Procedure: Laparoscopy

Description and Purpose

A laparoscopy , also referred to as a peritoneoscopy , celioscopy , and pelvic endoscopy , is a procedure where a laparoscope , a narrow tube with a fiber-optic light on the end, is introduced through the abdominal wall in order to allow the doctor a direct view of the pelvic organs. The reasons for this intervention include:

• To determine the cause of chronic pelvic pain.
• To identify tumours, ovarian cysts , uterine fibroid tumours , and endometrial growths (e.g. ectopic pregnancy ), and possibly to drain or remove them.
• To determine the cause of fertility problems .
• To perform a tubal ligation, i.e. cutting and tying off the fallopian tubes , for purposes of sterilisation.

Preparation and Procedure

Laparoscopy involves a general anaesthesia, and thus requires fasting for at least 8 hours before the procedure.
Once the anaesthesia takes effect, the doctor makes a 2.5 cm (1 inch) incision just below the navel. A gas insufflator is used to fill the abdominal cavity with carbon dioxide or nitrous oxide, the purpose of which is to elevate the abdominal wall and allow a better view of the pelvic organs.
The laparoscope is then introduced into the cavity through the incision. The physician looks at the reproductive organs , notes any abnormalities, and takes biopsy (cf. cervical biopsy / endometrial biopsy ) specimens if necessary. Sometimes this procedure allows complete removal, if detected, of an ectopic pregnancy.
When the procedure is over, the gas is allowed to escape, and the incision is closed with a few stitches and dressed. Any tissue specimens will be sent to the laboratory for analysis.

A variation of a laparoscopy is a hysteroscopy , where a hysteroscope (an endoscopic instrument similar to a laparoscope) is inserted through the vagina and cervix into the uterine cavity in order to examine the endometrium . A small electrified loop can be used to take biopsy samples of the endometrium for laboratory analysis. Hysteroscopy with directed biopsy is particularly helpful in the diagnosis of small polyps within the uterine cavity.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. The Yale University School of Medicine Patient's Guide to Medical Tests, Barry L. Zaret M.D., Senior Editor, published by Houghton Mifflin. Online: common_procedures/doppler_ultrasound.html