Gynecologic laparoscopy involves a group of minimally invasive surgical procedures on
the female reproductive organs performed with the aid of a small camera.
The first gynecologic procedures involving a laparoscope
included exploratory laparoscopy to diagnose ovarian pathology such as cysts, torsion, and
cancer. Subsequently, more complex operations have developed, including laparoscopic
removal of a tubal pregnancy, harvest of eggs for in vitro fertilization, and, more
recently, laparoscopic removal of the uterus (hysterectomy) and/or removal of the ovaries.
For complex laparoscopic operations, patients should consult with their primary health
care provider to find a center of excellence in the specific operation.
The procedure is usually done in the hospital, under general anesthesia. A catheter is
inserted through the urethra into the bladder. An additional tube, called a nasogastric
(NG) tube, may be passed through the nostril and into the stomach to remove intestinal
contents. The skin of the abdomen is cleansed, and sterile drapes are applied.
How will a
Gynecologic laparoscopy feel
If you are under general anesthesia, you will feel no pain during the procedure,
although the incisions may throb and be slightly painful afterward. A pain reliever may be
given by your physician.
With local anesthesia, you may feel a prick and a burning sensation when the anesthetic is
given. Pain may occur at the incision site. Afterward, the incisions may throb for several
hours and may be slightly painful. A pain reliever will be administered by your physician.
Additionally, you may experience shoulder pain for a few days, because the carbon
dioxide gas used to inflate your abdomen can irritate your diaphragm, which shares some of
the same nerves as the shoulder. You may also experience an increased urge to urinate,
since the gas can put pressure on the bladder.
Depending on the procedure performed, your health care provider may advise you to avoid
eating and drinking for a period of time after the procedure.
A small incision is made above or below the navel to allow the insertion of a tube
called a trocar, which allows passage of a tiny video camera into the abdomen. Prior to
insertion of the trocar, a needle is inserted into the incision and carbon dioxide gas is
injected to elevate the abdominal wall, thereby creating a larger space to work in. This
allows for easier viewing and manipulation of the organs.
The laparoscope is then inserted so that the organs of the pelvis and abdomen can be
examined. Additional small incisions are made for instruments that allow the surgeon to
move organs, cut tissue, suture, and staple structures as needed to safely and effectively
perform the procedure.
Following the examination, the laparoscope is then removed, the incisions are closed
with sutures, and bandages are applied. Depending