- ATHENS OFFICE MED4WOMAN ATHENS
- VOLOS OFFICE MED4WOMAN VOLOS
Obstetrician-Gynecologist
PhD, University of Athens Medical School
Obstetrician-gynecologist Panagiotis Polyzos practices at the Institute of Life and the IVF Unit of IASO Maternity Hospital.
Laparoscopy is the examination of the abdominal and pelvic organs using a special endoscope (laparoscope) that is inserted into the abdomen through a small incision just below the navel. The laparoscope is equipped with a light source to illuminate the inside of the abdominal cavity. This procedure is usually performed under general anesthesia.
The optical lenses of the laparoscope are connected to a video camera, allowing the surgeon to view the findings on a monitor. There is also the possibility of taking photographs or recording the entire procedure on video or DVD.
Many surgical procedures can be performed laparoscopically, thus avoiding the need for opening the abdomen (a procedure known as laparotomy). Laparoscopy is carried out by surgeons who have undergone appropriate training and possess the necessary skills for this type of operation. Two or three additional small incisions in the abdomen may be required for the insertion of surgical instruments needed to perform the procedure.
Gynecological procedures that can be performed laparoscopically:
After most procedures you go home the same or the next day. In the first 24 to 48 hours shoulder pain is common. It is caused by the gas used to inflate the abdomen and resolves on its own. The small incisions heal within a few days.
Compared with open surgery, laparoscopy means smaller incisions, less postoperative pain, less blood loss, fewer adhesions and faster recovery. Image magnification allows more precise handling, especially with 3D technology in laparoscopy.
Serious complications are rare. They include bleeding, infection, injury to the bowel, bladder or blood vessels and, rarely, the need to convert to open surgery. Contact your doctor if after surgery you develop fever, severe pain that gets worse, vomiting, or redness and discharge at the incisions.
Laparoscopy falls into two broad categories, and the distinction matters in practice for the length of the procedure, the anesthesia and the recovery.
It is done when imaging tests, such as ultrasound or MRI, do not give a clear answer. The surgeon inspects the uterus, fallopian tubes, ovaries and the pelvic peritoneum, checks whether the tubes are open using dye and, if needed, takes biopsies. One or two small incisions are often enough.
Here the goal is to treat the problem in the same session: removal of a cyst, fibroid or endometriosis lesions, releasing adhesions, tubal surgery or removal of the uterus. In practice, many procedures start as diagnostic and continue as therapeutic, provided you have given consent in advance for the possible findings. That is why the discussion before surgery should also cover the question “what happens if something different from what is expected is found.”
The decision is not based on a single test. Symptoms, age, the wish for pregnancy and ultrasound findings are all weighed together. The most common reasons are:
If you do not need surgery right away, there are usually alternatives, such as medication or monitoring with ultrasound. A good counseling discussion will explain what you gain and what you risk with each option.
When you know what comes next, anxiety drops noticeably. The usual sequence is as follows:
Make sure someone accompanies you home. After general anesthesia, you should not drive the same day.
No single technique suits everyone. The choice depends on the size and location of the problem, your history and the experience of the surgical team.
In a small percentage of procedures, laparoscopy is converted to open surgery during the operation. This is not a failure. It is a safety decision the surgeon makes when the findings require it.
Laparoscopy is safe for most women. However, some conditions increase the difficulty or the risk and call for more careful planning:
Also let the team know about any previous reactions to anesthesia, smoking and any history of blood clots. Small details in your history often change the plan.
Showering is usually allowed from the next day. Pat the incisions dry and avoid baths, swimming pools or the sea until they have fully healed, usually in two weeks. Light bruising around the incisions is expected.
Walk from the first day, a little and often. Gentle everyday activity is allowed right away. Running, the gym and heavy lifting resume gradually, depending on the type of procedure.
Bloating and constipation are common in the first days, because of anesthesia, painkillers and moving less. Light meals, plenty of fluids, fruit and fiber help. Walking speeds up absorption of the gas.
You can drive when you can brake suddenly without pain and you are not taking medication that causes drowsiness. Sex can resume when you feel comfortable, unless there was surgery in the vagina or removal of the uterus, in which case the wait is longer.
Sometimes an acute condition appears while a woman is pregnant: appendicitis, ovarian torsion or a complicated cyst. International guidelines consider laparoscopy safe in any trimester when performed by an experienced team. The surgeon adjusts the entry point to the size of the uterus, keeps the gas pressure low, and the baby's heart activity is checked before and after the procedure.
The key message is simple. Delaying a necessary operation during pregnancy often carries a greater risk for mother and baby than the operation itself.
Informed consent is not just a formal signature. Go to your appointment with your questions written down so you do not forget anything:
All tissue removed during laparoscopy, such as a cyst wall, fibroid, endometriosis lesion or peritoneal biopsy, is sent to a pathologist. The exam confirms the diagnosis and rules out cancer. Results usually come back in one to two weeks. In most benign conditions they simply confirm what the surgeon saw. Less often they reveal something unexpected, and the follow-up or treatment plan is adjusted accordingly.
A diagnostic laparoscopy takes 20 to 40 minutes. Operative procedures, such as removal of a cyst or fibroid, take one to three hours, depending on the findings.
The incisions are 5 to 10 millimeters long. One is hidden inside the navel and the others are low on the abdomen, and over time they become almost invisible.
It depends on the procedure. After a diagnostic laparoscopy, usually from the next cycle. After fibroid removal a wait of a few months may be needed, as defined by the surgeon.
Yes, laparoscopy is performed under general anesthesia.
After a diagnostic or simple operative laparoscopy, most women go home the same day or the next morning. For larger procedures, such as laparoscopic hysterectomy or removal of large fibroids, the stay is usually one to two days.
Usually not. Most stitches are absorbable and dissolve on their own within two to three weeks, and in some cases the incisions are closed with special tissue glue.
Yes. A previous cesarean section does not rule out laparoscopy. The surgeon takes possible adhesions into account and may choose a different entry point for greater safety.
Bloating is mainly caused by the carbon dioxide used during the procedure and by the temporary slowing of the bowels. It eases gradually over a few days, especially with walking and light meals.
Usually two to four weeks after surgery, when the histology results are also ready. The incisions are checked and the next step of treatment is discussed.
