Laparoscopy - How laparoscopy is performed

Laparoscopy is performed under general anaesthetic, so you will be unconscious throughout the procedure and have no memory of it. You can often go home on the same day.

Preparation

Depending on the type of laparoscopic procedure being performed, you will usually be asked not to eat or drink anything for 6-12 hours beforehand.

If you're taking blood-thinning medication (anticoagulants), such as aspirin or warfarin, you may be asked to stop taking it a few days beforehand. This is to prevent excessive bleeding during the operation.

If you smoke, you may be advised to stop during the lead-up to the operation. This is because smoking can delay healing after surgery and increase the risk of complications such as infection.

Most people can leave hospital either on the day of the procedure or the following day. Before the procedure, you will need to arrange for someone to drive you home because you will be advised not to drive for at least 24 hours afterwards.

The procedure

During laparoscopy, the surgeon will make a small cut (incision) of around 1-1.5cm (0.4-0.6 inches), which is usually placed near your belly button.

A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate your tummy (abdomen). Inflating your abdomen allows the surgeon to see your organs more clearly and gives them more room to work. A laparoscope is then inserted through this tube. The laparoscope will relay images to a television monitor in the operating theatre, giving the surgeon a clear view of the whole area.

If the laparoscopy is used to carry out a surgical treatment, such as removing your appendix, further incisions will be made in your abdomen. Small, surgical instruments can be inserted through these incisions, and the surgeon can guide them to the right place using the view from the laparoscope. Once in place, the instruments can be used to carry out the required treatment.

After the procedure, the carbon dioxide is let out of your abdomen, the incisions are closed using stitches or clips and a dressing is applied.

When laparoscopy is used to diagnose a condition, the procedure usually takes 30-60 minutes. It will take longer if the surgeon is treating a condition, depending on the type of surgery being carried out.

Recovery

After laparoscopy, you may feel groggy and disorientated as you recover from the effects of the anaesthetic. Some people feel sick or vomit. These are common side effects of the anaesthetic and should pass quickly.

Before you leave hospital, you will be told how to keep your wounds clean and when to return for a follow-up appointment or have your stitches removed (although dissolvable stitches are often used).

For a few days after the procedure, you're likely to feel some pain and discomfort where the incisions were made, and you may also have a sore throat if a breathing tube was used. You will be given painkilling medication to help ease the pain.

Some of the gas used to inflate your abdomen can remain inside your abdomen after the procedure, which can cause:

• bloating
• cramps
• shoulder pain, as the gas can irritate your diaphragm (the muscle you use to breathe), which in turn can irritate nerve endings in your shoulder

These symptoms are nothing to worry about and should pass after a day or so, once your body has absorbed the remaining gas.

In the days or weeks after the procedure, you will probably feel more tired than usual, as your body is using a lot of energy to heal itself. Taking regular naps may help.

Recovery times

The time it takes to recover from laparoscopy is different for everybody. It depends on factors such as the reason the procedure was carried out (whether it was used to diagnose or treat a condition), your general health and if any complications develop.

If you have had laparoscopy to diagnose a condition, you will probably be able to resume your normal activities within five days.

The recovery period after laparoscopy to treat a condition depends on the type of treatment. After minor surgery, such as appendix removal, you may be able to resume normal activities within two weeks. Following major surgery, such as removal of your ovaries or kidney due to cancer, the recovery time may be as long as 12 weeks.

Your surgical team can give you more information about when you will be able to resume normal activities.

When to seek medical advice

It's usually recommended that someone stays with you for the first 24 hours after surgery. This is in case you experience any symptoms that suggest there could be a problem, such as:

• a high temperature of 38°C (100.4°F) or above
• chills
• increasing abdominal pain
• redness, pain, swelling and discharge around your wounds
• pain and swelling in one of your legs
• a burning or stinging sensation when urinating

If you experience any of these symptoms during your recovery, you should contact either the hospital where the procedure was carried out, your GP or NHS 111 for advice.