“Going under the knife” is a rather ominous way to talk about having surgery. Until recently, the thought of having surgery, especially abdominal surgery, may have deserved its dire reputation.
Thanks to advancements in modern medicine, having surgery does not always mean days of recovery in the hospital and huge scars from long incisions. Chances are if you go in for abdominal surgery today, you’ll go home the same day with only a few small incisions, none longer than an inch.
What is Laparoscopy?
Laparoscopy is a type of surgical procedure designed to cause less pain, promote quicker recovery times, and lower the risk of potential complications for patients. Often performed at outpatient surgery centers, laparoscopy helps patients avoid the expensive hospital stay necessitated by open surgery. The lowered amount of physical trauma to the body during a laparoscopy helps patients recover more quickly and return to normal activities faster than conventional surgeries.
During this minimally invasive surgery, you will be placed under anesthesia. In some cases, it is possible you will only receive a local anesthetic. If this happens you will still be awake during surgery, though you will not feel any pain from the procedure. One or more small incisions are made in your abdomen. Often this incision will be made in the belly button to help reduce visible scarring. To begin the surgery, carbon dioxide or other inert gas will be pumped into your abdomen to make it easier for your doctor to see what is going on inside you.
The next step is to insert a surgical instrument called a laparoscope through the incision. A laparoscope is a thin tube with a video camera, light, and possibly other tools attached to the end. By viewing live video images sent back from the camera, your surgeon can see inside you without needing to make the large incisions used in open surgery to inspect your internal organs directly.
During a laparoscopy, between one and four incisions will be made in your abdomen. One or more laparoscopes will be inserted through these incisions. The individual laparoscopes can be used to view images of the affected tissues and organs, to remove samples of tissue for biopsy, or to remove damaged tissues or sometimes entire organs.
Why is Laparoscopy Performed?
Laparoscopic surgery is used most often in non-emergent settings when care and precision can help treat your condition. For life-threatening situations, it may be necessary for more traditional surgery to be performed.
Laparoscopy is used in a variety of cases. For both men and women, removal of the gall bladder, several kinds of tumors, blockages, bleeding, and infections in the abdomen can be addressed via laparoscopy. This can involve procedures as diverse as liver biopsy, partial kidney resection, colon cancer treatment, and investigation of bile duct blockages.
For women, different varieties of reproductive diseases and complications are often treated with laparoscopy. A gynecologist may recommend a laparoscopy to confirm a diagnosis of conditions such as uterine fibroids, ovarian cysts or tumors, endometriosis, ectopic pregnancies, pelvic adhesions (scar tissue), pelvic floor disorder, infertility, disorders of the fallopian tubes, or even reproductive cancers.
In addition to being used as an important diagnostic tool, gynecologic laparoscopy is used to perform various surgeries and treat many different conditions, some of which are listed below:
- hysterectomy, or removal of the uterus
- removal of the ovaries
- endometrial tissue ablation
- blocking blood flow to fibroids
- removal of fibroids
- removal of ovarian cysts
- adhesion removal
- tubal ligation reversal
- vault suspension to treat a prolapsed uterus
- Burch procedure for incontinence
What are the Risks of Laparoscopy?
The risks associated with laparoscopy are similar to those of any other abdominal surgery. While the smaller incisions used in a laparoscopy are designed to cause less trauma to your abdominal tissues, there can still be complications.
With any surgery, the risk of infection is always at the top of the list. By reducing the size of the incisions necessary to perform surgery, laparoscopic procedures can help mitigate the risk of traditional surgery. Despite this lowered risk, it is still vital your surgeon and their team work to ensure a sterile environment for your surgery. Since one or more instruments will be inserted into your abdomen, there is still a risk of bacteria or other pathogens being introduced into your abdominal cavity. Infections can spread quickly, and be hard to control, so this concern is very real.
Complications from anesthesia is another source of potential problems with your laparoscopy. Maintaining the unconscious state of general anesthesia during surgery is a delicate art and things can go wrong. Some people react poorly to the anesthesia and can be prone to nausea and vomiting after surgery, which is not ideal after having had surgery to tissues in the abdomen.
One of the benefits of laparoscopy is the smaller incisions cause less damage to the tissues in your abdomen. It is still possible for adhesions (scar tissue) to occur. You are at greater risk for adhesions if you have had multiple surgeries. Even if this is the case, the risk is lower than it would be from conventional surgery.
How do I Prepare for Laparoscopy?
Before your doctor orders a laparoscopy, you are likely to have gone through a series of tests and other diagnostic steps to ensure surgery is necessary. The exact tests you go through will depend on your medical condition and whether your laparoscopy is exploratory or intended to address a known condition.
The severity of your condition will also have an effect on which tests are performed before your surgery. Having blood work done is common, though this is usually only the tip of the iceberg. Imaging is often performed as well. Conventional x-rays, magnetic resonance imaging (MRI), CT-scans, and even ultrasound may be in the cards for you as your healthcare provider works to diagnose your condition and determine whether surgery is necessary.
Preparing for laparoscopy is similar to preparing for other invasive medical procedures. Your doctor will speak with you about specific requirements and preparations for your specific surgery, but in general, there are some common steps you will likely need to take.
How do I Know If Laparoscopy is Right for Me?
There are many different conditions which can be addressed through laparoscopy. Today this type of procedure is a powerful tool available to gynecologists, gastroenterologists and other doctors as they investigate and treat a large number of diseases and conditions. Just because surgery is available doesn’t mean it is the first option you should consider.
The incisions used in laparoscopy are much smaller than traditional open surgery, and the amount of physical trauma to the body is lower. Despite these benefits, many of the risks associated with other types of surgery also apply to laparoscopy. This is why your doctor will typically recommend several different types of tests, exams, and imaging be done before resorting to a laparoscopy.
For some patients, surgery is the only option. Imaging can tell your doctor many things about what is going on in your body, but there are times when a visual inspection is the only way to know for certain how severe your condition is. In other cases, this visual diagnosis only confirms the need to remove or repair tissue. Severe endometriosis ablation, clearing bile duct blockages, and even colectomies can all be performed laparoscopically.
At Needham Gastroenterology Associates, we are careful to only perform surgeries that are necessary. We know that the conditions affecting our patients can be life-impacting and even life-threatening. We also know the dangers and benefits of different modes of treatment. We will work with you to ensure you are receiving the appropriate treatment for your condition. We can also help you understand the risks and potential benefits of laparoscopy if your condition makes you a good candidate for surgery.
Book an appointment today to learn more about all the options available on your road to health.