Endometriosis: What is a Laparoscopy?

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Please note, I am not a healthcare professional. I'm just someone who lives with endometriosis, and the information I'm sharing here comes from my experience, from knowledge that has been shared with me by healthcare professionals, and also from studies, articles, films, and podcasts that I've come across.  


Laparoscopy 

A laparoscopy is a surgical procedure in which a small telescope (laparoscope) is inserted through the abdminal wall to view the organs in the abdomen. In this procedure, small incisions are made in the lower abdomen and the abdomen is carefully filled with gas to lift the abdomen wall from the bowel to help insert the laparoscope. Endometriosis UK have provided a helpful and thorough explanation of what happens during the operation...

"At the start of the operation, the bladder is emptied (catheterised). A fine needle is then inserted inside the belly button (umbilicus) and the abdomen is filled with carbon dioxide gas. The gas flow is carefully monitored throughout. The carbon dioxide gas lifts the tummy wall away from the bowel to make introduction of the laparoscope safer. Two other small (approximately 1cm) cuts (incisions) may be made, usually one just inside the belly button and one on the bikini line for an instrument to assist with visualising the organs. A careful inspection is made of the womb (uterus), ovaries, fallopian tubes, Pouch of Douglas, bowel, bladder and all surrounding areas and a record of the severity of the disease is made by either drawing, photographs or video. Many different appearances of endometriosis have now been recognised. In some cases, if the tissues are stuck together (adhesions), it may not be possible to see some or all of these organs."


At the end of the operation, the small cuts will be closed with a stitch, tape or glue. The stitches will either dissolve or can be removed after a few days.

Laparoscopies are carried out under general anaesthesia, and during a laparoscopy the surgeon can destroy (by burning the surface) or remove (by cutting it out) endometriosis, endometrial cysts or release scar tissues. Ideally, surgeons will cut out endometriosis rather than burn it. I talk more about the reasons for this in
 my 'Endometriosis Treatment' post.

As mentioned in the 'Endometriosis: I think I may have it - what now?' post, the only way to be certain you have endometriosis is to have a laparoscopy.

You must see a surgeon that is an expert in this type of surgery, and ensure that they aren't only going to do a laparoscopy to diagnose the disease, but that they are also going to treat the disease during surgery, if endometriosis is found.

Good to know: To confirm endometriosis, a sample must be taken during a laparoscopy and it must be sent off to pathology, the pathologists will then have a look under a microscope and confirm if it is endometriosis.



Pre Op  

Prior to the day of the surgery, you may have to attend a pre-op assessment where nurses will check your blood pressure, weight etc. This is also a good time for you to ask questions and ensure you are prepared for the surgery.

Laparoscopies are often day case surgeries; meaning you're in hospital just for the day, but do take an overnight bag just in case you end up having to stay in hospital overnight.

As you will be given general anaesthesia, you shoud fast for at least 6 hours prior to your surgery, but your hospital should give you all the information you need before your surgery.

Before being taken into theatre, you'll be asked to change into a hospital gown, and nurses will wrap a wristband around your wrist and ankle ~ this wristand should have your name, hospital details, and any allergies you have. You will also be given compression socks, these are used to prevent blood clots.

Although laparoscopy surgeries are regularly and frequently performed, there are risks attached. Most of these are minor, but others are more serious. Your surgeon and anaesthetist should speak to you before your surgery, and ask you to sign a consent form where you confirm that you understand the risks involved with your surgery ~ use this time to ask them about risks and any other questions you may have.


Post Op

Once the surgery is done, you're likely to be transferred to a recovery room, where nurses will keep checking on you until you are fully awake and feel okay. As the anaesthia wears off, you'll begin to feel more awake. You may feel nauseous, in which case inform someone so they can bring you something to help ~ I was given a disposable tray to throw up in and some anti sickness tablets, which was very helpful.

The surgeons will have given you painkillers during surgery, so these should still be in your system when you wake up. However, I woke up in quite a bit of pain and after speaking to a nurse, she gave me more morphine. Bliss. So, if you feel pain, tell a nurse and ask for pain relief.

The area around the incisions can be quite sore, swollen and bruised for a couple of weeks after surgery. For me, this pain was quite strong for around 2 weeks and faded over time. As the abdomen is carefully filled with gas during surgery, you may experience some pain and discomfort in your ribs and shoulders post op, which should disappear within days. If you are in discomfort and pain, do tell the nurses so that they can give you painkillers and make you as comfortable as possible.

The incisions should be kept clean and dried carefully after a bath or shower. Occasionally, wounds can become infected; if the cuts become red and inflamed or there is an unusual discharge, you should contact your doctor/GP urgently. 

Laparoscopies are usually day surgeries ~ which means that you go in, have the surgery, and go home, in the same day. However, you may need to stay in hospital overnight. It all depends on the following:


  • The time you have your surgery ~ if it's too late in the day and doctors want to monitor you, they may advise you to stay the night
  • Whether there are any complications during or post surgery
  • If you don't feel well enough 

You will have to bring someone with you to hospital, as you will need assistance getting home after your surgery. You should not drive or do much other than rest for around 2-7 days after surgery, but this depends on the amount of work undertaken during surgery and how you're feeling. You could start feeling better within 2 weeks, however the rate of recovery varies from person to person so you need to be guided by how you feel as well as the advice of your doctors. It's very important you listen to your body and be kind. 

The pain post surgery can be intense, and some doctors only prescribe paracetamol for you to take home ~ this is shocking to me, as I really don't see how anyone could rely on just paracetamol after having surgery! My surgeon tried to only give me paracetamol, I wasn't having it as I was in agony, and so I demanded codeine, which is what was eventually prescribed for my pain. Codeine can cause constipation so please do speak to your doctor about taking a laxative or something similar. 

I had quite a bit of bleeding after this surgery ~ from the vagina and from one of my wounds ~ and I was told by my doctor that this is completely normal and nothing to worry about. However, sometimes it can be an issue, so do contact your nurse or doctor if you're experiencing the following:


  • Severe pain or fever after going home
  • Nausea or vomiting
  • Increased bleeding from the cuts
  • One or more of the cuts become painful
  • Smelly vaginal discharge
  • Smelly discharge from the cuts

I've written all about my journey with endometriosis, including treatments I have tried and treatments I am trying ~ 'Endometriosis: My story & what has helped me'.

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