Diagnostic laparoscopy is a procedure that allows the doctor to look directly at the contents of the abdomen or pelvis.
How the test is performed
The procedure is usually done in hospital or in an outpatient surgery centre under general anaesthetic (while you sleep and feel no pain). The procedure is performed as follows:
- The surgeon makes a small cut (incision) under your belly button.
- A needle or hollow tube called a trocar is inserted into the incision. Carbon dioxide gas is introduced into the abdomen through the needle or tube. The gas helps to expand the area, giving the surgeon more room to visualize and work and helps the surgeon to see the organs more clearly.
- A tiny video camera (laparoscope) is then placed through the trocar and is used to see inside your pelvis and abdomen. More small cuts may be made if other instruments are needed to see specific organs better.
- If you are having a gynaecological laparoscopy, a dye may be injected into your cervix so the surgeon can see your fallopian tubes.
- After the examination, the gas, laparoscope and instruments are removed, and the cuts are closed. You will have bandages over those areas.
How to prepare for the test
Follow instructions not to eat or drink before the operation.
You may need to stop taking medication, including narcotic painkillers, on or before the day of the examination. DO NOT change or stop taking medications without first discussing it with your healthcare provider.
Follow any other instructions on how to prepare for the procedure.
How will you feel?
You will not feel any pain during the procedure. Afterward, the incisions may be a little bit painful. Your doctor may prescribe a painkiller.
You may also have shoulder pain for a few days. The gas used during the procedure can irritate the diaphragm, which has some of the same nerves as the shoulder. You may also have an increased urge to urinate, as the gas can put pressure on your bladder.
You will recover for a few hours in hospital before going home. You probably won’t stay overnight after a laparoscopy.
You will not be allowed to drive home. Someone must be available to drive you home after the procedure.
Why the test is performed
Diagnostic laparoscopy is often done for the following:
- Finding the cause of pain or a growth in the abdomen and pelvic area when X-ray or ultrasound results are unclear.
- After an accident, to see if there is damage to any organs in the abdomen.
- Before cancer treatment procedures to find out if the cancer has spread. If so, the treatment will change.
Normal results
Laparoscopy is normal if there is no blood in the abdomen, no hernias, no bowel obstruction, and no cancer in any visible organ. The uterus, fallopian tubes and ovaries are normal size, shape and colour. The liver is normal.
What abnormal results mean
Abnormal results can be due to several different conditions, including:
- Scar tissue inside the abdomen or pelvis (adhesions)
- Appendicitis
- Cells inside the uterus growing in other areas (endometriosis)
- Inflammation of the gallbladder (cholecystitis)
- Ovarian cysts or ovarian cancer
- Infection of the uterus, ovaries, or fallopian tubes (pelvic inflammatory disease)
- Signs of injury
- Spread of cancer
- Tumours
- Non-cancerous tumours of the uterus, such as fibroids
Risks
There is a risk of infection. You may be given antibiotics to prevent this complication.
There is a risk of perforating an organ. This could cause leakage of bowel contents. There could also be bleeding in the abdominal cavity. These complications could lead to immediate open surgery (laparotomy).
Diagnostic laparoscopy may not be possible if you have a swollen bowel, fluid in your abdomen (ascites) or if you have had surgery in the past.
