Laparoscopic Surgery - What Is It?

Laparoscopic or “minimally invasive” surgery is a specialized technique for performing surgery. In the past, this technique was commonly used for gynecologic surgery and for gall bladder surgery. Over the last 10 years the use of this technique has expanded into intestinal surgery. In traditional “open” surgery the surgeon uses a single incision to enter into the abdomen. Laparoscopic surgery uses several 0.5-1cm incisions. Each incision is called a “port.” At each port a tubular instrument known as a trochar is inserted. Specialized instruments and a special camera known as a laparoscope are passed through the trochars during the procedure. At the beginning of the procedure, the abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the surgeon. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors in the operating room. During the operation the surgeon watches detailed images of the abdomen on the monitor. This system allows the surgeon to perform the same operations as traditional surgery but with smaller incisions.

In certain situations a surgeon may choose to use a special type of port that is large enough to insert a hand. When a hand port is used the surgical technique is called “hand assisted” laparoscopy. The incision required for the hand port is larger than the other laparoscopic incisions, but is usually smaller than the incision required for traditional surgery.

What are the advantages of laparoscopic surgery?

Compared to traditional open surgery, patients often experience less pain, a shorter recovery, and less scarring with laparoscopic surgery.

What kinds of operations can be performed using laparoscopic surgery?

Most intestinal surgeries can be performed using the laparoscopic technique. These include surgery for Crohn’s disease, ulcerative colitis, diverticulitis, cancer, rectal prolapse and severe constipation.

In the past there had been concern raised about the safety of laparoscopic surgery for cancer operations. Recently several studies involving hundreds of patients have shown that laparoscopic surgery is safe for certain ­colorectal cancers.

How safe is laparoscopic surgery?

Laparoscopic surgery is as safe as traditional open surgery. At the beginning of a laparoscopic operation the laparoscope is inserted through a small incision near the belly button (umbilicus). The surgeon initially inspects the abdomen to determine whether laparoscopic surgery may be safely performed. If there is a large amount of inflammation or if the surgeon encounters other factors that prevent a clear view of the structures the surgeon may need to make a larger incision in order to complete the operation safely.

Any intestinal surgery is associated with certain risks such as complications related anesthesia and bleeding or infectious complications. The risk of any operation is determined in part by the nature of the specific operation. An individual’s general heath and other medical conditions are also factors that affect the risk of any operation. You should discuss with your surgeon your individual risk for any operation

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Dr. Sankar Dasmahapatra performs best cesarean section surgery in Kolkata. Providing cesarean section or C section Surgery in Kolkata over last 20 years at very affordable cost. Dr. Mahapatra has performed hundreds of successful cesarean delivery in Kolkata. Dr. Sankar Dasmahapatra is attached with best hospitals in Kolkata, Saltlake Kolkata conducting cesarean section or C section delivery.

What is Caesarean Delivery

A cesarean section, also called a c-section, is a surgical procedure performed when a vaginal delivery is not possible or safe, or when the health of the mother or the baby is at risk. During this procedure, the baby is delivered through surgical incisions made in the abdomen and the uterus.

What is Caesarean Delivery

At the start of the procedure, the anesthesia will be administered, and a screen or sterile drape will be used to prevent you from watching the surgery. Your abdomen will then be cleaned with an antiseptic, and you might have an oxygen mask placed over your mouth and nose to increase oxygen to the baby.

C Section surgeon Dr.Mahapatra will then make an incision through your skin and into the wall of the abdomen. Dr. Mahapatra might use either a vertical or transverse incision. (A horizontal incision is also called a bikini incision, because it is placed beneath the belly button.) Next, a 3- to 4-inch incision is then made in the wall of the uterus, and the Gynecologist and obstetrician Dr.Mahaptra removes the baby through the incisions. The umbilical cord is then cut, the placenta is removed and the incisions are closed.

How Long Does The Procedure Take?

If the cesarean is an emergency, the time from incision to delivery takes about two minutes. In a non-emergency, a cesarean birth can take 10 to 15 minutes, with an additional 45 minutes for the delivery of the placenta and suturing of the incisions.

What Happens After the Delivery?

Because the cesarean is major surgery, it will take you longer to recover from this type of delivery than it would from a vaginal delivery. Depending on your condition, you will probably stay in the hospital from 3 to 4 days.

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Laparoscopic Surgery - What Is It?

Laparoscopy is the examination and inspection of the interior of body organs or cavities using a device called an endoscope. Endoscopy involves laparoscopy as well as hysteroscopy.

Laparoscopy involves visualization of pelvic structures (uterus, tubes & ovaries) with the help of a special optical device called as laparoscope. Operative intervention can be done simultaneously, which helps in restoring the pelvic anatomy & improving your chance of conception.

Hysteroscopy is a surgical procedure that enables us to diagnose and operate on pathologies inside the cavity of the uterus. This consists of the introduction of an instrument with fibre optics called hysteroscope, through the cervical canal, which enables us to visualize the cavity of the uterus. We can diagnose and treat any existent uterine pathologies simultaneously.

We have state of the art, fully equipped dedicated theatres where these endoscopic procedures are performed usually as day care procedures and the patient does not need to be admitted overnight.

Laparoscopy

(Intra abdominal 'Keyhole' Surgery) Laparoscopy is an operative procedure done under general anaesthesia that allows intra abdominal surgery to be performed with the help of a special optical device called laparoscope. This is inserted through a tiny incision (1) made in the abdominal wall near the navel for viewing the abdominal cavity. By introducing special instruments though additional incisions or cut over abdomen (2) it is possible to perform minimally invasive surgical procedures without the need of creating a large opening in the abdominal wall.

Why does one require laparoscopy?

Laparoscopy is an important diagnostic tool in the evaluation of an infertile patient. An inspection through the laparoscope gives us a general impression of the state of the pelvis and enables us to find the cause of infertility. Also, the tubal patency can be checked by injecting a blue dye into the uterus, through a thin tube inserted through the cervix (mouth of the uterus), and seeing it spill out though the tubes.

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Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscope, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

What is diagnostic hysteroscopy?

Diagnostic hysteroscopy is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG). HSG is an X-ray dye test used to check the uterus and fallopian tubes. Diagnostic hysteroscopy can many times be done in an office setting.

Additionally, hysteroscopy can be used with other procedures, such as laparoscopy, or before procedures such as dilation and curettage (D&C). In laparoscopy, your doctor will insert an endoscope (a slender tube fitted with a fiber optic camera) into your abdomen to view the outside of your uterus, ovaries and fallopian tubes. The endoscope is inserted through an incision made through or below your navel.

What is operative hysteroscopy?

Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscope.

When is operative hysteroscopy used?

• Polyps and fibroids — Hysteroscopy is used to remove these non-cancerous growths found in the uterus.
• Adhesions — Also known as Asherman’s Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow. Hysteroscopy can help your doctor locate and remove the adhesions.
• Septums— Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth.
• Abnormal bleeding — Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding.

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What is Normal Delivery Process?

A vaginal delivery is when a person gives birth through their vagina. It’s the most common method of childbirth. During a vaginal birth, your uterus contracts to thin and open your cervix and push your baby out through your vagina

How Do Doctors Do Normal Delivery?

The physician making episiotomy (a cut to widen the opening of the vagina) Continuous pushing by the mother to expel the baby out. The baby’s head comes out first, then the shoulders, and then the butt. Cutting the umbilical cord as a final step after the baby is completely out and has the first cry.

What Is Normal Delivery Time? Is Normal Delivery Good for Baby?

As per the painless normal delivery specialist in Newtown Kolkata a major benefit when it comes to vaginal birth is that the child is exposed to what is known as “beneficial bacteria” in their mother’s birth canal. As the baby moves through the birth canal, fluid passes through the baby’s nose and mouth, making its way into the digestive system. In a first pregnancy, labor usually lasts 12 to 18 hours on average; subsequent labors are often shorter, averaging 6 to 8 hours.

Is Normal Delivery Painful?

Yes, childbirth is painful. But it’s manageable. In fact, nearly half of first-time moms (46 percent) said the pain they experienced with their first child was better than they expected.

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Reasons that a pregnancy may be considered high risk include:

• Maternal Age: One of the most common risk factors for a high-risk pregnancy is the age of the mother-to-be. Women who will be under 17 or over 35 when their baby is due are at greater risk of complications than those between their late teens and early 30s. The risk of miscarriage and genetic defects further increases after age 40.


• Medical conditions that exist before pregnancy: Conditions such as high blood pressure; breathing, kidney, or heart problems; diabetes; autoimmune disease; sexually transmitted diseases (STDs); or chronic infections such as human immunodeficiency virus (HIV) can present risks for the mother and/or her unborn baby. A history of miscarriage, problems with a previous pregnancy or pregnancies, or a family history of genetic disorders are also risk factors for a high-risk pregnancy.
  
  If you have a medical condition, it's important to consult your doctor before you decide to become pregnant. Your doctor may run tests, adjust medications, or advise you of precautions you need to take to optimize the health of you and your baby.


• High-risk pregnancy: Know what to expect A high-risk pregnancy can be stressful. Know what kind of prenatal care you might need and how to cope. A high-risk pregnancy might pose challenges before, during or after delivery. If you have a high-risk pregnancy, you and your baby might need special monitoring or care throughout your pregnancy. Understand what causes a high-risk pregnancy, and what you can do to take care of yourself and your baby.

What are the risk factors for a high-risk pregnancy?

Sometimes a high-risk pregnancy is the result of a medical condition present before pregnancy. In other cases, a medical condition that develops during pregnancy for either mom or baby causes a pregnancy to become high risk. Specific factors that might contribute to a high-risk pregnancy include:

• Advanced maternal age Pregnancy risks are higher for mothers age 35 and older.


• Lifestyle choices Smoking cigarettes, drinking alcohol and using illegal drugs can put a pregnancy at risk.


• Medical history A prior C-section, low birth weight baby or preterm birth — birth before 37 weeks of pregnancy — might increase the risks for subsequent pregnancies. Other risk factors include a fetal genetic condition, a family history of genetic conditions, a history of pregnancy loss or the death of a baby shortly after birth.


• Underlying conditions Chronic conditions — such as diabetes, high blood pressure and epilepsy — increase pregnancy risks. A blood condition, such as anemia, an infection or an underlying mental health condition also can increase pregnancy risks.


• Pregnancy complications Various complications that develop during pregnancy pose risks, such as problems with the uterus, cervix or placenta, or severe morning sickness (hyperemesis gravidarum) that continues past the first trimester. Other concerns might include too much amniotic fluid (polyhydramnios) or too little amniotic fluid (oligohydramnios), restricted fetal growth or Rh (rhesus) sensitization — a potentially serious condition that can occur when your blood group is Rh negative and your baby's blood group is Rh positive.


• Multiple pregnancy Pregnancy risks are higher for women carrying twins or higher order multiples.


• Overdue pregnancy You might face additional risks if your pregnancy continues too long beyond the due date.

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A hysterectomy is an operation to remove a woman's uterus. The uterus is the place where a baby grows when a woman is pregnant. Sometimes, the ovaries and fallopian tubes also are taken out. Hysterectomies are very common - one in three women in the United States has had one by age 60.

Your health care provider might recommend a hysterectomy if you have

• Fibroids
• Endometriosis not cured by medicine or surgery
• Uterine prolapse - when the uterus drops into the vagina
• Cancer of the uterus, cervix, or ovaries
• Vaginal bleeding that persists despite treatment
• Chronic pelvic pain; surgery can be a last resort

Before having a hysterectomy, it is important to discuss other possible treatments with your health care provider. A hysterectomy will stop your periods, and you will no longer be able to get pregnant. If the surgery removes both ovaries, you will entermenopause.

A hysterectomy is medically necessary for many women in the treatment of uterine fibroids, cancer, abnormal bleeding and endometriosis. This procedure significantly impacts a woman’s physical and emotional well-being. It has long been associated with negative side effects, including hormonal imbalances and deterioration of sex drive, leading many women to refuse the procedure and live with excruciating pain. But, studies have shown that women do not have to fear a hysterectomy; in fact, many experience an improvement in their sex lives.

A 1999 study, published in the Journal of the American Medical Association, tracked the sexual function of more than 1,000 women between the ages of 35 and 49 who had had a hysterectomy. Ninety percent of the subjects had not yet entered menopause during the course of the study. The women were followed for two years after the procedure and the outcomes surprised researchers. According to the researchers at the University of Maryland Medical Center, where the study was conducted:

1. Sexual activity increased after hysterectomy

The number of women having sexual relations at least five times a month increased by 10 percent.

2. Orgasm frequency increased

After surgery, 72 percent said they were experiencing orgasms, compared to 63 percent before the surgery.

3. Orgasm strength improved

The number of women who said they had strong orgasms increased from 45 percent before the hysterectomy to 57 percent after surgery.

4. Sex

The proportion of women experiencing pain during sex dropped dramatically, from 40 percent before hysterectomy to 15 percent two years later. The lead researcher of the study was quick to point out that some of the subjects experienced a negative impact on their sexual health, but the vast majority saw improvements. One reported side effect is reduced orgasms, which some link to loss of the cervix. However, no research has proven that loss of the cervix affects stimulation. There is speculation that vaginal orgasms may be hampered, while orgasms from clitoral stimulation are not likely to be affected.

These results are not an endorsement of a hysterectomy as a sort of sex therapy. In fact, women should only consider a hysterectomy when all other options have been exhausted. Each year, 600,000 women undergo a hysterectomy and at least 10 to 15 percent of the procedures are unnecessary.

In some cases, women can avoid a hysterectomy through hormone therapy or banish the negative side effects if the surgery is not optional. An imbalance of estrogen, progesterone and even testosterone can lead to sexual impairment and other symptoms similar to those reported by menopausal women. These symptoms may be remedied safely and effectively through a comprehensive hormone therapy treatment plan for a specially trained physician.

A 2012 study uncovered evidence that a combination of bioidentical progesterone with bioidentical estrogen therapy provides the greatest improvements in sexual function for women experiencing symptoms of menopause, including increased lubrication, desire, arousal, orgasm and decreased pain during intercourse. And the best news is that hysterectomy patients tend to have the greatest responses to hormone therapy treatment

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Myomectomy (my-o-MEK-tuh-mee) is a surgical procedure to remove uterine fibroids — also called leiomyomas (lie-o-my-O-muhs). These are common noncancerous growths that appear in the uterus, usually during childbearing years, but they can occur at any age.

The surgeon's goal during myomectomy is to take out symptom-causing fibroids and reconstruct the uterus. Unlike hysterectomy, which removes your entire uterus, myomectomy removes only the fibroids and leaves your uterus intact.

Women who undergo myomectomy report improvement in fibroid symptoms, including heavy menstrual bleeding and pelvic pressure.

Why it's done?

Your doctor might recommend myomectomy for fibroids causing symptoms that are troublesome or interfere with your normal activities. If you need surgery, reasons to choose a myomectomy instead of a hysterectomy for uterine fibroids include:

• You plan to bear children
• Your doctor suspects uterine fibroids
• You want to keep your uterus

Here's what you can do to prepare:

1. Gather information. Before surgery, get all the information you need to feel confident about your decision to have a myomectomy. Ask your doctor and surgeon questions.

2. Follow instructions about food and medications. You'll need to stop eating or drinking anything in the hours before your surgery — follow your doctor's recommendations on the specific number of hours. If you're on medications, ask your doctor if you should change your usual medication routine in the days before surgery. Tell your doctor about any over-the-counter medications, vitamins or other dietary supplements that you're taking.

3. Discuss the type of anesthesia and pain medication you may receive. Abdominal, laparoscopic and robotic myomectomies are performed under general anesthesia, which means you're asleep during the surgery. Hysteroscopic myomectomy is performed under general anesthesia or spinal anesthesia, where medication is injected into your spinal canal to numb the nerves in the lower half of your body. Ask about pain medication and how it will likely be given.

4. Arrange for help. Your facility may require that you have someone accompany you on the day of surgery. Make sure you have someone lined up to help with transportation and to be supportive.

5. Plan for a hospital stay if necessary. Whether you stay in the hospital for just part of the day or overnight depends on the type of procedure you have. Abdominal (open) myomectomy usually requires a hospital stay of two to three days. In most cases, laparoscopic or robotic myomectomy only requires an overnight stay. Hysteroscopic myomectomy is often done with no overnight hospital stay.

What you can expect?

Depending on the size, number and location of your fibroids, your surgeon may choose one of three surgical approaches to myomectomy.

1. Abdominal myomectomy

In abdominal myomectomy (laparotomy), your surgeon makes an open abdominal incision to access your uterus and remove fibroids. Your surgeon enters the pelvic cavity through one of two incisions: A horizontal bikini-line incision that runs about an inch (about 2.5 centimeters) above your pubic bone. This incision follows your natural skin lines, so it usually results in a thinner scar and causes less pain than a vertical incision does. It may be only 3 to 4 inches (8 to 10 centimeters), but may be much longer. Because it limits the surgeon's access to your pelvic cavity, a bikini-line incision may not be appropriate if you have a large fibroid.

A vertical incision that starts in the middle of your abdomen and extends from just below your navel to just above your pubic bone. This gives your surgeon greater access to your uterus than a horizontal incision does and it reduces bleeding. It's rarely used, unless your uterus is so big that it extends up past your navel.

2. Laparoscopic or robotic myomectomy

In laparoscopic or robotic myomectomy, minimally invasive procedures, your surgeon accesses and removes fibroids through several small abdominal incisions.

During laparoscopic myomectomy, your surgeon makes a small incision in or near your bellybutton. Then he or she inserts a laparoscope — a narrow tube fitted with a camera — into your abdomen. Your surgeon performs the surgery with instruments inserted through other small incisions in your abdominal wall. During robotic myomectomy, instruments are inserted through similar small incisions, and the surgeon controls movement of instruments from a separate console.

The fibroid is cut into smaller pieces and removed through these small incisions in the abdominal wall or, rarely, through an incision in your vagina (colpotomy).

Laparoscopic and robotic surgery use smaller incisions than a laparotomy does. This means you may have less pain, lose less blood and return to normal activities more quickly than with a laparotomy. Uterine size and fibroid number and location are factors in determining when laparoscopic surgery is appropriate

3. Hysteroscopic myomectomy

To treat fibroids that bulge significantly into your uterine cavity (submucosal fibroids), your surgeon may suggest a hysteroscopic myomectomy. Your surgeon accesses and removes fibroids using instruments inserted through your vagina and cervix into your uterus.

Your surgeon inserts a small, lighted instrument — called a resectoscope because it cuts (resects) tissue using electricity or a laser beam — through your vagina and cervix and into your uterus. A clear liquid, usually a sterile salt solution, is inserted into your uterus to expand your uterine cavity and allow examination of the uterine walls. Using the resectoscope, your surgeon then shaves pieces from the fibroid until it aligns with the surface of your uterine cavity. The removed tissue washes out with the clear liquid that's used to expand your uterus during the procedure.

Rarely, surgeons also use a laparoscope inserted through a small incision in your abdomen to view the pelvic organs and monitor the outside of the uterus during a complicated hysteroscopic myomectomy.

When you go home?

At discharge from the hospital, your doctor prescribes oral pain medication, tells you how to care for yourself, and discusses restrictions on your diet and activities.

You may have to avoid certain activities, such as driving, lifting heavy objects, climbing stairs or exercising vigorously until you recover. Also, your doctor may advise that you not use tampons or have sexual intercourse during recovery. You can expect some vaginal spotting or staining for a few days up to six weeks, depending on the type of procedure you've had.

• Abdominal myomectomy recovery typically takes four to six weeks.
• Laparoscopic or robotic myomectomy recovery typically takes two to three weeks.
• Hysteroscopic myomectomy recovery typically takes less than a week.

Results

Outcomes from myomectomy may include:

Symptom relief. After myomectomy surgery, most women experience relief of bothersome signs and symptoms, such as excessive menstrual bleeding and pelvic pain and pressure.

Tiny tumors (seedlings) that your doctor doesn't detect during surgery could eventually grow and cause symptoms. New fibroids, which may or may not require treatment, also can develop. Women who had only one fibroid have a lower risk of needing to have treatment for additional fibroids — often termed the recurrence rate — than do women with multiple fibroids.

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What is Endometriosis?

Endometriosis (say "en-doh-mee-tree-OH-sus") is a problem many women have during their childbearing years. It means that a type of tissue that lines your uterus is also growing outside your uterus. This does not always cause symptoms. And it usually isn't dangerous. But it can cause pain and other problems.

The clumps of tissue that grow outside your uterus are called implants. They usually grow on the ovaries, the fallopian tubes, the outer wall of the uterus, the intestines, or other organs in the belly. In rare cases they spread to areas beyond the belly.

How does endometriosis cause problems?

Your uterus is lined with a type of tissue called endometrium (say "en-doh-MEE-tree-um"). Each month, your body releases hormones that cause the endometrium to thicken and get ready for an egg. If you get pregnant, the fertilized egg attaches to the endometrium and starts to grow. If you do not get pregnant, the endometrium breaks down, and your body sheds it as blood. This is your menstrual period. When you have endometriosis, the implants of tissue outside your uterus act just like the tissue lining your uterus. During your menstrual cycle, they get thicker, then break down and bleed. But the implants are outside your uterus, so the blood cannot flow out of your body. The implants can get irritated and painful. Sometimes they form scar tissue or fluid-filled sacs (cysts). Scar tissue may make it hard to get pregnant.

What causes endometriosis?

Experts don't know what causes endometrial tissue to grow outside your uterus. But they do know that the female hormone estrogen makes the problem worse. Women have high levels of estrogen during their childbearing years. It is during these years-usually from their teens into their 40s-that women have endometriosis. Estrogen levels drop when menstrual periods stop (menopause). Symptoms usually go away then.

What are the symptoms?

Some women with endometriosis don't have symptoms. Other women have symptoms that range from mild to severe. Symptoms may include:

1. Pain, which can be:

• Pelvic pain.
• Severe menstrual cramps.
• Low backache 1 or 2 days before the start of the menstrual period (or earlier).
• Pain during sexual intercourse.
• Rectal pain.
• Pain during bowel movements.

2. Abnormal bleeding. This can include:

• Blood in the urine or stool.
• Some vaginal bleeding before the start of the menstrual period.
• Vaginal bleeding after sex.

Symptoms are often most severe just before and during your menstrual period. They get better as your period is ending. Some women, especially teens, have pain all the time.

Several other conditions can cause symptoms that are similar to endometriosis. These conditions include painful periods,adenomyosis, and uterine fibroids.

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What is diagnostic laparoscopy?

Diagnostic laparoscopy is a surgical procedure doctors use to view a woman's reproductive organs. A laparoscope, a thin viewing tube similar to a telescope, is passed through a small incision (cut) in the abdomen. Using the laparoscope, the doctor can look directly at the outside of the uterus, ovaries, fallopian tubes, and nearby organs.

Laparoscopy is often recommended when other diagnostic tests, such as ultrasound and X-ray, cannot confirm the cause of a condition. Your doctor might use laparoscopy to:

• Find the cause of pain in the pelvic and abdominal regions
• Examine a tissue mass
• Confirm endometriosis or pelvic inflammatory disease
• Look for blockage of the fallopian tubes or for other causes of infertility

How is the procedure performed

The procedure is performed while you are lying down in a slightly tilted position, with your head lower than your feet. You will be given a general anesthetic to relax your muscles and prevent pain during surgery.

Next, a small incision is made near the navel. The laparoscope is inserted through this incision, and the abdomen is inflated to make the organs easier to view. The laparoscope might also be equipped with surgical devices for taking tissue samples or removing scar tissue.

A second incision might also be made at the pubic hairline. This incision provides an additional opening for instruments needed for completing minor surgical procedures.

After surgery, patients generally stay in a recovery room for about one hour. Patients are then taken to an outpatient surgery unit for continued observation.

You will be discharged after you receive instructions for your home recovery. In most cases, patients can leave the hospital about four hours after laparoscopy. Rarely a patient will need to stay overnight to aid recovery.

Patients are asked to return to their doctors for follow-up checkups within two to eight weeks. Please confirm your follow-up appointment before leaving the hospital.

Is laparoscopy safe?

Yes. Diagnostic laparoscopy is very safe. About three out of every 1,000 women who have laparoscopy have complications. Possible complications include injury to nearby organs, bleeding, or a problem related to the anesthesia. Discuss any concerns you have with your doctor.

Preparing for laparoscopy

Please follow these guidelines before coming to the hospital for your laparoscopy:

• DO NOT eat, drink (including water), or smoke after midnight prior to the day of surgery.
• Wear low-heeled shoes the day of surgery. You might be drowsy from the anesthesia and unsteady on your feet.
• Do not wear jewelry. (Wedding rings may be worn.)
• Wear loose-fitting clothing. You will have some abdominal tenderness and cramping after surgery.
• Remove nail polish prior to surgery.

Recovering at home

Don't drink alcohol or drive for at least 24 hours after surgery.

• You can bathe anytime after surgery.
• You may remove the bandage the morning after the surgery. Steri-strips, which resemble tape, can be removed two to three days after surgery.
• Patients can return to work three days after surgery. (If you need a doctor's letter excusing you from work, please request one at your pre-operative appointment.)
• Do not be concerned if your urine is green. A blue dye might have been used to check if your fallopian tubes are open.

Discomforts

• Your abdomen might be swollen for several days after the surgery. You may take Tylenol to relieve pain.
• You might have a sore throat for a few days. Try using a throat lozenge.
• You might have mild nausea. Try eating a light evening meal the day of surgery. Tea, soup, toast, gelatin, or crackers might help relieve nausea.
• Gas in the abdomen might cause discomfort in the neck, shoulders, and chest for 24 to 72 hours after surgery. Try taking a warm shower, using a heating pad, or walking.

Vaginal bleeding and menstruation

Vaginal bleeding up to one month after surgery is normal. Many women do not have their next normal menstrual cycle for four to six weeks after surgery. When your normal cycle returns, you might notice heavier bleeding and more discomfort than usual.

Wait two to three menstrual cycles before determining if laparoscopy has helped to relieve your condition.

Sexual activity

You can resume sexual activity one week after surgery. However, pregnancy can still occur during recovery. If you wish to prevent pregnancy, use a contraceptive.

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