The most common uses for a gynecologic laparoscopy include hysterectomy, tubal ligation, and the removal of eggs for in vitro fertilization. The procedure may also be done to diagnose an ectopic pregnancy or endometriosis and for treatment of those conditions. Initially, gynecologic laparoscopy was used only for sterilization procedures such as tubal ligation, but it came to be used in place of open surgery for many procedures. Although only a small incision is made into a woman's body during a laparoscopy, the procedure still requires general anesthesia.
Gynecologic laparoscopy is commonly used to sterilize a woman who doesn't want to have any more children. Two small cuts are made in her abdomen. The doctor threads a small camera, or laparoscope, through one incision, and forceps are inserted into the other. The laparoscope allows the doctor to see what he is doing, even though the abdomen isn't fully open. During a tubal ligation, a woman's fallopian tubes may be clamped shut or sealed off.
A doctor may also use gynecologic laparoscopy to perform a hysterectomy, during which he removes a woman's uterus. During a laparoscopic hysterectomy, the doctor makes several incisions on a woman's abdomen. Using the laparoscope to see inside, he cuts the uterus into several smaller pieces so that it can be easily removed through the cuts. A doctor can also perform a laparoscopically aided vaginal hysterectomy. The laparoscopy is inserted into the abdomen to help the doctor see, but the uterus is pulled out through the vagina.
Another common use of gynecologic laparoscopy is as a diagnostic procedure. A doctor can thread the laparoscope into a woman's abdominal area to examine the organs. Laparoscopy can determine if a woman has an ectopic pregnancy, meaning the fetus is growing in a fallopian tube or other area outside of the uterus. It can also diagnose endometriosis, a condition that causes the uterine lining to grow in other areas of the body outside of the uterus. A doctor can also use laparoscopy to treat lesions from endometriosis or to remove an ectopic fetus.
Gynecologic laparoscopy has several advantages over traditional open surgery. It usually is less expensive, and a woman's recovery time is shorter, because she isn't completely cut open as she would be during a traditional surgery. Since the body isn't completely open, the procedure is generally considered safer as well.
There may be some pain and discomfort following laparoscopy. Some women may feel pain in their shoulder from nerve irritation. They may also need to urinate more frequently than normal for a few days, because the gas used in the procedure can put pressure on the bladder.