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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Diagnostic Laparoscopy for Chronic Pelvic Pain
What is a diagnostic laparoscopy?
A diagnostic laparoscopy is a procedure in which the doctor
uses a laparoscope to look at the organs and tissues inside
your abdominal cavity. A laparoscope is a thin metal tube
with a light and tiny camera.
When is it used?
This operation may be performed to learn more about the
cause of chronic pain in your pelvic area. Chronic pain is
pain that has lasted for a long time. Before you have the
laparoscopy you will have a complete history, physical exam,
neurologic exam, and pelvic exam.
Alternatives include:
- having an ultrasound, a scan with high-frequency sound
waves
- having blood and other lab tests
- having a CT scan of the abdomen
- trying other procedures, such as abdominal surgery
- choosing not to have treatment.
You should ask your doctor about these 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 the bellybutton, puts a
laparoscope through the cut, and puts another instrument
through a second small cut in the lower abdomen. The
laparoscope is guided to look at the pelvic organs and
tissues. If the doctor finds a growth that should not be
there, the other instrument may be used to take a sample or
remove the growth. 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 activities
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. He or she may then know how to
treat and get rid of your pain.
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.
- You may have 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 over 100°F (37.8°C).
- You become dizzy and faint.
- 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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