Diagnostic laparoscopy

Laparoscopy is a minimally invasive procedure that allows the assessment and, when necessary, treatment of conditions affecting the pelvic organs. This technique is primarily used for gynecological disorders, but it may also be applied in the diagnosis and treatment of other abdominal conditions. Compared with traditional open surgery, laparoscopy is associated with a shorter recovery period, less tissue trauma, and reduced postoperative discomfort.

What Is Laparoscopy?

Laparoscopy is a modern, reliable, minimally invasive gynecological procedure in which the pelvic organs are examined or surgical treatment is performed through small incisions measuring approximately 0.5-1 cm. During the procedure, a specialized optical camera (laparoscope) is inserted into the abdominal cavity, allowing the obstetrician-gynecologist to view the internal organs on a monitor and perform the required procedures with precision.

One of the key advantages of this method is that if abnormalities are identified during a diagnostic laparoscopy, surgical treatment can often be initiated during the same procedure.

When Is Laparoscopy Performed?

Laparoscopy is most commonly performed in the following situations:

• Unexplained pain in the lower abdomen or lower back.
• Suspected or confirmed ectopic pregnancy.
• Endometriosis.
• Removal of ovarian cysts.
• Investigation of infertility, including the assessment of fallopian tube patency, pelvic adhesions, and other potential causes.
• Suspected pelvic inflammatory disease.
• Diagnosis or treatment of other gynecological, urological, or abdominal conditions.

How Is Laparoscopic Surgery Performed?

The procedure typically follows these steps:

1. The patient is positioned on the operating table and placed under general anesthesia.
2. The obstetrician-gynecologist makes several small incisions in the abdomen using specialized instruments. One incision is typically made near the navel, while others are placed in the lower abdomen.
3. The abdominal cavity is inflated with carbon dioxide gas to improve visibility of the organs.
4. A laparoscope is inserted through one incision, transmitting images to a monitor, while specialized surgical instruments are introduced through the remaining incisions to perform diagnostic and/or therapeutic procedures.
5. Once the procedure is completed, all instruments are removed, the gas is released, and the incisions are closed with sutures or surgical dressings.

How Should You Prepare for Laparoscopy?

Before surgery:

• Inform your doctor about all medications you are taking, particularly those that affect blood clotting, such as anticoagulants or anti-inflammatory medications.
• Complete all preoperative tests as instructed, which may include blood tests, urine tests, an ECG, a chest X-ray, and others.
• Do not eat or drink for at least 6-8 hours before the procedure (in some cases, up to 12 hours).
• Shower before surgery and remove any jewelry or accessories that may interfere with the procedure.
• Arrange for someone to drive you home after surgery, as the effects of anesthesia may cause drowsiness.

How Long Does Laparoscopy Take?

A diagnostic laparoscopy usually takes approximately 30-60 minutes. If a therapeutic procedure is performed, such as a laparoscopic cystectomy, the surgery may last 1-3 hours or longer, depending on the complexity of the procedure.

Benefits of Laparoscopy

The main advantages of laparoscopy include:

• Less postoperative pain compared with traditional open surgery.
• A shorter hospital stay.
• Faster recovery.
• Better cosmetic results with smaller scars.

Laparoscopy: Recovery After Surgery

Recovery time following laparoscopy depends on the type and complexity of the procedure. After a diagnostic laparoscopy, patients often recover within a few days, whereas recovery after more complex interventions may take 2-6 weeks or longer. Many patients can return to non-strenuous work within 1-3 weeks.

In Lithuania, sick leave following laparoscopy is commonly 10-14 days, although it may be extended depending on the patient's health condition, the nature of their work, and the physician's recommendations.

Postoperative Care Typically Includes:

• Pain management using medications prescribed by your doctor.
• Wound care, including dressing changes and incision site cleaning.
• Avoiding heavy physical activity and lifting heavy objects.
• Monitoring for signs of infection, such as redness, swelling, pain, discharge, or fever.
• Attending scheduled follow-up appointments with your doctor.