Laparoscopy: Answers to common questions

Laparoscopy is a type of minimally invasive surgery. This means your surgeon works through small cuts in your belly, also called the abdomen, instead of one large cut.

A thin camera called a laparoscope lets your surgeon see inside your abdomen or pelvis. The camera sends pictures to a screen, and the surgeon can place other surgical tools through small openings as needed.

Laparoscopy can be used to help find the cause of a health condition, collect tissue for testing or treat some conditions.

Laparoscopy uses small cuts, also called incisions, that often are less than 1 inch long. Open abdominal surgery, also called a laparotomy, uses a larger incision to give the surgeon direct access to the abdomen or pelvis.

For some operations, laparoscopy may mean less pain, a shorter hospital stay and a faster recovery than open surgery. The benefits depend on the type of operation you have. Sometimes a surgeon starts with laparoscopy but needs to switch to open surgery if that is a safer way to complete the operation.

These procedures use different ways to look and reach inside the body.

• Laparoscopy. A surgeon places a small camera through an incision in the abdomen. Other small incisions may be used for surgical tools.
• Laparotomy. This is open abdominal surgery. The surgeon uses a larger incision to reach the abdomen or pelvis.
• Endoscopy. An endoscope is a small camera used to look inside the body. Some types of endoscopy reach an area through a natural opening, such as the mouth or rectum, instead of through cuts in the abdomen.

The main difference is how the surgeon uses the surgical tools. During standard laparoscopy, the surgeon works with tools placed through small incisions while viewing images from a camera on a screen.

During robot-assisted surgery, the surgeon sits at a control center and uses controls to move mechanical arms that hold the surgical tools. The robotic system also gives the surgeon a magnified, high-definition 3D view of the surgical area.

The robotic system may increase precision, flexibility and control during some operations. Both approaches can use small incisions, but the approach used depends on the type of surgery and your needs.

Yes. A surgeon can use laparoscopy to look inside the abdomen or pelvis and help find the cause of symptoms. This is called diagnostic laparoscopy. The surgeon may collect tissue for testing.

Diagnostic laparoscopy may help find the cause of ongoing or sudden pain in the abdomen or pelvis. A surgeon also may use it to look more closely at a lump or growth or to evaluate liver disease or unexplained fluid in the abdomen. It also may help find and, in some cases, treat injuries inside the abdomen.

Laparoscopy can be used to treat some conditions. For example, it may be used to remove the appendix or gallbladder, repair a hernia, or perform some types of colon surgery. In some cases, the surgeon can find and treat a condition during the same operation.

Cancer staging helps your care team learn whether cancer has spread. During a staging laparoscopy, a surgeon can look inside the abdomen for signs of cancer and collect tissue from an area where there may be cancer. Testing that tissue can help show whether cancer is present in that area.

The results may help your care team plan surgery or other treatment. Laparoscopy also may help your care team decide whether a cancer can be removed with surgery.

For some people with pancreatic cancer, staging laparoscopy can find small areas where cancer has spread. These areas may not show up on imaging tests, which make pictures of the inside of the body. Finding this spread may help the care team plan treatment and avoid an open operation that may not be needed. Laparoscopy also is used to stage some other types of cancer, including lymphoma.

Laparoscopy is usually done with general anesthesia. General anesthesia puts you in a sleeplike state during the procedure. For some diagnostic laparoscopies, you may get medicine that numbs an area of your body. This is called local anesthesia. You also may get medicine to help you relax or feel sleepy. This is called sedation.

Your surgeon puts carbon dioxide gas into your abdomen. The gas creates more room so the surgeon can see and work. The surgeon then makes a small cut and places a hollow tube called a port through the abdominal wall.

The laparoscope goes through the port. Other ports may be used for surgical tools. At the end of the procedure, the surgeon releases the gas. The incisions may be closed with stitches that dissolve on their own or with surgical tape.

Some laparoscopies are outpatient procedures, which means you can go home the same day. You stay in a recovery area until the effects of the anesthesia or sedation have worn off enough for you to leave safely. Other laparoscopic procedures require a hospital stay.

How long a laparoscopy takes depends on why you're having the procedure and whether your surgeon is looking for the cause of symptoms, treating a condition or doing both. Your surgical team can give you an estimate based on the procedure you are having.

The number of incisions depends on the procedure. Your surgeon may start with one incision near the belly button and make more small incisions for surgical tools as needed.

Laparoscopic incisions often are less than 1 inch (2.5 centimeters) long. Many surgical tools fit through openings about 0.2 inch (5 millimeters) wide, while some tools need openings that are about 0.5 to 0.6 inch (12 to 15 millimeters) wide.

The incisions may be closed with stitches that dissolve on their own or with surgical tape. Your surgical team can give you instructions to care for the incisions as they heal.

The belly button is a common access site for laparoscopy. The surgeon can use an incision there to place the camera or another surgical tool. The exact location and size of the incision depend on the procedure.

Laparoscopy uses small incisions, which typically leave smaller scars than incisions used for open surgery. The number, size and location of the incisions depend on the procedure. An incision may be closed with stitches that dissolve on their own or with surgical tape.

As an incision heals, new skin grows over the cut, and the area becomes stronger. Wounds generally heal over about 4 to 6 weeks. The scar keeps changing after the skin heals. About three weeks after surgery, the scar begins a longer healing phase that can last up to a year.

Your surgeon can tell you where your incisions are likely to be and what to expect as they heal.

Laparoscopy is surgery, so complications can happen. These may include bleeding, infection, or injury to an organ, bowel, bladder or blood vessel.

Gas is used to expand your abdomen during laparoscopy. You may feel bloated because of the gas, which is released at the end of the procedure.

You also may have soreness around the incisions. The soreness usually gets better from day to day. How much soreness you have and how long it lasts can depend on what your procedure involves. Recovery from a laparoscopy that includes treatment may take longer than recovery from a diagnostic laparoscopy alone.

Contact your surgical team if you have any of the following signs or symptoms:

• Fever or chills.
• Increasing swelling in your abdomen.
• Bleeding or drainage from an incision or a change in skin color around an incision.
• Nausea or vomiting that doesn't go away.
• A cough that doesn't get better or shortness of breath.
• Trouble urinating.
• Pain that your medicine doesn't control.

Your surgical team can tell you if there are other things to watch for based on the procedure you had.

After a laparoscopic surgery, you stay in a recovery area while the anesthesia or sedation wears off. If you have an outpatient procedure, you may be able to go home once you can get up and walk without help. Some laparoscopic surgeries require a hospital stay. Your surgical team will let you know when you can go home safely.

Your incisions may feel sore at first. The soreness generally gets better each day.

Most people who have diagnostic laparoscopy can shower the next day and return to their usual activities within about a week. Your recovery may be different if your laparoscopy also includes treatment. Your surgeon can tell you what activities are safe based on the operation you had.

If you receive sedation, you'll need someone else to drive you home. Wait until the next day to drive or operate machinery because the medicine used can affect your judgment and reflexes. For some laparoscopic surgeries, you may need to wait longer to drive.

Do not drive or operate machinery while taking opioid pain medicine. Opioids can cause drowsiness, dizziness and slowed reaction times.

After diagnostic laparoscopy, many people can return to their usual activities within about a week. But recovery after a laparoscopy that includes treatment can vary. You may need to wait longer to lift heavy items or return to activities that take a lot of physical effort. Before you go home, make sure you know which activities you need to limit or avoid.