What Is A Laparoscopy?

Laparoscopy is a process used to diagnose and treat certain pathologies at the pelvic, colorectal and gynecological level. Find out how it works and what are its benefits.

Laparoscopy is an extremely minimally invasive alternative to the conventional open abdomen operation, laparotomy. During this intervention – less spectacular from a physiological and medical point of view –  a small camera (laparoscope) is used to see into the patient’s abdomen.

Its prevalence has increased significantly in recent years as it now occupies 29% of all colorectal processes instead of 5% a few years ago. This is a popular method because it is minimally invasive and has a high success rate; gynecologic laparoscopy produces gastric damage in 1 in 33,000 cases.

Calculating the exact uses of this process worldwide is almost impossible. Nonetheless, an estimated 5,000 people go through it to tackle obesity each year. Based on these figures, it should be noted that  laparoscopy is on the rise in the surgical world thanks to its multiple benefits. Read on to find out more about it.

What is a laparoscopy?

Laparoscopy is a type of abdominal operation in which the professional is able to access the interior of the abdomen without having to make very large incisions in the skin. As a publication in the National Health Service (NHS) indicates,  laparoscopy provides many benefits when compared to a traditional laparotomy. Among others, we find the following:

• The patient spends less time in the hospital and recovers faster.
• The bleeding is weaker, as is the pain after the operation.
• The marks and scars are much smaller than during a traditional operation.

Either way, just because it’s a minimally invasive operation doesn’t mean it’s risk free. Each patient should take into account that the process provides access to vital organs that may be affected. Therefore, there is always the possibility that something will go wrong. We will deal with this point a little later.

Who needs it?

Through its web page, the American Cancer Society details who are the candidates for a laparoscopy. We are now going to tell you about the clinical cases for which it is useful.

1. The patient could have cancer

Laparoscopy can be used to remove or biopsy (obtain tissue samples) of lymph nodes in the pelvis and abdomen. This is why it is recommended for patients with cancers of the gynecological type,  such as cancer of the cervix, cancer of the ovaries and cancer of the endometrium.

2. There is an intestinal obstruction

A bowel obstruction or obstruction occurs when the contents of the intestine cannot pass or leave the patient’s body. When the obstruction is complete, the individual is in a medical emergency requiring immediate surgery.

Depending on the severity of the situation, a laparoscopy or laparotomy may be used. Regardless,  sometimes it is necessary to make larger incisions  to remove what is blocking and remove or repair areas of the intestine that have been damaged.

3. Diseases specific to women

There are many pathologies that can be resolved through laparoscopy in women because they are more prone to diseases in the pelvic area. This surgical process can be used to treat fibroids, ovarian cysts, endometriosis, pelvic prolapse, among other female-related conditions.

4. Other processes

The United States National Library of Medicine details some ancillary processes that can be addressed with laparoscopy. Among them, we find:

• Remove an ectopic pregnancy:  this is a pregnancy that develops outside the uterus. For a pregnant woman, it can be fatal, and it is therefore necessary to address this problem with an operation, as soon as possible.
• Hysterectomy:  the uterus is removed. It can be useful for certain cancers, deformities, excessive bleeding, and other clinical settings.
• Tubal ligation:  a process to prevent pregnancy by blocking the fallopian tubes.
• Treatment of urinary incontinence.

What happens during a laparoscopy?

The total process usually lasts between 30 and 45 minutes under general anesthesia; it is therefore perfectly viable to perform it in a day hospital in many cases. We will describe all of its steps in detail.

Before laparoscopy

If the person is going to be undergoing general anesthesia (as is usually the case), they may not be able to eat food and drink 6 hours before the operation. In addition to this,  it is necessary, in the majority of cases, to be accompanied  due to the effects of anesthesia after the operation.

During laparoscopy

It begins by taking into account the following key points:

1. It is necessary to place the patient in a lithotomy position  (with the legs elevated and the body extended). His buttocks should be placed at the edge of the table, in order to allow good management of the uterine mobilizer.
2. The patient should be channeled (placed a line) through the right arm.
3. It is recommended to perform a bladder emptying,  either by urination or through a catheter, when it is considered necessary.

After that, a Veress-Palmer needle must be inserted into the patient, which is essential for inflating their abdominal cavity with CO2 gas (known as pneumoperitoneum). About 35-40% of complications in endoscopic operations appear at this level, so special care should be taken. This needle is generally introduced through the umbilical route.

Peritoneal insufflation allows surgeons to be able to act properly in the abdomen of patients without damaging their vital organs. Once made and after making relevant incisions,  professionals use the laparoscope to observe the abdominal cavity  and make the necessary diagnosis.

If another type of surgical procedure is required, additional incisions may be required for the introduction of instruments. Regardless, these injuries usually do not exceed 0.5-1 centimeters in length.

After laparoscopy

Once the procedure is finished, the patient needs a rigorous follow-up for the hours which follow to verify that all is well. Also, he will not be allowed to eat or drink while the sedation is working.

If you have had this operation as an outpatient,  you will be able to go home a few hours later, in most cases. However, it will still be necessary, after a laparoscopy, to make new medical appointments with the relevant professionals in order to discuss and discuss the results obtained.

Possible risks of laparoscopy

This method involves a series of delicate organs: it is therefore not without risks. Diagnostic laparoscopy has a risk of intestinal injury of 0.08%. For medium and more complex transactions, this rate rises to 0.33%. The following things can happen:

• Infection of the surgical incision or internal organs. In the worst cases, this can lead to bacteremia and sepsis, which endanger the patient’s life.
• Bleeding from the surgical incision or internal organs.
• Poor healing of the incision. The abdominal tissue is quite delicate.
• Allergy to drugs used during the operation (sedatives and anesthetics).
• Anaphylactic shock  (exceptional, it hardly ever occurs).

What should be remembered about laparoscopy?

Laparoscopy is a great alternative to laparotomy because the incisions made during this process are much smaller, the patient recovers faster, and the chances of something going wrong are very low.

However, not  all patients are suitable for laparoscopy. Those who have a tumor that has spread to the abdominal cavity, bleeding problems, chronic tuberculosis, and other conditions cannot undergo it. In these cases, it is necessary to resort to other operations.