What is laparoscopy?
About thirty-five years ago, fibre optic technology was introduced. It was found that light could be transmitted along a flexible tube composed of thousands of glass fibres. Fibre optics has revolutionised medical diagnostic options. With fibre optics, it is possible to look into a body cavity with a variety of telescopes with the light source outside the body. Prior to fibre optics, the light would have to be within the body cavity with risks of heat damage to adjacent structures.
For thirty years-five, gynaecologists have been introducing a thin telescope (laparoscope Figure 18.1) into the abdomen to visualise the pelvic organs. Under a general anaesthetic, a small cut is made at the lower edge of the umbilicus (navel). A guarded needle is introduced into the abdominal cavity, which is then filled with about three litres of gas (carbon dioxide). The laparoscope can then be passed through and the gynaecologist can observe the womb, ovaries and Fallopian tubes as well as the surrounding areas. Laparoscopy may be indicated for persistent pain and also at times in the assessment of sudden (acute) pelvic pain. Sometimes minor surgery can be undertaken with the laparoscope (minimally invasive surgeryFigure 18.1).
Diagram of Laparoscopy and Dye Insufflation.
Although we now have a wealth of experience with laparoscopy, the investigation should not be undertaken lightly; as with any operation there can occasionally be complications (surgery risks) with damage to internal structures (about 1 in a thousand). Occasionally the gas is inadvertently introduced into the abdominal wall and the procedure may have to be abandoned or the surgeon may decide that a mini-laparotomy is required.
When laparoscopy was introduced around 1970, research showed that it frequently changed the provisional diagnosis. Since that time new investigation options, such as ultrasound and sensitive pregnancy tests, have increased our ability to evaluate the pelvis and exclude problems such as an ectopic pregnancy. These have decreased the need for laparoscopy.
A 1978 survey of laparoscopy found that 52% of laparoscopies were to investigate pelvic pain. Another study found that 86% of laparoscopies for pelvic pain revealed no abnormality.
Related Medical Abstracts - Click on the paper title:-
- Acute nonspecific abdominal pain: a randomized, controlled trial comparing early laparoscopy versus clinical observation. (2006-01)
- How long does laparoscopic surgery really take? Lessons learned from 1000 operative laparoscopies.(1999-01)
- The role of laparoscopy in the management of pelvic pain in women of reproductive age (1997-01).
Please click on the required question.
- 1 Pelvic Pain. Is this a common problem?
- 2 What are the common causes of pelvic pain in women?
- 3 What are the more common gynaecological causes of pelvic pain?
- 4 What are the more common non-gynaecological causes of pelvic pain?
- 5 What are primary and secondary dysmenorrhoea - painful periods?
- 6 What is retrograde menstruation?
- 7 How can dysmenorrhoea - painful periods be treated?
- 8 What are ovarian cysts?
- 9 How do ovarian cysts cause pain?
- 10 How are ovarian cysts diagnosed?
- 11 How are ovarian cysts treated?
- 12 I think I may be pregnant and I have some pelvic pain. What should I do? 13 What is pelvic inflammatory disease and how can it be treated?
- Mittelschmertz
- 14 What are fibroids?
- 15 I have fibroids. What difficulties might they cause for me?
- 16 How are fibroids diagnosed?
- 17 How could my fibroids be treated?
ENDOMETRIOSIS
- 18 What is endometriosis?
- 19 How prevalent is endometriosis?
- 20 What causes endometriosis?
- 21 How can my endometriosis be treated?
- 22 How can my doctor determine the cause of my pelvic pain?
- 23 What investigations might be recommended by my gynaecologist to investigate my pelvic pain?
- 24 What is laparoscopy?
- 25 What are pelvic adhesions?
- 26 I have chronic pelvic pain. Could this be related to adhesions?
- 27 What is uterine retroversion (retroverted uterus)
- 28 Does a retroverted uterus (backward tilted uterus) cause symptoms?
- 29 How is a retroverted uterus - backward tilted uterus - treated?
- 30 What is pelvic congestion?
- 31 What causes pain associated with sexual intercourse (dyspareunia)
- 32 How can painful sexual intercourse (dyspareunia) be treated?
- 33 What is a pelvic mass?
IRRITABLE BOWEL SYNDROME - IBS
- 34 What is irritable bowel syndrome?
- 35 How can we find out if I have irritable bowel syndrome?
- 36 Is irritable bowel syndrome (IBS) a common condition?
- 37 What causes IBS?
- 38 What is the pain associated with IBS like?
- 39 Can IBS be mistaken for gynaecological problems?
- 40 How can my IBS be treated?
- 41 What other treatments are available for IBS?
- 42 What can be done to reduce the amount of bowel gas(flatus)
- 43 What is constipation?
- 44 What causes constipation?
- 45 How can constipation be treated?
- 46 How could we summarise the treatments that are available for my pelvic pain?
- 47 Where can I obtain more information?
- 48 Support Groups.
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
