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Gynecologic Specialty Surgery

Laparoscopy

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Laparoscopy is a low-risk, minimally invasive surgery used to examine organs inside the abdomen. Diagnostic laparoscopy is typically used to diagnose pelvic or abdominal pain that noninvasive procedures cannot explain.

Types of laparoscopic surgeries include robotic-assisted laparoscopy and traditional laparoscopy. At NewYork-Presbyterian, our expert team of gynecologic surgeons provides comprehensive care for individuals receiving any kind of laparoscopic surgery.

What is Laparoscopy?

What is Laparoscopy?

Laparoscopy is a minimally invasive surgery that allows doctors to examine organs inside the abdomen. Through very small incisions near the belly button, the surgeon inserts a laparoscope, a thin instrument that sends images to a video monitor. 

With diagnostic laparoscopy, the surgeon looks for abnormalities or signs of disease and can remove a small piece of tissue, called a biopsy, for testing. Compared with traditional open surgery, the incisions are much smaller. This results in less pain after surgery and allows for faster recovery and minimal scarring.

With laparoscopy, a surgeon can examine these and other organs:

  • Uterus
  • Ovaries
  • Fallopian tubes
  • Spleen
  • Gallbladder
  • Liver
  • Pancreas

In addition to helping with diagnosis, laparoscopy can be used to carry out surgery, such as a hysterectomy (removal of the uterus). The surgeon will make additional small incisions in order to insert miniaturized tools needed to do the surgery. 

In traditional laparoscopic surgery, surgeons move the tools with their hands. In robotic laparoscopy, the surgeon operates the tools from a computer console that moves a robot. Robotic laparoscopy provides magnified 3D imaging and allows for more precise control of the surgical instruments.

Laparoscopy is usually done in the hospital; most people can go home within several hours after the surgery. Your care team will advise you on how to prepare for the procedure. 

During the procedure, you will lie on your back. You will be given general anesthesia, unconscious, and won't feel pain. After the surgery, you will be taken to the recovery area. You should plan to have someone with you to help you get home safely after your procedure.

Why May You Need a Laparoscopy?

Purpose

To diagnose gynecological problems, a doctor first tries noninvasive methods. These may include a physical exam and imaging tests such as X-rays and ultrasound. If these do not provide answers, laparoscopy may be the next step.

A patient may need diagnostic laparoscopy if they have these symptoms:

  • Unexplained abdominal or pelvic pain 
  • Heavier than normal menstrual periods
  • Trouble becoming pregnant
  • A lump or mass in the abdomen

Many gynecologic conditions can be diagnosed or treated using laparoscopy, including:

  • Fibroids - Noncancerous growths inside the uterus that cause pain and heavy menstrual periods for some 
  • Ovarian cysts - Fluid-filled sacs that develop in the ovary 
  • Endometriosis - When tissue similar to the lining of the uterus grows outside the uterus
  • Pelvic prolapse - When the uterus and other organs press into the vagina because of weakened muscles 
  • Conditions that cause infertility - Such as blocked fallopian tubes
  • Ectopic pregnancy - When a fertilized egg begins growing outside the uterus
  • Cancer – Cancer in the uterus, ovaries, or fallopian tubes
  • Incontinence - Leaking of urine

Laparoscopy for endometriosis

Endometriosis is when the type of tissue that normally lines the uterus starts to grow outside of it, often on the ovaries or fallopian tubes. This can be painful and make it harder for individuals to become pregnant. Imaging tests such as ultrasound and MRI do not provide a clear enough picture to detect endometriosis in most cases. Laparoscopy is the only procedure that can definitively diagnose this condition. 

A patient with endometriosis might benefit from laparoscopic surgery if medications do not relieve symptoms, or to help make a definitive diagnosis. Our expert gynecologic surgeons offer these types of laparoscopic surgeries for endometriosis:

  • Diagnostic laparoscopy with biopsies
  • Laparoscopic or robotic surgery to excise endometriosis
  • Laparoscopic or robotic removal of ovarian endometriomas (endometriosis cysts)
  • Laparoscopic or robotic hysterectomy (removal of the uterus)

Laparoscopy Risks

Risks

Laparoscopy is generally a very safe procedure. Mild abdominal pain after the surgery is common. After laparoscopy, there is also a small risk of:

  • Bleeding around the incisions
  • Infection
  • Damage to an organ or blood vessel that causes bleeding

Common side effects in the first days after laparoscopic surgery include:

  • Fatigue
  • Tenderness around incisions
  • Shoulder pain

Laparoscopy Recovery

Recovery

The laparoscopy recovery time is typically one to two weeks. This varies depending on your health before the surgery and what procedure you had. You will likely feel tired during the first few days after surgery, and your abdomen may feel sore. Rest, drink fluids, and wear loose clothing to stay comfortable. Many feel well enough to return to work or school after three days, but it often takes longer. Each person heals differently.

Do's and don'ts after laparoscopy

You can help set the stage for a quick recovery during the first three days after laparoscopic surgery:

  • In the first 24 hours, DO eat light foods like clear soup and crackers to prevent nausea; DON'T drive a car or drink alcohol.
  • After 48 hours, DO move about as much as is comfortable, DO remove bandages (but not steri-strips), take a shower, and keep incisions clean and dry; DON'T drive if you are taking narcotic pain medication.
  • After 72 hours, DO go for a walk if you can; DON'T forget to schedule a follow-up appointment with your doctor

More to explore

Laparoscopy FAQ

FAQ

Your healthcare team will provide recovery instructions specific to you and your individual surgery. Here are some common questions about laparoscopy and recovery.

During the surgery, a tube was inserted in your throat by the anesthesiologist to help you breathe. This can make your throat sore for a day or two afterward. Gargling with warm salt water can help.

During the surgery, carbon dioxide gas was pumped into your belly to puff up the abdominal wall and give the surgeon a clear view of your organs. Doctors remove the gas, but a small amount sometimes remains and causes shoulder pain for a few days. A heating pad and acetaminophen can help.

Walking is a good exercise in the first one to two weeks after laparoscopic surgery. But the timetable for returning to more vigorous exercise is different for everybody. It can range from five days to 12 weeks, depending on the specific surgery you had, your general health before surgery, and whether you have any complications.

Follow your doctor's advice about returning to exercise and build up slowly.

A small amount of abdominal swelling and puffiness around incisions is normal. It may last for six to eight weeks. In the first few days after surgery, applying an ice pack may help.

Call your doctor if your belly feels distended, hard, or tender or if you have nausea or vomiting.

The dressings left after your laparoscopy are to be removed after two days. Your incisions will still be covered by steri-strips or closed by surgical glue. These will fall off after a few days. Be sure to keep the incision areas clean and dry.

Laparoscopy incisions are about a half-inch long and appear red after surgery. The scars they leave will fade over time.

Most people can resume driving one to two weeks after surgery. Don't drive while taking narcotic pain medication.

Anesthesia and narcotic pain medication can lead to constipation. Walk as much as is comfortable, drink plenty of water, and slowly add high-fiber foods to your diet. Check with your doctor for advice on taking an over-the-counter medication for constipation.

If you have any of the following symptoms, call your doctor:

  • Fever higher than 100° F for more than 24 hours
  • Severe pain not relieved by pain medication
  • Heavy bleeding from your vagina
  • Redness, bleeding, or pus at incisions 
  • Vomiting more than 24 hours after surgery
  • Shortness of breath
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Experts in Laparoscopy at NewYork-Presbyterian

At NewYork-Presbyterian we provide gynecologic surgical care that is individualized, comprehensive, and compassionate. We view each patient as a whole person with emotional, ethical, spiritual, and physical needs. 

Our expert gynecologic surgeons are renowned for their skills in laparoscopy and robotic-assisted laparoscopic surgery. They have experience in treating the most complex and challenging gynecologic conditions. 

After laparoscopic surgery, we continue to collaborate with medical subspecialists from various disciplines to provide the absolute best health care. This ensures we treat all aspects of an individual's health and well-being affected by the gynecologic condition.