Laparoscopy is a minimally invasive technique that empowers medical professionals to examine the interior of the abdomen and pelvis through the use of a specialized instrument known as a laparoscope. This device, featuring a slender, telescopic rod equipped with a miniature camera, enables surgeons to visualize internal organs by inserting it through small incisions in the abdominal region. Additional surgical tools may be introduced through these incisions, facilitating a comprehensive examination and the identification of potential abnormalities. This procedure, which projects real-time images onto a monitor, is particularly valuable when other diagnostic methods fail to pinpoint the cause of a medical condition, and it allows for the collection of tissue samples for further analysis.
What is a Laparoscopy?
A laparoscopy, also known as keyhole surgery or diagnostic laparoscopy, is a surgical procedure that allows doctors to examine the organs inside your abdomen and pelvis. It can be used to diagnose and, if necessary, treat various conditions. Unlike traditional open surgery (laparotomy), laparoscopy requires only small incisions in the skin, making it a minimally invasive procedure. Instruments needed for the procedure are inserted into the abdominal cavity through these small incisions. Laparoscopy is a type of endoscopy.
When is a Laparoscopy Used?
Laparoscopy can be used for both diagnosis and treatment. Accordingly, experts distinguish between diagnostic and therapeutic laparoscopy. The two forms can also be combined: if the doctor discovers adhesions in the abdominal cavity, for example, these can be removed directly. This has the advantage that a second procedure is not necessary.
Diagnostic Laparoscopy
If other examinations have failed to find a cause for persistent symptoms, a laparoscopy can provide answers.
It is used, among other things, to:
- Visually inspect the abdominal and pelvic organs and check for pathological changes.
- Take a tissue sample for laboratory analysis.
- Assess the extent of a disease – for example, whether a tumor has spread.
- Evaluate whether open surgery is necessary.
Therapeutic Laparoscopy
If the diagnosis is confirmed, treatment can often be performed surgically during the same procedure. For example, laparoscopic removal is possible for:
- The gallbladder.
- The appendix in cases of appendicitis.
- Adhesions in the abdominal cavity.
- Diseased or injured sections of the intestine.
Therapeutic laparoscopy also plays a significant role in the treatment of gynecological conditions, such as endometriosis or uterine fibroids.
Are Preparations Necessary?
Since laparoscopy is performed under general anesthesia, it is important to arrive for the examination or treatment on an empty stomach – meaning nothing to eat or drink for about 6 to 8 hours beforehand. Depending on the area being examined or operated on, it may also be necessary to take a laxative.
In preparation, the doctor will check certain blood values. The abdominal area will be shaved and disinfected.
How is the Procedure Performed?
After administering anesthesia, the surgeon makes a small incision in the skin near the navel. A harmless gas – usually carbon dioxide (CO2) – is then introduced into the abdominal cavity through a special cannula or tube. This slightly inflates the abdomen, making the organs more accessible and visible.
A tube is inserted through the resulting opening in the abdominal wall, and then an instrument with a video camera and a light (laparoscope) is passed through it. The camera is connected to a monitor, which displays the organs and abdominal cavity.
For a surgical procedure, two more small skin incisions are usually necessary. The surgeon also inserts the instruments needed for the procedure through these incisions, via tubes – such as small forceps, suction devices, or scissors.
Depending on the purpose of the laparoscopy, the procedure takes a varying amount of time: a diagnostic laparoscopy takes about 30 to 60 minutes, and a therapeutic laparoscopy takes a little longer, depending on what is being operated on.
The graphic shows a therapeutic laparoscopy where surgical treatment can be performed directly – in this case, using the example of appendicitis.
Therapeutic Laparoscopy, Example Appendectomy.
What Happens Afterward?
After the laparoscopy, the surgeon removes the instruments and the tubes. The gas escapes from the abdominal area. The skin incisions are stitched closed.
While the anesthesia wears off, you will be monitored in the recovery room for about 1 to 3 hours. Pain medication will be given to relieve discomfort. Depending on the extent of the procedure, it may be necessary to stay in the hospital for a few days. After minor procedures, it is usually possible to be picked up after the observation period in the recovery room and go home.
