Laparoscopy: What You Should Know

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Laparoscopy (lap-er-OSS-co-pee) is an operation that lets your doctor look inside your abdomen through a small incision in your bellybutton. Your doctor will look through an instrument called a laparoscope. It is a long metal tube connected to a video camera, magnifying glass and a light. The laparoscope is put into a small (1-2 inch) incision in or below your bellybutton. A type of air called carbon dioxide is used to help the surgeon see inside. You may have three additional small incisions on your belly depending on the procedure. These are less than 1/2 inch in size. They are used to place instruments in the belly so that the surgeon can perform your surgery. You will have stitches at the incision sites. These stitches will dissolve on their own. It may take 3-4 weeks for them to dissolve.

The laparoscopy may be done to find out what is causing your problem, or it may be done to treat your problem. Abdominal pain, a growth in the abdomen, or removal of the ovaries are reasons for a laparoscopy. Other small surgeries may be done using a laparoscope.

Admitting Area

On the day of your surgery, please go to the Day Surgery Department at Brigham and Women's Hospital (75 Francis Street). Take the elevators to L1 and follow the signs for day surgery. You should arrive two hours in advance of your scheduled surgery. Upon arrival, check in with the receptionist. He or she will direct you to the pre-operative waiting area. You will remain in this waiting area until called for your surgery. Once you have been called for surgery, your family and friends will be directed to the family waiting area. This area provides a comfortable central location for family members to wait while surgery is underway.

Operating Rooms

You will be taken to an area where you will change into a hospital gown and helped onto a stretcher. Next, you will meet the anesthesia team. An intravenous needle will be placed in a vein. This will be used to administer medication to relieve anxiety and make you drowsy. You will then be moved into the operating room. The operating room is staffed with physicians, nurses and technicians. All will be involved with your care during surgery. After your surgery, you will be moved to the Post Anesthesia Care Unit (PACU or Recovery Room).

Post-Anesthesia Care Unit

After surgery, you will be monitored closely. You will wake up in the recovery room where nurses will be checking your blood pressure and pulse frequently. Although you will feel like sleeping, occasionally you will be asked to cough and take deep breaths to keep your lungs clear. You may be receiving oxygen by facemask. If you feel cool, the nurse will give you extra blankets.

The nurses want to make you as comfortable as possible, so let them know how you are feeling. You will still have an intravenous (IV) tube in your arm or hand. If it feels uncomfortable, please tell your nurse. It will be removed before leaving the hospital. If you wish to know about any equipment or procedures, the staff will be happy to explain it to you. Once you have sufficiently recovered from surgery, you will be discharged.

Recovery After Surgery

After surgery, you may feel weak and tired from the anesthesia you received during the procedure. It may take a couple of days for the tired feeling to go away. You should continue to take deep breaths and cough every 3-4 hours while awake for the first 24 hours after surgery. Deep breathing opens the tubes going to your lungs and helps to clear the lungs of sputum (spit).

Pain Medicine

  • You may experience neck or shoulder pain following the procedure. This is because of the carbon dioxide/air you got during surgery. This gas helps to inflate the abdomen, making it easier to see in the abdomen. Resting and using heat on your shoulder may help this pain. This pain is normal; it will go away within several days.
  • You may have abdomen (belly) cramps or feel bloated. This is normal, and should be gone in 1-3 days.
  • You may have vaginal bleeding for up to a week after the surgery; this is also normal.
  • You will be given a prescription for pain medicine. Call your caregiver if the medicine is not relieving your pain. The pain medicine may cause you to become constipated or hard for you to have a bowel movement. Drinking plenty of fluids and increase fiber in your diet can help with constipation. Examples of foods high in fiber are high fiber cereals, beans, vegetables, and whole grain breads. Prune juice is also very helpful. And you may also take a tablespoon or two of milk of magnesia. You may take a stool softener called Colace to help soften the stool.

Restrictions

  • You may resume sexual activity according to your doctor's instructions. Make sure and ask about this because it varies depending on the procedure. It usually is about 1 to 2 weeks, but may vary.
  • You may drive unless taking medication that makes you drowsy.
  • You may return to work as soon as you feel up to it, usually within 2 to 3 days, or even less, depending on how you feel.
  • You may resume normal activities in 2 to 3 days, depending on how you feel.
  • Avoid any heavy lifting (medium size grocery bag) or aerobic type exercises for 7 to 14 days.

Reasons to Call Us

  • Temperature over 100.5 F;
  • Yellow/green foul smelling vaginal discharge;
  • Persistent/severe abdominal or vaginal pain;
  • Your stitches come apart; or
  • Vaginal bleeding or clotting more than a pad an hour.

Telephone Numbers to Call During Office Hours (9:00 a.m.-4:30 p.m.)

Dana-Farber: 617-632-3669
Brigham and Women's: 617-732-8844

If it is after 4:30 p.m. or a weekend, please call the page operator at 617-732-6660 and have the gynecologic oncology fellow on call paged.

Follow-Up

The final pathology report is usually sent out in 5-7 business days. To inquire about results, please call 617-732-8844.

Call 617-632-3669 a few days after the procedure to schedule a post-operative appointment.