Download Leaflet for Having a Laparoscopy

Dr Nikki Kroon
MRCOG, Dip Gum, DFFP,
Dip Advance Obstetric Ultrasound
Consultant Obstetrician & Gynaecologist
Having a Laparoscopy
Dr Kroon has recommended that you have a laparoscopy. This leaflet provides some general
information and advice about the procedure, but your own case may be more complex and the
differences will be discussed with you before the operation.
If you have an unanswered questions or concerns, please do not hesitate to ask Dr Kroon or a nurse for
more information. It is natural to feel anxious, but often knowing what to expect can help.
What is a Laparoscopy?
A laparoscopy is an examination of the organs within the pelvis or abdomen using a flexible, tube-like
telescope called a laparoscope. It is called a ‘key-hole’ procedure because it involves only small
incisions (cuts).
Laparoscopy is used to help find out what is causing the gynaecological symptoms that you are
experiencing. It is normally carried out as a day case, requiring no overnight stay in hospital.
Sometimes no cause is found for the symptoms you describe. If this is the case, your Consultant will
discuss how to proceed with this information.
Sometimes additional procedures are performed at the time of the operation, eg treatment of
endometriosis or adhesions, and sometimes we place dye into the womb to check if your tubes are
open. This will be discussed with you before the operation.
A laparoscopy is performed under a general anaesthetic. This means you will be asleep and will feel no
pain throughout the procedure.
Preparing for you Operation
Before you come into hospital for your laparoscopy, you will need to:
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Have a bath or shower on the day of your admission.
Remove any rings, make-up or nail varnish and bulky or sharp jewellery. Rings and earrings that
you would prefer not to remove can usually be covered with adhesive tape.
Follow the fasting instructions given in your admission confirmation letter by your Consultant’s
secretary.
All women of childbearing age will have Chlamydia screening before the procedure or
treatment with antibiotics following the procedure.
Mount Carmel Hospital
Braemor Park, Churchtown
Dublin 14
St Vincent’s Private Hospital
Herbert Avenue, Merrion
Dublin 4
Suite 16, Blackrock Clinic
Rock Road, Blackrock
Co. Dublin
Dr Nikki Kroon
MRCOG, Dip Gum, DFFP,
Dip Advance Obstetric Ultrasound
Consultant Obstetrician & Gynaecologist
When you arrive at the hospital, a nurse will explain how you will be cared for during your stay and will
perform some simple tests such as checking your pulse and blood pressure. Dr Kroon and your
anaesthetist will also talk to you. This is a good time to ask any outstanding questions about your
treatment. Your nurse will help you prepare for theatre.
Consent
Dr Kroon will sign a consent form with you. By doing this, you confirm that you understand what the
procedure involves, including the benefits and risks and give your permission for it to go ahead.
Risks
Dr Kroon will try to address serious and common less serious complications of a laparoscopy at the time
of your clinic visit, and again prior to the operation.
Though this leaflet attempts to offer general information, there are times when the risks quoted below
may be slightly higher. This may be because you have previously had operations on your tummy, or we
may have planned to remove a cyst or ovary, or you are overweight or you are very thin.
Serious risks include:
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The overall risk of serious complications from diagnostic laparoscopy, approximately two
women in every 1,000 (uncommon)
Damage to bowel, bladder, uterus or major blood vessels which would require immediate repair
by laparoscopy or laparotomy (uncommon). However, up to 15% of bowel injuries might not be
diagnosed at the time of laparoscopy.
Failure to gain entry to abdominal cavity and to complete intended procedure.
Hernia at site of entry.
Death; three to eight women in every 100,000 undergoing laparoscopy die as a result of
complications (very rare).
Frequent risks include:
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Bruising
Shoulder-tip pain
Wound gaping
Wound infection
Mount Carmel Hospital
Braemor Park, Churchtown
Dublin 14
St Vincent’s Private Hospital
Herbert Avenue, Merrion
Dublin 4
Suite 16, Blackrock Clinic
Rock Road, Blackrock
Co. Dublin
Dr Nikki Kroon
MRCOG, Dip Gum, DFFP,
Dip Advance Obstetric Ultrasound
Consultant Obstetrician & Gynaecologist
About the Operation
Two small incisions are made in the skin; these cuts are between 0.5 and 1.5 cm in size. The first is
made just below the navel, where a hollow needle is used to inflate the abdomen slightly with carbon
dioxide gas. This creates more room for your surgeon to work and allows a clearer view of the internal
organs.
The second incision is made where the laparoscope is to be inserted (this depends on which organs are
being investigated). Dr Kroon will then view and probe the area, looking directly through the ‘scope or
at pictures it sends to a video monitor.
If any treatment is performed, additional small cuts are made in order to insert the necessary
instruments.
At the end of the operation, the instruments are removed, the carbon dioxide gas is allowed to escape
through the laparoscope and the cuts are closed with two or three stitches.
After you Operation
You will be taken from the operating theatre to a recovery room where you will come round from the
anaesthetic under close supervision. After this, you will return to the day care unit, where a nurse will
make you comfortable. He or she will assess the operation sites and monitor your blood pressure and
pulse at regular intervals.
Recovery
You will need to rest on your bed until the effects of the anaesthetic have passed. If you are sore, you
may require painkillers, which can usually be taken every four to six hours
When you feel ready, you can begin to drink and eat, starting with clear fluids such as water and go out
to pass water.
Going Home
If you operation has been planned as a day case, you will be able to go home once you have made a full
recovery from the anaesthetic and you feel that the pain is manageable. However, you will need to
arrange for someone to drive you home and then stay with you for the first 24 hours. Before you are
discharged, the nurse will advise you about caring for your wound. The nurse will also give you a
contact telephone number for the hospital, in case you need to ask for any further advice, and will make
arrangements for you to have any stitches removed. If you have not had Chlamydia screening you will
be prescribed with antibiotics to be taken on the day of your operation.
Mount Carmel Hospital
Braemor Park, Churchtown
Dublin 14
St Vincent’s Private Hospital
Herbert Avenue, Merrion
Dublin 4
Suite 16, Blackrock Clinic
Rock Road, Blackrock
Co. Dublin
Dr Nikki Kroon
MRCOG, Dip Gum, DFFP,
Dip Advance Obstetric Ultrasound
Consultant Obstetrician & Gynaecologist
After you return home
If you need them, continue taking painkillers as advised by the hospital. A general anaesthetic can
temporarily affect your co-ordination and reasoning skills, so you should avoid driving, drinking alcohol,
using power tools, making any vital decisions for 24 hours afterwards.
Take things gently for a day or two after returning home.
You should follow your surgeon’s advice about heavy lifting or strenuous exercise.
You may shower or bath the next day and change the plasters after bathing. The stitches will either
dissolve or be removed at a follow-up appointment.
Following a gynaecological operation performed laprascopically, it is quite normal to have a small
amount of vaginal bleeding.
At your follow-up appointment, which will be scheduled after the procedure, your surgeon will advise
you when you can resume your other normal activities.
Audit
Dr Kroon records all the operations that she performs and has logged her cases since 1996. In addition
to the operation, she records the complications that her patients have experienced. This is a form of
monitoring her performance. If you have any questions regarding this, please ask her when you meet
her in the clinic. In addition to this she may wish to record the surgery of your case for teaching
purposes if this is acceptable to you. If you are in agreement that the videos may be used for teaching
purposes, she will ask you to sign an additional consent form in relation to this.
Reference
RCOG Guidance on consent for Laparoscopy (Consent no 2, produced December 2008)
Mount Carmel Hospital
Braemor Park, Churchtown
Dublin 14
St Vincent’s Private Hospital
Herbert Avenue, Merrion
Dublin 4
Suite 16, Blackrock Clinic
Rock Road, Blackrock
Co. Dublin