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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Diagnostic Laparoscopy for Adnexal Masses
What is a diagnostic laparoscopy?
A diagnostic laparoscopy is a procedure in which the doctor
uses a laparoscope to observe your ovaries and fallopian
tubes for tissue growths. A laparoscope is a thin metal
tube with a light and tiny camera. The ovaries are the
organs that make and store eggs. The fallopian tubes bring
eggs to the uterus. The area in the pelvis where the
ovaries and fallopian tubes are located is called the
adnexal area.
When is it used?
This operation may be performed because you have pain in the
pelvic area. Adnexal masses are growths in the ovaries or
tubes.
Diagnostic laparoscopy is always preceded by a pelvic exam
and usually radiological procedures such as ultrasound or CT
scans.
As an alternative you could choose not to have treatment.
You should ask your doctor about your choices.
How do I prepare for a diagnostic laparoscopy?
Plan for your care and recovery after the operation. Allow
for time to rest and try to find other people to help you
with your day-to-day duties.
Follow instructions provided by your doctor. Eat a light
meal, such as soup or salad, the night before the procedure.
Do not eat or drink anything after midnight and the morning
before the procedure. Do not even drink coffee, tea, or
water.
What happens during the procedure?
You are given a general anesthetic, which relaxes your
muscles, makes you feel as if you are in a deep sleep, and
prevents you from feeling pain.
Your peritoneal cavity will be inflated with carbon dioxide
gas. This will expand your peritoneal cavity like a balloon
and help the doctor see your organs. The doctor makes a
small cut in or just below your bellybutton, puts a
laparoscope through this cut, and puts another tool through
a second small cut in the lower abdomen. The laparoscope is
guided to look at the ovaries and tubes. If the doctor
finds a growth that should not be there, the other
instrument may be used to take a sample of the growth or
remove it. The sample is sent to the lab for analysis.
What happens after the procedure?
You may stay in the hospital several hours or overnight to
recover. The anesthetic may cause a little sleepiness or
grogginess for a while. You may have some shoulder pain,
feel bloated, or find a change in bowel habits for a few
days. You may not be able to urinate right away and may
have a catheter (a small tube) placed into your bladder
through the urethra (the tube from the bladder to the
outside) for a few days. You should avoid heavy activity
such as lifting. You should ask your doctor how much you
should lift.
Ask your doctor what steps you should take and when you
should come back for a checkup.
What are the benefits of this procedure?
This minor surgical procedure may help the doctor make a
more accurate diagnosis. Certain problems may be treated
surgically at the time of laparoscopy. Many times the mass
can be removed through the laparoscope, so a more extensive
operation, with several days in the hospital, is avoided.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia.
Discuss these risks with your doctor.
- The abdominal organs, glands, intestines, or blood
vessels may be damaged. The doctor may perform abdominal
surgery to repair them at the time of the laparoscopy.
- The lining of the abdominal wall may become inflamed.
- A blood clot may break off, enter the bloodstream, and
clog an artery in the lung, pelvis, or legs. Rarely, a
clot may break off and clog an artery in the heart or
brain, causing a heart attack or stroke.
- You may develop an infection or bleeding.
- There may be some pain after the procedure.
You should ask your doctor how these risks apply to you.
When should I call the doctor?
Call the doctor immediately if:
- You develop a fever.
- You develop chest pains.
- You experience nausea and vomiting.
- You become short of breath.
- You have abdominal pain or swelling that gets worse.
Call the doctor during office hours if:
- You have questions about the procedure or its result.
- You want to make another appointment.
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