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Operative Laparoscopy

Operative laparoscopy is a procedure used to help diagnose and treat a woman's pelvic condition. By using a specialized camera called a laparoscope, your doctor can view the inside of your abdomen on a video screen. This will allow him or her to see abnormalities more clearly, and determine if treatment is required. If treatment is required, or if an operative laparoscopy was already planned, your doctor can then perform that part of the procedure.

Operative Laparoscopy: An Introduction

Your doctor may have recommended a procedure called diagnostic laparoscopy or operative laparoscopy to help diagnose, and possibly treat, your condition. A diagnostic laparoscopy can turn into an operative laparoscopy if the doctor finds an abnormal condition during the procedure that can be also be treated.
It is impossible to list all of the possible conditions that could require exploration and possible treatment with a laparoscopy. However, common gynecological problems evaluated during laparoscopy include:
  • Endometriosis
  • Pelvic adhesions
  • Ectopic pregnancy
  • Pelvic or ovarian masses, such as ovarian cysts 
  • Fibroids
  • Infertility and sterilization.

Operative Laparoscopy: The Procedure Itself

After your anesthesia takes effect, your abdomen and vagina will be washed with a special disinfectant solution. Your feet will then be placed in stirrups. A catheter, or small tube, will be placed in your bladder to empty it of urine. The catheter will be taken out before the procedure begins.
Your doctor will begin by placing a speculum into your vagina. A small instrument will then carefully be placed into the end of your cervix. This makes it possible for your doctor to gently move the uterus into different positions, so that your pelvic structures can be seen more clearly through the laparoscope.
Then a small incision, or cut, will be made in or just below your navel. A tube, called a trocar, will then be inserted into your abdomen. Through this, your doctor will fill your abdomen with carbon dioxide gas, which is like the air you breathe out. This gas helps your doctor see your pelvic structures more clearly. The laparoscope will then be inserted. Through this, your doctor will view the inside of your abdomen on a video screen. The laparoscope can also take pictures and videotape the procedure.
Your doctor will be looking for anything that appears abnormal. If your doctor finds something abnormal during the examination, or if an operative laparoscopy was already planned, the main part of the procedure will then begin. Occasionally, two or three small incisions may need to be made just below the navel for other instruments.
The specifics of this portion of the procedure will depend on your particular pelvic problem, its location, and size.
Once the operative laparoscopy is complete, the air and instruments are removed. The incisions are then stitched closed and covered with bandages. Over time, these stitches will be absorbed by your body.
Last reviewed by: Arthur Schoenstadt, MD
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