McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
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What is a therapeutic laparoscopy?

A therapeutic laparoscopy is a procedure in which the doctor uses a laparoscope and a thin tube with a cutting instrument to remove a cyst from your ovaries. A laparoscope is a thin metal tube with a light and tiny camera.

When is it used?

This operation may be performed because you have a cyst on or in one of your ovaries, the organs that make and store eggs. The cyst may be premalignant, which means it can develop into cancer. If it grows too large, it may rupture or twist and stop the ovary's blood flow, causing severe abdominal pain.

Examples of alternatives are:

• having abdominal surgery
• choosing not to have treatment.

You should ask your doctor about these choices.

How do I prepare for a therapeutic 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 with a needle through the navel. 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 the laparoscope through this cut, and puts another tool through a second small cut in the lower abdomen. The laparoscope is used to guide the other instrument to the ovary. The doctor removes the cyst from your ovary by using a laser, electrocautery, clips, sutures, or microscissors. The cyst may be large or connected to so much of the ovary that the doctor may have to remove the whole ovary. The doctor then inspects the other ovary for cysts. He or she also looks at the rest of the pelvic and abdominal cavity for any abnormalities.

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?

The cysts can be removed without abdominal surgery, which would involve a longer hospital stay and recovery time, and greater discomfort and expense.

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.
• Sterilization can occur if both ovaries are damaged.
• 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 become dizzy and faint.
• You experience nausea and vomiting.
• You become suddenly 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.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.