Laparoscopy

Laparoscopy

What is a Laparoscopy?

Laparoscopy is a procedure used to examine the organs of the abdominal cavity and pelvis. Laparoscopy utilizes a laparoscope, a thin flexible tube containing a video camera. The laparoscope is placed through a small incision in the abdomen and produces images that can be projected on a computer screen. 

The advantage of laparoscopy is that it allows the liver to be biopsied under direct view.  It can also be used t olook for causes of unexplained problems with the liver and to evaluated liver masses.

Preparation
  • Your physician will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
  • You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if something is not clear.
  • In addition to a complete medical history, your physician will perform a physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood or other diagnostic tests.
  • You will be asked to fast for eight hours before the procedure, generally after midnight.
  • If you are pregnant or suspect that you are pregnant, you should notify your physician.
  • Notify your physician if you are sensitive to or are allergic to any medications, iodine, latex, tape, and anesthetic agents (local and general).
  • Notify your physician of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
  • Notify your physician if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
  • The area of the abdomen where the incision is to be made may be shaved.
  • A cleansing enema may be given a few hours before the procedure.
  • You may receive a sedative prior to the procedure, depending on the type of procedure being done. If your procedure is to be done on an outpatient basis, you will need to have someone drive you home afterwards because of the sedation given prior to and during the procedure.
  • Based upon your medical condition, your physician may request other specific preparation.

Procedure

A laparoscopy may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.

Generally, a laparoscopy follows this process:

  • You will be asked to remove any jewelry or other objects that may interfere with the procedure.
  • You will be asked to remove clothing and be given a gown to wear.
  • An intravenous (IV) line will be inserted in your arm or hand.
  • An indwelling catheter may be inserted into the bladder to reduce the risk of bladder perforation.
  • You will be positioned on your back on the operating table.
  • The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
  • The skin over the surgical site will be cleansed with an antiseptic solution.
  • A local anesthetic may be injected into the incision site to numb the area. You will feel a needle stick and a brief stinging sensation.
  • A small incision will be made in the abdomen just below the navel, or belly button.
  • Additional incisions may be made so that other surgical instruments can be used during the procedure.
  • Carbon dioxide gas will be introduced into the abdomen to inflate the abdominal cavity so that organs and other structures can be easily visualized.
  • You may experience some discomfort in the abdomen and top of the shoulder as carbon dioxide is instilled and as instruments are manipulated.
  • The laparoscope will be inserted and the examination will be performed.
  • Once the examination and any additional procedures have been completed, the laparoscope will be removed.
  • The incision(s) will be closed with stitches or surgical staples.
  • A sterile bandage/dressing or adhesive strips will be applied.

What happens after the Laparoscopy?

After surgery, you will be taken to the recovery room for observation. Your recovery process will vary depending upon the type of anesthesia that is given. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room.

This pain may last for a few days but should become less intense each days.  Take a pain reliever for soreness as recommended by your physician.  Aspirin or certain other pain medications may increase the chance of bleeding.  Be sure to take only recommended medications

You may be allowed to drink clear fluids within a few hours of the procedure. Your diet may gradually be advanced to more solid foods as tolerated.

You may be instructed to limit physical activity for several days after the procedure.

Notify your physician to report and of the following:

  • fever and/or chills
  • redness, swelling, or bleeding or other drainage from the incision site(s)
  • increased pain around the incision site(s)
  • vomiting 

Following a laparoscopy, your physician may give you additional or alternate instructions depending on your particular situation.

Once you are home, it is important to keep the surgical incisions clean and dry. Your physician will give you specific bathing instructions. If stitches or surgical staples are used, they will be removed during a follow-up office visit. If adhesive strips are used, they should be kept dry and generally will fall off within a few days.

Possible complications of Laparoscopy

Laparoscopy is generally safe and complications are rare when the test is performed by a Hepatologist.

Bleeding may occure from a biopsy site or where the cope is inserted.  Bleeding is usually minimaland rarely requires blood tranfusions or surgery.

Irritation may occur at the vein where medications were given, sometimes leaving a tender lumplasting several weeks.  Applying hot mosit towels may help relieve discomfort.

Rarely, some people experinces severe abdominal pain, fever, dizziness, or weakness afterward.  If you have any of these side effects, contact your physician immediately.  Read your discharge instructions carefully.

Medications such as blood-thinners may need t obe stopped for a short time after having your laparoscopy, especially if a biopsy was performed.  Full recovery by the next day is normal and expected and you may return to your regular activities.

Other rare risks include a raction to the sedatives used, aggravation of heart or lung diseases, or perforation (a tear that might require surgery to repair).

Please call the Hepatology Department immediately if after the procedure you develop fever, pain, or bleeding.