Laparoscopy is the examination of the abdominal area. This is also known as abdominal endoscopy. The name of the method is derived from the instrument used, which is called a laparoscope. A laparoscope is a specialized endoscope used to examine the abdominal area. This is a diagnostic device outfitted with a small camera attached to the end of a thin tube. In addition, the laparoscope has a system of lenses used for optical magnification, a light source, and frequently a rinsing and suction device as well.
Laparoscopy can be conducted on an inpatient or outpatient basis. This treatment is often used in gynecology, urology and surgery. During treatment, the endoscope is inserted into the abdominal or pelvic cavity. In conventional diagnostic laparoscopy, a small incision just a few centimeters in size is made in the skin of the abdomen. The surgeon inserts a hollow tube into the abdomen through this opening. This tube, called a trocar, is used to insert a harmless gas such as carbon dioxide or nitrous oxide into the abdomen. The gas expands the abdomen so that abdominal organs which are situated close together can be moved and separated. This allows the surgeon a clearer view and better orientation in the abdominal/pelvic cavity. The surgeon then pushes the laparoscope itself through the tube, the trocar, and into the abdomen. Now, the surgeon can carefully examine all of the patient’s organs. A small pair of forceps can also be used to take tissue samples during this examination if necessary.
Mini laparoscopy also uses a trocar, but it has a diameter of just three millimeters, making it somewhat narrower than a conventional diagnostic laparoscopy. Mini laparoscopy is preferred over conventional laparoscopy, for instance, to address abdominal growths and known clotting disorders. This is a less invasive procedure, because the insertion point is smaller and does not have to be sutured.
Uses and applications of laparoscopy!
Abdominal endoscopy, or laparoscopy, is frequently used to diagnose disorders of the abdominal and pelvic organs. It is primarily useful in cases where abdominal issues remain unexplained in spite of other examinations such as a gastroscopy or colonoscopy. Laparoscopy can be used to identify pathological changes in the abdominal/pelvic cavity and diagnose the causes of any complaints.
Abdominal endoscopy may be useful to address the following illnesses or issues in the abdominal or pelvic region:
Unexplained liver disorders, liver failure, fatty liver disease, hepatitis and cirrhosis of the liver. Cysts, ascites (abdominal fluid), tumors and chronic pain in the abdominal and pelvic area.
Apart from using laparoscopy as a reliable diagnostic procedure, the treating physician can also take tissue samples if needed during the examination.
Abdominal/pelvic endoscopy plays another important diagnostic function within gynecology. Gynecological laparoscopy can be used to investigate organ function (ovaries, fallopian tubes and uterus). If there are suspected cysts in the area of the ovaries, an ectopic pregnancy or endometriosis (fragments of uterine lining in the abdomen), laparoscopy can provide a reliable diagnostic method. This is in particular important for unexplained abdominal and pelvic issues and infertility (the fallopian tubes can be checked for blockages).
In addition to the diagnostic applications indicated above, abdominal endoscopy is also used for therapeutic purposes: It can be used for cholecystectomy (gallbladder removal), hernia operations, colon resection (removal of part of the large intestine), appendectomy, to insert a gastric bypass (for stomach stapling or bypassing the small intestine in chronic obesity) and sterilization (fallopian tube ligature).
In these therapeutic applications, it is a major advantage that laparoscopy is significantly less invasive and lower risk than open abdominal surgery. The laparoscope can also be used to display a detailed view of the abdomen on a monitor, making it easier for the surgeon to view tight angles and areas hidden between different organs.
Laparoscopy procedure and risks!
Intravenous access is inserted as a precaution before abdominal endoscopy. If there is an emergency during the laparoscopy, this access can be used to quickly administer medications. The patient’s blood pressure and pulse are monitored continuously during the laparoscopy. In general, the examination takes around 30 minutes and is conducted under full anesthesia. Incisions in the skin are generally sutured following conventional laparoscopy, leaving a scar. Mini laparoscopy may be conducted on an outpatient basis for patients without serious pre-existing conditions. Patients are still monitored after outpatient treatment.
Serious complications are rare during or after laparoscopy. One very frequent complication is bleeding from the abdominal wall (caused by the trocar) or organs, for instance after a biopsy (in particular of the liver). Generally, this bleeding can be staunched during the laparoscopy. Whether a patient will experience pain following abdominal endoscopy depends on a variety of factors. Sometimes, gas inserted into the abdomen can rise and collect under the diaphragm. This may cause pain in the patient’s right shoulder (called post-laparoscopic pain syndrome). In addition, patients may experience pain at the incision site following laparoscopy.
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