A ‘diagnostic’ laparoscopy (Lapar = abdomen, oscopy = to look into) is used to examine the abdomen to investigate pelvic pain, pain and bleeding, subfertility, and to diagnose a suspected ectopic pregnancy.
An ‘operative’ laparoscopy, is used to remove the ovary or ovarian cysts, endometriosis, infection, treat subfertility, fibroids, to assist with a hysterectomy and to perform a sterilisation.
In this procedure, a small, fibre-optic ‘telescope’ is used to see the internal organs. After filling the abdomen with gas (carbon dioxide), a telescope is passed through the belly button (umbilicus), so the contents of the pelvis can be visualised. Other small (5mm or 10mm diameter) holes may be placed in the abdomen, especially where an operation will be carried out (keyhole surgery). A laparoscopy is usually performed under general anaesthetic as a day-case procedure and takes 15-20 minutes. Very rarely it can be performed under local anaesthetic. Following laparoscopy, patients may experience a pain similar to a period pain or ‘wind’ for up to 1 week.
Minimally invasive or ‘key-hole’ surgery can be performed using laparoscopy. This has the advantages of reduced postoperative pain, a shorter stay in hospital, a smaller incision and therefore a better cosmetic result than conventional surgery.
Complications include pain for a few days after the operation. Occasionally there may be infection in the wounds. The risk of serious complications, e.g. perforation of the bowel or excessive bleeding is about 1,000:1, but is higher if the laparoscopy is operative.