Laparoscopy

A laparoscopy is a procedure that involves a surgeon inserting a small camera into your abdomen to assess your internal organs. Laparoscopic procedures can diagnose a range of colon-related diseases and conditions. The procedure can also be used as a form of treatment for a range of gastrointestinal diseases.

The camera, known as a laparoscope, is a thin tube attached with a light that can enter your body via a small incision on your umbilicus. This camera relays images back to a monitor so the surgeon can efficiently and effectively assess your internal abdominal organs.

The procedure is a type of keyhole surgery, meaning that the surgery is minimally invasive, low risk, and avoids any large incisions being made on your abdomen.

Laparotomy vs Laparoscopy

While a laparoscopy makes use of keyhole techniques, a laparotomy is a form of open surgery, requiring the surgeon to make large incisions on your abdomen.

Typically, laparoscopies are the preferred surgical method as they offer patients faster recovery times, less risk of infection, little cosmetic impact and minimal postoperative pain.

In rare circumstances, your surgeon may encounter conditions that would deem a laparoscopy ineffective and therefore resort to a laparotomy. Such conditions can include the discovery of large tumours that block the insertion of the laparoscope or if the technical equipment is malfunctioning.

The two main functions of laparoscopy are the diagnosis and treatment of certain conditions or diseases.

Our laparoscopic surgeons specialise in diagnosing and treating all conditions related to your gastrointestinal health, including the stomach, oesophagus, large and small intestines, liver, gallbladder and pancreas.

Laparoscopy to Diagnose Disease

If you're experiencing abdominal pain, your doctor may use imaging techniques to try to diagnose your condition. Such imaging techniques include ultrasounds, CT scans or MRI scans.

However, sometimes these diagnostic tools cannot provide enough insight for a proper diagnosis. In this instance, you will need to undergo a laparoscopy so your surgeon can gain a clearer understanding of your organs within the abdominal wall.

Laparoscopies can be used to assess the following organs:

• Appendix
• Gallbladder
• Liver
• Pancreas
• Colon (small and large intestine)
• Spleen
• Stomach
• Pelvic and reproductive organs

Therefore, diseases or conditions that are detected by a laparoscopy include:

• Gastrointestinal stromal tumours (tumours within the abdomen and colon)
• Ascites (fluid in the abdominal cavity)
• Liver disease
• Female infertility
• Adhesions (scar tissue in the pelvic cavity)

Laparoscopy to Treat Disease

Surgeons can also use a laparoscopy to effectively treat and manage diseases or conditions.

This can include:

• Hysterectomy (surgical removal of the uterus)
• Ectopic pregnancy (surgical removal of a lodged embryo in the fallopian tubes)
• Management of colorectal cancers
• Hernia repair

If you have been diagnosed with any of the following diseases, talk to your doctor to see if laparoscopy is an appropriate treatment option for you.

Laparoscopic surgery is a straightforward procedure that will help you return to normal activities as fast as possible. The best way to prepare yourself for an upcoming laparoscopic surgery is by informing yourself of each stage, so you know what to expect.

Here's everything you need to know for your laparoscopy.

Laparoscopy Preparation

The best way to prepare for your upcoming laparoscopy is to sit down with your surgeon for a consultation. It's a good idea to inform them of any over-the-counter medications you're currently taking. In some circumstances, your surgeon may change the dosage of the medications to avoid potential complications. Particular medications of concern include blood thinners, nonsteroidal anti-inflammatory drugs, vitamin K or other medicines that may cause a blood clot.

You should also inform your doctor if you're pregnant, or think you could be pregnant. This information can help surgeons ensure that no damage is inflicted on the womb during the procedure. Ultimately, open communication between you and your surgeon is one of the best ways to guarantee a successful laparoscopy with no complications.

To better prepare for your laparoscopy, you should also:

• Avoid eating or drinking 8 hours before your procedure.
• Avoid smoking before your procedure.
• Avoid wearing any jewellery, high-heeled shoes or any nail polish.
• Wear comfortable, loose fitting clothes.
• Organise someone to pick you up following your discharge.

Initial Tests

Your surgeon may also require you to complete some initial tests to ensure you are in a suitable condition for the minimally invasive surgery.

Some tests that your doctor may refer you to take include:

• Chest X-rays
• Blood test
• Urinalysis
• Electrocardiogram
• Operative report
• Pathology report
• Cytology slide
• Tissue specimen analysis

The tests will help your surgeon better understand the reason for your laparoscopy and aid the overall effectiveness of the procedure.

Depending on the type of laparoscopy, your procedure time may vary. For a diagnostic laparoscopy, the procedure should take 30-60 minutes. However, if you are undergoing an operative laparoscopy, you can expect the surgery to last close to 75 minutes.

During your laparoscopy, you will be administered a general anaesthetic, which means you will be asleep for the procedure. Once unconscious, the surgeon will make a small 2-centimetre incision near your umbilicus (belly button) and insert the laparoscope into the abdominal cavity. In instances where your laparoscopy procedure is used to treat a disease, another 2 to 3 small incisions may be made to allow access for other surgical instruments.

To help the surgeon better view your cavity, they will inflate your abdomen with a non-harmful carbon dioxide or nitrous oxide gas that separates your internal organs from the abdominal wall.

After the surgeon has completed their diagnosis or treatment, they will remove all surgical instruments and close your incisions with dissolvable stitches or surgical tape. You will then be treated with surgical bandages and remain under observation while unconscious.

As your laparoscopy is a keyhole surgery, you will not be required to stay in hospital overnight. Generally, if you present no signs of any possible complications, you can anticipate being home within four hours from waking. We advise that you organise someone to pick you up when discharged, as you will not be in a suitable condition to drive.

When you do regain consciousness, you can expect some of the following symptoms:

• Tenderness around the sites of your incision
• Pain around your shoulder (caused by the inflation of your abdominal cavity)
• Abdominal cramps
• Constipation
• Nausea

What to Eat After Laparoscopic Surgery

As the laparoscopy may cause nausea, you may not be hungry following the procedure. However, it's still essential for your recovery to maintain regular fluid intake. If you're feeling nauseous following the laparoscopy, you can try drinking a mix of water and ginger-ale to try to settle your stomach.

You should avoid consuming anything spicy, acidic or substances containing dairy following your surgery. Some good ideas for post-procedure meals can include jelly, sandwiches, or soup with toast.

Regular consumption of foods can return 2 to 3 days following the surgery or when you're feeling comfortable enough.

Laparoscopic Surgery Recovery Time

Your post-operative symptoms should last around 1 to 2 days. If approved by your doctor, you may also be able to take some painkillers to help deal with the discomfort. However, suppose your symptoms persist after the second day. In that case, you should go to your doctor immediately to ensure there are no complications.

If you are not presenting any signs of complications you can expect to gradually return to your normal routine within a week from the surgery.

Lifting and Exercise After Laparoscopic Surgery

You should gradually return to normal physical activities over the following 3 weeks from your procedure. It's essential to avoid any heavy lifting or abdominal strain within the first couple weeks of your laparoscopy, as this may re-open the incisions.

The best idea is to book a follow-up appointment with your doctor after a week. Your doctor will have the best advice for when you can return to regular exercise, as they can have a proper assessment of your wound and recovery status.

Laparoscopic Surgery Scars

As a keyhole surgery is only a small incision that's 2 centimetres in length, ​you can expect minimal noticeable scarring on your abdomen. If you're worried about scarring, there are a range of methods that you can use to care for your wound.

This includes:

• Avoiding sun exposure to the wound.
• Maintain a protein-rich diet.
• Topical treatments (silicone gels, compression bandages and creams).
• Keep an eye out for infection.
• Once healed, gently massage the tissue around the scar.

You should always consult your doctor before undertaking any cosmetic medications that alleviate scarring.

A key benefit of laparoscopy is that it has less risk of complications than traditional open surgery. However, it's essential to be aware of potential complications for early detection and intervention.

If you spot any of the following complications, immediately consult your doctor. In extreme cases, you may require further surgery to correct severe complications.

Signs of Infection After Laparoscopic Surgery

Although the incisions are small, they can still be susceptible to infection. Scientific studies have found that around 18% of people who underwent colorectal laparoscopies need to be readmitted due to infection around the incision sites. However, this can be easily avoided through regular cleaning and dressing your wound with fresh bandages.

If your wound may be infected if it presents any of the following:

• Pus
• Bad odour
• Hot skin
• Redness
• Painful or sore to touch surrounding area

You should seek medical attention immediately as later stages of infection can have serious health complications.

Bleeding After Laparoscopic Surgery

Another potential complication from your laparoscopy is internal bleeding in the abdominal cavity. This can have serious health implications, and you should seek immediate medical assistance if you present any of the following signs:

• Abdominal or chest pain
• Shortness of breath
• Nausea and vomiting
• Urine containing blood
• Dizziness
• Extensive bruising around the abdomen

According to the Australian Government, the average price for laparoscopy is around $2,600, with medicare covering up to $1,000 in expenses and private insurers paying out $920.

In total, if you have health insurance, this would leave you $480.00 out of pocket. Before your laparoscopy, consult your private health insurer so you can get an idea of how much they will cover for the procedure.

The Centre for Gastrointestinal Health offers professional laparoscopic surgery. Dr Sanjay Adusumilli is our senior Colorectal Surgeon at the Centre and provides the highest quality care when it comes to your laparoscopy.

How Long Does Gas Pain Last After Laparoscopy?

Pain caused by the gas used during a laparoscopy may last 1 to 2 days, with peak periods of pain experienced within the first 12 to 24 hours following the procedure. The pain is typically located in your abdomen or shoulder.

Is Laparoscopy a Major Surgery?

Although it is a minimally invasive keyhole surgery with minimal risk of complications, laparoscopies are considered a major surgery.

Why is My Belly so Big After Laparoscopy?

The gas used during a laparoscopy can cause temporary bloating and constipation. To help manage this, you can do some light daily walking to help encourage bowel movements.