Laparoscopy
What is Laparoscopy?
Laparoscopy is a minimally invasive surgical technique that allows the gynecologist to examine, diagnose, and treat conditions of the pelvic cavity without the need for large incisions. It is performed through small abdominal incisions (usually 3 to 4), through which a thin optical instrument with a camera (laparoscope) and specialized surgical instruments are inserted.
The image from the camera is transmitted to a monitor, allowing the surgeon to have a detailed view of the surgical field and to perform even complex procedures with precision.
Laparoscopy can be used for both diagnosis and treatment — often combining both during the same procedure.
Advantages over Open Surgery
Laparoscopy has largely replaced open surgery in gynecology. Its advantages are significant and immediately apparent to the patient:
Less pain and faster recovery
Since there is no large incision, postoperative pain is significantly reduced and the need for pain medication is limited. Most women return to their daily activities within a few days to two weeks, depending on the procedure.
Minimal Hospital Stay
The majority of laparoscopic procedures are performed as day-case surgeries. The patient returns home the same day or, at the latest, the next day.
Reduced risk of complications
The specialized instruments used in laparoscopy are thinner and cause less tissue trauma, reducing the risk of bleeding, infections, and postoperative adhesions.
Better cosmetic results
The small incisions leave barely visible marks on the skin, in contrast to the large scars of open surgery.
Important: Not all procedures are suitable for a laparoscopic approach. The gynecologist evaluates each case individually and selects the method that ensures the best outcome for the patient.
For which conditions is it used?
Laparoscopy is currently the method of choice for a wide range of gynecological procedures. Its most common applications include:
Endometriosis
Laparoscopy is the only way to definitively diagnose and simultaneously treat endometriosis. It allows for the identification and removal of endometriotic lesions, the separation of adhesions, and the restoration of normal pelvic anatomy.
Fibroids
For fibroids that are not suitable for hysteroscopic removal, laparoscopic myomectomy allows for their removal while preserving the uterus.
Ovarian cysts
Laparoscopic cystectomy allows for the removal of cysts of any size while fully preserving healthy ovarian tissue.
Hydrosalpinx
Laparoscopic salpingectomy or salpingostomy is the recommended treatment for hydrosalpinx, especially prior to in vitro fertilization.
Ectopic pregnancy
Early diagnosis allows for laparoscopic management of this emergency in most cases.
Hysterectomy
Laparoscopic hysterectomy—total or subtotal—can be performed in less than an hour with a very rapid recovery for the patient.
Chronic pelvic pain & adhesions
In cases of chronic pelvic pain resistant to treatment, laparoscopy allows for simultaneous diagnosis and treatment, including the removal of intra-abdominal adhesions.
Fertility Evaluation
In some cases of infertility, laparoscopy is used to assess fallopian tube patency, remove adhesions, or treat endometriosis.
How it works
Laparoscopy is performed under general anesthesia in a hospital or clinic setting and follows specific steps.
Preparation
Before the procedure, you must fast for at least 8 hours and undergo a preoperative evaluation that includes blood tests and an anesthesiological assessment. Your gynecologist will inform you of any additional instructions depending on the procedure to be performed.
Procedure
First, CO2 is injected into the abdominal cavity to create a working space. Next, the laparoscope is inserted through a small incision near the navel, while 2 to 3 additional small incisions are made to insert the surgical instruments. The gynecologist performs the procedure while viewing the camera feed on a high-resolution screen.
Duration
The duration depends on the type and complexity of the procedure. A diagnostic laparoscopy can take 20 to 30 minutes, while more complex procedures such as the removal of fibroids or the treatment of extensive endometriosis can take 1 to 3 hours.
Hospitalization
In most cases, the patient returns home the same day or the next day at the latest. More extensive procedures may require a hospital stay of 1 to 2 days.
Frequently Asked Questions (FAQ)
The CO2 that remains in the abdominal cavity after surgery is gradually absorbed by the body. Light walking and movement significantly help speed up this absorption. It usually dissipates completely within 2 to 3 days. In contrast, prolonged bed rest slows down the process.
In most cases, the next menstrual period arrives at the expected time. Some women may experience a slight delay or a change in the flow of their first period after the procedure, which is completely normal. If the delay exceeds 6 weeks or if you experience unusual bleeding, it is advisable to contact your gynecologist.
Light movement and walking are encouraged from the very first days, as they aid in recovery. However, strenuous physical activity, running, and lifting heavy objects should be avoided for at least 2 to 4 weeks, depending on the type of surgery. Your gynecologist will provide you with personalized instructions.
Pain in the navel is one of the most common symptoms following laparoscopy, as that is where the main incision is made. It usually subsides within 3 to 7 days and can be effectively managed with simple pain relievers. If the pain persists or is accompanied by redness or discharge from the incision site, contact your gynecologist.
The most common side effects include mild pain at the incision sites, a feeling of bloating, shoulder pain from the CO2, mild fatigue, and nausea from the anesthesia. All of these are temporary and subside within a few days. Serious complications such as infection or bleeding are rare but require immediate medical evaluation.
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