Laparoscopy is a form of minimally invasive surgery. The surgeon inserts a tiny telescope (laparoscope) though a small incision at the umbilicus (belly-button).
The laparoscope allows the surgeon to visualize the pelvic organs on a video monitor. Several additional smaller incisions are made in the abdomen for the surgeon to place specially designed surgical instruments, which help the surgeon carry out the same procedure as in open surgery.
How is Laparoscopy performed
After the general anesthesia is given, a small incision is usually made below or inside the umbilicus (belly-button). Carbon dioxide gas is then put into the abdomen by inserting a special needle through the umbilicus. The gas allows the pelvic organs to be seen more clearly. After an adequate volume of gas is insufflated into the abdominal cavity, the surgeon removes the needle and inserts a trocar. A trocar is a specially designed tube, 5 or 10 mm in diameter, with a valve through which a surgeon can insert special instruments.
The patient’s body will be tilted slightly with the feet raised higher than the head. This shifts some of the abdominal organs into the upper abdomen and out of the way. The laparoscope is placed through the trocar sleeve in the umbilicus. Additional incisions are made just at the pubic hairline and in the left and right lower abdomen. Using special surgical instruments the procedure is completed through these small incisions.
A device called a uterine manipulator may be placed in the uterus through the vagina to move the uterus during the procedure. Following the procedure the instruments are removed and the gas is released. The incisions are then closed with steri-strips or with stitches that dissolve.
What is open surgery (laparotomy)
Open surgery involves making a large incision in the abdomen to expose the pelvic organs. The same procedure is carried out through this incision as would be carried out laparoscopically. As a result of this large incision post operative recovery is slower and patients often need to stay in the hospital for up to five days.
After open surgery patients may require up to six weeks of convalescence before they feel able to return to normal activities. There is also a higher risk of infection because of the greater exposure of the body tissues to the outside.