A biopsy is a small sample of tissue. This can be sent to a laboratory for testing to determine the types of cell and if these are benign (not cancerous) or cancerous. Sometimes biopsies are also carried out to diagnose conditions such as endometriosis.

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.

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An image showing a gynaecological laparoscopy

Details

  • Preparation Preparing for a gynaecological laparoscopy

    You’ll 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.

    Your surgeon will explain how to prepare for your procedure. For example, if you smoke, you’ll be asked to stop. Smoking increases your risk of getting a chest problem or wound infection and slows your healing. If you’re having a gynaecological laparoscopy to diagnose a condition, you’ll 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.

    You may be asked not to eat or drink for some hours before your operation. At the hospital, you may have some tests to check you’re healthy for surgery. These include checking your heart function, your blood count and testing your urine.

    You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. Also, you may be given an anticlotting medicine.

    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. You may want to ask questions 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. You’ll be asked to do this by signing a consent form.

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  • Alternatives What are the alternatives to gynaecological laparoscopy?

    Gynaecological laparoscopy isn't suitable for everyone. Depending on your symptoms and circumstances there may be other investigations or treatments available.

    An ultrasound or MRI scan can also be used to diagnose some gynaecological conditions such as fibroids. An ultrasound investigation uses sound waves to produce an image of the inside of part of your body. Most commonly, a trans-vaginal ultrasound is used, which involves an ultrasound probe being put into your vagina. An MRI scan uses magnets and radio waves to produce images of the inside of your body.

    Your surgeon will recommend the best treatment option for you.

  • The procedure What happens during a gynaecological laparoscopy?

    A gynaecological laparoscopy is usually done with general anaesthetic. This means you’ll be asleep during the procedure.

    Laparoscopy is a type of ‘key-hole surgery’. It uses a piece of equipment called a laparoscope. A laparoscope is a small telescope with an attached camera, which your surgeon will use to see inside your abdomen (tummy). It’s put through a small cut in your belly button. The procedure can take between 30 minutes and three hours, 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, which expands your abdomen and separates your organs. This makes it easier for your surgeon to look at your organs with the laparoscope and to perform surgery if you need it.

    Your surgeon may need to move some of your organs to get a good view. He or she may make one or more small cuts lower down on your abdomen. Any surgical instruments (such as a grasper) that are needed for your 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. He or she will close the cuts with stitches, clips or glue.

    An image showing a gynaecological laparoscopy

  • Gynaecological treatments on demand

    You can access a range of our health and wellbeing services on a pay-as-you-go basis, including gynaecological treatment.

  • Aftercare What to expect afterwards

    You’ll need to rest until the effects of the anaesthetic have passed and may need pain relief to help with any discomfort. General anaesthesia can affect your co-ordination and reasoning skills for 24 hours. During this time, you shouldn’t drive, drink alcohol or make important decisions. If you’re in any doubt about driving, get advice from your motor insurer, and always follow your surgeon’s advice.

    You’ll usually be able to go home after a few hours, when you feel ready. You’ll 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 advice about caring for your wounds, hygiene and bathing. You may be given a date for a follow-up appointment.

    Your surgeon may use stitches, clips or glue to close the cuts made during your surgery. If you have dissolvable stitches they will usually fall off after a week. Glue can usually be washed off after seven days. If you have non-dissolvable stitches, staples or clips, you’ll need to have them taken out after about five to seven days. Your surgeon will tell you when and where to have them removed. Often, a nurse at your local doctor’s surgery can do this.

  • Recovery Recovering from a gynaecological laparoscopy

    Your surgeon may prescribe painkillers for you to take after your operation. He or she will explain when to take these, and any side-effects you might get. 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. If you have any questions, ask your pharmacist for advice.

    Try to get around the house and do a little each day. This will help with your recovery. Listen to your body though – you’ll be more tired than usual during your recovery and may need naps. You should be able to have sex after a few days, when you feel ready, unless your surgeon has given you specific advice.

    If you have a laparoscopy to diagnose a condition, you’ll probably be ready to get back to your usual routine (including work) in a week. If you have treatment during your laparoscopy – for example for endometriosis or a hysterectomy – you may need two to three weeks to recover.

    If you feel unwell while you’re recovering, contact your GP or doctor for advice.

  • Side-effects Side-effects of gynaecological laparoscopy

    Each type of laparoscopic procedure has its own risks. We haven’t included the chance of these happening, as they’re specific to you and differ for every person. How risky the procedure is can depend on many things, so be sure to ask your surgeon about how these risks apply to you. In this section, we focus on the possible side-effects of having a laparoscopy. For information about problems that may happen during or after your procedure, see our complications section below.

    There’s a chance you may have some side-effects. These are the unwanted but mostly temporary effects you may get after having your procedure. For example, you’re likely to feel some pain in your abdomen (tummy) and shoulders. Shoulder pain is thought to be caused by the gas used to inflate your abdomen irritating internal structures and nerves. Pain usually improves within a few days.

    You may have some bruising around the cuts in your abdomen – this usually gets better without treatment.

  • Complications Complications of gynaecological laparoscopy

    This is when problems occur during or after your procedure. The possible complications of any operation include:

    • an unexpected reaction to the anaesthetic
    • excessive bleeding
    • developing a blood clot, usually in a vein in your leg (deep vein thrombosis, DVT)

    Other complications of having a gynaecological laparoscopy are listed below.

    • Other organs in your abdomen (tummy), such as your bowel, bladder, womb or major blood vessels, may be damaged during the operation.
    • If there is a complication during your laparoscopy, your surgeon may need to change to open surgery. This involves him or her making a bigger cut 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, which is a bulge under the skin. It happens when part of your abdomen, (such as fat or your bowel) comes through your stomach muscle.

    Most women don’t have any problems after a gynaecological laparoscopy. But if you develop any of the following symptoms, contact your doctor or the hospital where you had your operation.

    • Severe pain or pain that gets worse in your abdomen, especially if you have a fever and are feeling or being sick.
    • A hot, red, swollen leg, or difficulty standing on your leg.
    • Red or painful skin around your wound.
    • Burning or stinging when you urinate, or needing to urinate very often.
    • If your symptoms aren’t slowly improving day-by-day
    Speak to your surgeon for more information about the complications that could occur and the symptoms to look out for after your surgery.
  • FAQs FAQs

    How is laparoscopy different to open surgery?

    Answer

    Laparoscopy (keyhole surgery) uses smaller cuts than open surgery. It means that your scars will be smaller and you may recover more quickly.

    More detail

    Gynaecological laparoscopy (also known as keyhole surgery), involves you having one or more small cuts in your abdomen (tummy). Your surgeon will use a laparoscope to see inside your abdomen and perform your operation. A laparoscope is a small telescope with an attached camera. Open surgery uses a much larger cut, so your surgeon can see directly into your abdomen.

    The benefits of laparoscopy over open surgery include:

    • your stay in hospital is likely to be shorter
    • your scars will be smaller
    • you may have less pain.
    • your recovery is likely to be quicker

    Laparoscopy does have some downsides over open surgery though. For example, you may get pain in your shoulder after the operation. Also, with laparoscopy, it may be slightly harder for your surgeon to see your insides as clearly as if you had open surgery. If they accidentally damage an organ, there’s a small chance they may not spot this. For more information, see our complications section.

    Laparoscopy isn't suitable for everyone, for example if you’re overweight or have had previous surgery, then open surgery may be better. Your surgeon will discuss your treatment options with you.

    I’m having a gynaecological laparoscopy for sterilisation. What does this involve?

    Answer

    Sterilisation is surgery to stop future pregnancy. It’s a permanent type of contraception. During the procedure your surgeon will block your fallopian tubes so that your eggs can’t travel down them.

    More detail

    Sterilisation is a type of surgery some women have to stop them being able to get pregnant. It’s a permanent type of contraception. 

    Sterilisation can be performed through laparoscopy. During the procedure your surgeon will block your fallopian tubes using chips or sometimes heat from an electric current. This means your eggs can’t travel from your ovaries down your fallopian tubes. If you have unprotected sex, sperm cannot meet your eggs and you can’t get pregnant.

    If you’re considering sterilisation, you’ll usually have counselling first. This is to help you think through the decision and make sure it is not one you're likely to regret in the future.

    There are alternatives to having the operation, such as using other forms of contraception or your partner having a vasectomy. A vasectomy is a smaller operation where the tubes that carry sperm from the testicles to the penis are cut.

    Your doctor can explain more about your options and answer any questions you may have.

  • Resources Resources

    Further information

    • Royal College of Obstetricians and Gynaecologists
      www.rcog.org.uk
    • 020 7772 6200

    Sources

    • Gynaecologic laparoscopy. Medscape. www.emedicine.medscape.com, published 29 October 2013
    • Recovering well: Information for you after a laparoscopy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published July 2010
    • Ahmad G, O’Flynn H, Duffy JMN, et al. Laparoscopic entry techniques (review). Cochrane Database of Systematic Reviews 2012, Issue 2. doi: 10.1002/14651858.CD006583.pub3
    • Sterilisation (vasectomy and female sterilisation). PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 8 May 2015
    • Infertility. Medscape. www.emedicine.medscape.com, published 30 March 2015
    • Having an operation? Your patient journey. Royal College of Surgeons of England. www.rcseng.ac.uk, published 2008
    • Venous thromboembolism: reducing the risk. Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital. National Institute for Health and Care Excellence (NICE), January 2010, www.nice.org.uk
    • Fibroids. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published February 2013
    • Map of Medicine. Endometriosis. International View. London: Map of Medicine; 2011 (Issue 4)
    • PatientPlus. Fibroids. www.patient.co.uk/patientplus.asp, reviewed 20 January 2015
    • Cheng Y, Lu J, Xiong X, et al. Gases for establishing pneumoperitoneum during laparoscopic abdominal surgery. Cochrane Database of Systematic Reviews 2013, Issue 1. doi: 10.1002/14651858.CD009569.pub2
    • Schollmeyer T, Mettler, L, Ruther D, et al. Practical manual for laparoscopic and hysteroscopic gynaecological surgery. 2nd ed. New Delhi, India: Jaypee; 2013
    • Consent advice no. 2: diagnostic laparoscopy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published December 2008
    • Taş B, Meller Donatsky A, Gögenur I. Techniques to reduce shoulder pain after laparoscopic surgery for benign gynaecological disease: a systematic review. Gynecological Surgery 2013; 10(3):169−75. doi: 10.1007/s10397-013-0791-7
    • Abdominal wall hernias. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 4 January 2013
    • Minimally invasive surgery. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 14 January 2013
    • Sterilization. The Merck Manuals. www.merckmanuals.com, published June 2013
    • Your guide to male and female sterilisation. Family Planning Association. www.fpa.org.uk, accessed 14 May 2015
    • For medical practitioners. At a glance guide to the current medical standards of fitness to drive. Drivers Medical Group, DVLA. www.gov.uk, published May 2014
    • Perrin M, Fletcher A. Laparoscopic abdominal surgery. Contin Educ Anaesth Crit Care Pain 2004; 4(4):107–10.doi: 10.1093/bjaceaccp/mkh032
    • Personal communication, Miss Shirin Irani MD FRCOG, Consultant Gynaecologist and Honorary Senior Clinical Lecturer, Heart of England Foundation Trust, Birmingham, June 2015
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    Reviewed by Hemali Bedi, Bupa Health Content Team, June 2015.

    Peer reviewed by Dr Shirin Irani.

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