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Laparoscopy is an endoscopic technique using a laparoscope that allows direct visualization of the abdominal or peritoneal cavity, including the abdominal wall itself; the stomach, intestines, gallbladder, liver, and kidneys; and the reproductive organs such as the ovaries, fallopian tubes, and uterus. A laparoscope is a tubular fiberoptic instrument that has a miniaturized telescope at one end and a light source that illuminates the inside of the abdomen. Light and images are conducted by fine synthetic fibers contained in the length of the laparoscope. Laparoscopy can be used for abdominal examination only or to perform minimally invasive surgical procedures instead of open surgery. It is often used for gynecologic (reproductive organs) examination and surgery and is used increasingly as a less invasive alternative for simpler abdominal surgeries.
Before the surgeon performs a laparoscopy, the abdomen is filled (insufflated) with carbon dioxide (CO2) through a special needle inserted just below the navel. The gas distends the abdomen and helps to separate the organs inside the abdominal cavity, making it easier for the physician to view abdominal and pelvic organs during the procedure. The surgeon is able to view the entire procedure on a video monitor over the operating table, guiding the laparoscope visually to examine the organs and surrounding tissues.
If the surgeon finds abnormal growths or tissues, another small incision may be made to allow the passage of a needle for needle biopsy or a tiny scalpel for the laparoscopic removal of growths such as cysts (especially ovarian cysts), polyps, or small tumors. Other surgeries that are sometimes performed laparoscopically include hernia repair; gastric bypass (for obesity); removal of the appendix, gallbladder, or spleen; and treatment of colon cancer. A newer treatment using the laparoscope is laparoscopic antireflux surgery (LARS) for individuals with gastroesophageal reflux disease (GERD); it is performed to relieve esophageal sphincter pressure.
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Source: Medical Disability Advisor
| A laparoscopy is indicated in any situation in which internal examination of the abdomen will help establish a diagnosis and determine subsequent treatment. Individuals undergoing this procedure will have a complete preoperative evaluation prior to the surgical procedure.
Laparoscopy can be both diagnostic and operative. A diagnostic or exploratory laparoscopy is performed to determine the cause of abdominal or pelvic pain, such as severe menstrual pain, or to investigate a mass that was palpable on physical examination. Laparoscopy is also used to diagnose or rule out infertility.
An operative laparoscopy (laparoscopic surgery) may be used to remove abdominal or scar tissue (pelvic adhesions); to treat ectopic (tubal) pregnancy or endometriosis; or to perform other gynecologic procedures, such as the removal of ovarian cysts or the entire ovary, uterine fibroids, or the uterus (hysterectomy). Laparoscopy is rapidly becoming the most common surgical procedure for liver biopsy, gallstones, appendicitis, colon pathology, and many other abdominal surgeries.
Laparoscopy is also frequently used to assess blunt or penetrating trauma and as a follow-up examination after cancer surgery. |
Source: Medical Disability Advisor
| Laparoscopy is most often performed under general anesthesia in an operating room. The laparoscope is introduced through a small incision in the navel, and the abdominal cavity is filled with carbon dioxide to distend the abdomen and lift the abdominal wall away from underlying organs, generally improving visibility for the surgeon. The entire procedure is viewed on a video monitor over the operating table, allowing the laparoscope to be guided visually to examine organs of interest and surrounding tissues. Abnormal growths or tissues may be biopsied or excised through another small incision that allows passage of a needle for needle biopsy or a tiny scalpel for removal of growths or, in more complex surgeries, organ treatment or removal.
A simple diagnostic laparoscopy usually takes about 10 to 15 minutes. Operative laparoscopy can take several hours, depending on the procedure being performed. Still photographs or a videotape of the procedure are taken to include in the medical record.
After the instruments have been removed and the carbon dioxide gas has been released, dissolving stitches are used to close each incision site. After complex surgery, a thin drain tube (catheter) may be left in the abdominal wall for 24 hours to remove excess fluid and also to allow examination of the fluid for bleeding or possible infection in the surgical site. |
Source: Medical Disability Advisor
| The outcome depends on the severity of any condition or disease discovered during the procedure. Generally, the prognosis is good with this less invasive procedure. |
Source: Medical Disability Advisor
| Complications are rare. However, the most common complications are cardiac and respiratory problems resulting from insufflation or anesthesia. Other complications include vascular damage and related bleeding, tissue damage, and blood vessel damage (bowel or urologic injury). Injury to the intestines will require another surgical procedure to repair the injury. When general anesthesia is required, reaction to the anesthesia is a possible complication. |
Source: Medical Disability Advisor
| Unless complications are present, no work restrictions or special accommodations are required. |
Source: Medical Disability Advisor
| "Laparoscopy." Georgia Reproductive Specialists. 20 May 2005 <http://www.ivf.com/laprscpy.html>. |
Source: Medical Disability Advisor