Diagnostic Laparoscopy

About 250,000 women have laparoscopic surgery in the UK every year. Most women have no problem, but complications can happen in about one in every 1,000 cases.

The known risks are:

• Damage to the bowel, bladder or major blood vessels.
• Failure to enter the abdominal cavity.
• Uterine perforation.

In extremely rare cases it is necessary to make a bigger incision than planned and the procedure is then called a laparotomy. If this happens you will need to stay in hospital longer to recover.

After your first consultation, you will be assessed either by telephone or in our pre-admission clinic to make the final arrangements and to check if you are fit for surgery. We will organise a routine blood test for you two to three days prior to your admission to ensure we have a blood match saved for you in case of an emergency. Without this we are unable to perform the procedure.

Pregnancy. If you are taking the contraceptive pill, there is no need to stop as the surgery is only a day case procedure. Please avoid unprotected intercourse during the month of your laparoscopy as if there is any chance of you being pregnant your operation will be cancelled. We will carry out a pregnancy test on the day of the operation to check there is no risk. You can have the procedure if you are menstruating.

The procedure is usually done as day surgery so you will come into hospital on the morning of your operation and be allowed to go home approximately four hours after.

You will come into the unit having eaten nothing for six hours and you will only be allowed clear fluids for the two to six hours before your procedure. After you have been admitted, your consultant gynaecologist and anaesthetist will come and answer any questions you may have and ask you to complete and sign a consent form. A pregnancy test will be performed if appropriate.

The operation will take about 15 minutes. A small 1cm cut will be made under the navel and one or two smaller cuts made just above the pubic hairline. Some medical gas is put into your abdomen, so the surgeon has a better view when the laparoscope (telescope) is inserted through the first small cut to inspect your womb and fallopian tubes. Further instruments may be used to assist the inspection or for treatment and a vaginal examination and womb manipulation may also be required.

At the end of the operation the medical gas will be released, and the small cuts closed using an absorbable stitch or surgical glue. Although an absorbable stitch may be used, it can be removed after 10 days to speed up healing.

The results of your laparoscopy will be discussed with you before you go home, but a follow up appointment is generally arranged for a few weeks after. This is to discuss findings and further treatment if necessary.

After the operation you may have a sore throat or feel sick from the anaesthetic.

You may have to rest for a few days.

Paracetamol and ibuprofen are recommended for the first couple of days, with codeine (if appropriate) supplied by the hospital for any breakthrough pain. Do not exceed the recommended maximum daily dose.

 You may have some vaginal bleeding following the operation. Tampons may be used. If pain or bleeding becomes excessive you should contact your GP for advice.

You may also experience discomfort around the shoulders because of the medical gas used to distend the abdomen and protect the internal organs. It creates pressure on the abdominal nerve, which is connected to the shoulder area. Changing your position may help with the pain but it will gradually disperse over a couple of days. Regular painkillers will help.

Your stitches will dissolve but can be removed earlier if they irritate you. Please make an appointment with the practice nurse at your GP’s surgery to remove the stitches 10 days post operation.

You may have a shower the day after your surgery. Sexual relations can be resumed as soon as you are comfortable to do so.

Most patients are well enough to go back to work two to three days after their surgery, but it depends on the individual as some patients may find they need longer to recover. If requested by your employer, your consultant can issue a Statement of fitness for work for up to a week.

While most women recover well after a laparoscopy, complications can occur. You should call the Tetbury Hospital switchboard between 08:30 to 16:30, Monday to Friday on 01666 502336, or outside these hours seek medical advice from your GP or dial 111 if you experience:

• Burning and stinging when you pass urine or pass urine frequently. This may be due to a urine infection which can be treated with a course of antibiotics.
• Red and painful skin around your scars. This may be due to a wound infection which can be treated with a course of antibiotics.
• Increasing abdominal pain. If you also have a temperature, have lost your appetite and are vomiting, this may be due to damage to your bowel or bladder, in which case you will need to be admitted to hospital.
• A painful, red, swollen, hot leg or difficulty bearing weight on your legs. This may be due to a deep vein thrombosis (DVT). If you have shortness of breath or chest pain or cough up blood, it could be a sign that a blood clot has travelled to the lungs (pulmonary embolism). If you have these symptoms, you should dial 999 immediately.
• There is no improvement in your symptoms. You should expect a gradual improvement in your symptoms over time. If this is not the case, call the Tetbury Hospital switchboard between 08:30 to 16:30, Monday to Friday on 01666 502336.