The information provided by Advanced Healthcare for Women and E. Daniel Biggerstaff, III, M.D. is for informational purposes only. As each woman is unique, do not rely on this information for diagnosis and treatment. We cannot guarantee the accuracy of the content and advise that you see a qualified Health Care Professional for individual needs and care.

Video laparoscopy is commonly referred to as laser surgery. Although a laser is sometimes used during laparoscopy, other instruments may be preferred. What makes the surgery unique is not the use of the laser but the fact that the surgery is performed with small incisions, allowing for much quicker recovery. The surgery is usually performed under general anesthesia (patient is asleep) using a laparoscope. The laparoscope, a surgical instrument similar to a skinny telescope, is inserted through a small incision in the bellybutton. A small video camera is attached to the laparoscope, and the surgery is performed while looking at a video monitor. The abdomen is distended with a gas called carbon dioxide; this lifts the abdominal wall and gives your physician better visualization of internal organs. Small second, third and fourth incisions are often made at the pubic hairline to introduce scissors, coagulators, lasers, or other instruments to perform major surgery at laparoscopy. Additional small incisions in the lower abdominal wall may be necessary, especially when suturing through the laparoscope.

The main advantages of laparoscopy over the traditional large abdominal incision are:

• much less post operative pain
• quicker recovery time, and
• better visualization at the time of surgery. In many instances, but not all, your physician can get closer to where he or she is working and do more precise surgery than when working through a big incision.

Recovery time depends on the procedures that were performed. Some patients are able to return to work within several days after surgery, and others may require several weeks. Shoulder pain from the carbon dioxide gas is common. This gas is absorbed by your body over a 2-3 day period. Your throat may be sore from the endotracheal tube used with general anesthesia, and this usually resolves in a day or two.

Common procedures performed by gynecologists at laparoscopy include:

• tubal ligation
• diagnosis of pelvic pain
• appendectomy
• treatment of endometriosis
• removal of ovarian cysts
• removal of tubes and ovaries
• treatment of ectopic or tubal pregnancies
• hysterectomy.

A few physicians perform more advanced procedures such as:

1. removal of severe adhesions and scar tissue involving the intestine
2. removal of extensive endometriosis
3. Burch procedure to tack up the bladder
4. suspension of the vagina when severe prolapse is present
5. removal of fibroid tumors
6. tubal reanastamosis (rejoining the tubes after a tubal ligation)
7. hysterectomy involving removal of very large fibroids
8. presacral neurectomy for treatment of severe midline menstrual pain

Occasionally procedures cannot be performed laparoscopically, even by those physicians who perform the more advanced procedures. If this is the case, a larger abdominal incision needs to be made to complete the surgery. It is appropriate to ask your physician how often he or she has to make a large incision. If you are having surgery and a large incision is planned, ask if there are any physicians in your area who are able to perform the surgery laparoscopically.