Laparoscopy – Information and Recovery

What is laparoscopy?

Laparoscopy is a way of doing surgery using small incisions (cuts). It is different from “open” surgery where the incision on the skin can be several centimetres long. Laparoscopic surgery sometimes is called “minimally invasive surgery.”
Laparoscopic surgery uses a special instrument called a laparoscope. The laparoscope is a long, slender device that is inserted into the abdomen through a small incision. It has a camera attached to it that allows the doctor to view the abdominal and pelvic organs on a screen. If a problem needs to be fixed, other instruments can be used. These instruments usually are inserted through additional small incisions in the abdomen.

Usual length of stay in hospital:

If you are having a diagnostic laparoscopy, you should be able to go home on the same day. This operation is usually done as a day case. When you wake from the anaesthetic, your nurse will want to make sure that you are not in pain and that it is safe for you to go home before you are discharged. This usually takes between three and four hours. When you go home, make sure that you are not alone and that someone can stay with you overnight. If you have had a simple procedure as part of an operative laparoscopy, you may be able to go home on the same day, though you may be asked to stay in hospital overnight.

After-effects of general anaesthesia:

Most modern anaesthetics are short lasting. You should not have, or suffer from, any after-effects for more than a day after your operation. During the first 24 hours you may feel more sleepy than usual and your judgement may be impaired. If you drink any alcohol, it will affect you more than normal. You should have an adult with you during this time and you should not drive or make any important decisions.

Scars:

You will have between one and four small scars on different parts of your abdomen – one scar will usually be in your belly button. Each scar will be between 0.5 cm and 1 cm long.

Stitches and dressings:

Your cuts will be closed by stitches. They dissolve by themselves. Your cuts will initially be covered with a dressing. You should be able to take this off about 72 hours after your operation and have a wash or shower (see section on washing and showering).

Vaginal bleeding:

You may get a small amount of vaginal bleeding for 24 to 48 hours, depending on the type of operation done through the laparoscope.

Pain and discomfort:

You can expect some pain and discomfort in your lower abdomen for the first few days after your operation. You may also have some pain in your shoulder. This is a common side effect of the operation. When leaving hospital, you will usually be provided with painkillers for the pain you are experiencing. Sometimes painkillers that can make you sleepy, slightly sick and constipated. If you do need to take these medications, try to eat extra fruit and fibre to reduce the chances of becoming constipated.

Formation of blood clots – how to reduce the risk:

There is a small risk of blood clots forming in the veins in your legs and pelvis (deep vein thrombosis) after any operation. These clots can travel to the lungs (pulmonary embolism), which could be serious. You can reduce the risk of clots by:

• being as mobile as you can as early as you can after your operation
• doing exercises when you are resting, for example:
• pump each foot up and down briskly for 30 seconds by moving your ankle
• move each foot in a circular motion or 30 seconds
• bend and straighten your legs – one leg at a time, three times for each leg.

Tiredness:

You may feel much more tired than usual after your operation as your body is using a lot of energy to heal itself. You may need to take a nap during the day for the first few days. For many women this is the last symptom to improve.

What can help recovery?

A daily routine:
Establish a daily routine and keep it up. For example, try to get up at your usual time, have a wash and get dressed, move about and so on. Sleeping in and staying in bed can make you feel depressed. Try to complete your routine and rest later if you need to.
Stop smoking:
Stopping smoking will benefit your health in all sorts of ways, such as lessening the risk of a wound infection or chest problems after your anaesthetic. By not smoking – even if it is just while you are recovering – you will bring immediate benefits to your health.
A positive outlook:
Your attitude towards how you are recovering is an important factor in determining how your body heals and how you feel in yourself. You may want to use your recovery time as a chance to make some longer-term positive lifestyle choices such as:

• starting to exercise regularly if you are not doing so already and gradually building up the levels of exercise
• eating a healthy diet

What can slow down my recovery?

It can take longer to recover from a laparoscopy if:
you had health problems before your operation; for example, women with diabetes may heal more slowly and be more prone to infection

• you smoke – smokers are at increased risk of getting a chest or wound infection during their recovery, and smoking can delay the healing process
• you were overweight at the time of your operation – if you are overweight, it can take longer to recover from the effects of the anaesthetic and there is a higher risk of complications such as infection and thrombosis
• there were any complications during your operation.

When will I know the outcome of my operation?

Doctor will inform you after the operation of the findings, but this information is often forgotten due to the effects of the anesthesia. You will be scheduled for a post-operative appointment 1 week after your operation where all the finer details of the procedure will be discussed with you.