Gynaecology

Laparoscopy

What is it?

Laparoscopy is a procedure that enables the doctor to look at the pelvic organs through a small fibre optic telescope inserted just below the umbilicus (tummy button).

Why is it carried out?

Laparoscopy is used mainly in three situations: First of all to assist in the diagnosis of someone who has pelvic pain whether it is of acute or chronic nature, secondly in order to check the potency of the fallopian tubes for patients experiencing difficulty in conceiving. Finally, laparoscopy is used to sterilise a woman by clipping the tubes.

About the operation

The operation is carried out under general anaesthetic and takes about 20 minutes. In order to insert a fibre optic telescope, a small cut about a centimetre long is made in the lower edge of the umbilicus. Some carbon dioxide gas is placed in the cavity of the abdomen through a small needle in order to produce an air bubble into which the telescope can safely be inserted. This gas is released after the operation. At the same time it is necessary to insert a small instrument through the vagina into the uterus via the cervix (neck of the womb). This is necessary in order to make sure that the uterus (womb) is tilted forwards during the procedure so that the ovaries and tubes can be seen behind it. As well as inserting the instrument to move the uterus forwards, it is also necessary to make sure the bladder is empty so you will be catheterised under the anaesthetic.

If the indication for laparoscopy is because of pain this is all that will be performed after the surgeon has had a careful look at the ovaries and uterus. If it is being carried out because of infertility, then a blue solution is inserted into the neck of the womb through the vagina and instilled in the uterus, after which, if the fallopian tubes are open, the solution will pass up the tubes and out into the abdomen.

Finally if the laparoscopy is for sterilisation, a second small incision about half a centimetre long is placed in the hair line just above the pubic bone and another instrument is inserted through this which carries some clips which are used to block the tubes on both sides near the uterus. One or two clips are used on both tubes close together. This prevents the sperm traveling along the tubes and fertilizing the egg.

 

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