Gynecologic Laparoscopy

A gynecologic laparoscopy is a procedure for some tests and treatments. Small cuts (incisions) are made in the belly (abdomen). Then, a slime telescope (laparoscope) is used to see inside the body. Some conditions that may be found (detected) or treated are: 

• Endometriosis
• Ovarian cysts
• Ovarian torsion
• Other pelvic conditions

Before the Procedure

• The nurse will call you to ask you questions about your child's health.
• The nurse will tell you when to stop giving your child food and liquids, when to get to the hospital, and the time of the procedure.
• Do not eat gum, cough drops, or hard candy. If your child has been chewing gum, the procedure will be delayed 2 hours from the time it is spit out. If the gum has been swallowed, the procedure will be delayed up to 8 hours from the time it was swallowed.

During the procedure

•  Your child's surgeon will make an incision in the belly. A small tube (cannula) will fill the belly with gas.
• The surgeon will insert the laparoscope. They may make more incisions.
• For endometriosis, small pieces of tissue may be taken to test. This is called a biopsy. Scar tissue that is found may be removed. 
• For an ovarian cyst, the cyst will usually be removed.
• The incisions will be closed with stitches.

Diagnosis

Any tissue from the biopsy or a removed cyst will be tested. You will be contacted with the results. This may take up to 2 weeks.

Pain At Home

Your child may have pain after their procedure. Below are things that may help with pain. 

• They may be prescribed pain medicine. Follow the directions on the label or in the going-home (discharge) instructions. 
• Over-the-counter (OTC) pain medicine can be used by switching ibuprofen (Motrin) and acetaminophen (Tylenol) every 3 to 4 hours. For example, if your child takes ibuprofen at 10 a.m., they can take acetaminophen at 1 to 2 p.m., then take ibuprofen again at 4 to 6 p.m. Do this for at least the first 2 days after the procedure. After the first 2 days, keep using these medicines every 6 to 8 hours as needed.
• Shoulder pain or chest discomfort are common. Moving around, taking ibuprofen, and using heating pads can help.
• They may have a sore throat. This usually goes away within 24 to 48 hours. Gargling with salt water or using throat lozenges can help.

Incision Care

Your child's incisions need special care. Follow the directions below.

• Incisions will be closed with stitches that dissolve on their own. They will be covered with special glue or white bandage strips (Steri-Strips^®). The strips fall off on their own.
• If Ster-Strips are used, there may be a gauze and tape bandage (dressing) over the strips. It can be removed the day after the procedure. If glue is used, the incision is usually not covered by anything else.
• Your child cannot shower or bathe for 24 hours. After 24 hours, they need to let warm water and mild soap run over the incision. Then, rinse and gently pat dry. Do not rub the incision.
• Your child may have some bruising where the skin is stitched. This is normal.

Diet

Your child can eat and drink slowly. Avoid foods that cause an upset stomach, gas, or bloating. Offer plenty of fluids without caffeine if they feel nauseated.

Activity

After your child's procedure, they:

• Cannot drive a car or operate machinery if they're taking prescription pain medicine.
• Cannot lift anything over 10 pounds for at least 3 weeks.
• Should not use tampons, be sexually active, or put anything in their vagina until after their follow-up visit.
• Need to only do light activities. They should avoid intense sports or exercise until after their follow-up visit.
• May have vaginal bleeding. This is usually light and not a normal monthly period. Their next period may start earlier or later than it normally does. 
• Can return to normal activities when they feel ready. This is usually after about 1 week. 

Infection Signs and Symptoms

Early signs

• Skin is warm to the touch
• Redness
• Swelling

Later signs

• Thick, yellow drainage or discharge (pus) from the incision
• Fever over 100.4° Fahrenheit (F) or 38° Celsius (C)
• Vomiting or severe pain

When to Call the Doctor

Call your child's doctor or health care provider if they have:

• A fever over 100.4°F (38°C).
• Not been able to poop.
• A firm or full feeling in their belly.
• Pain that's not controlled by pain medicines.
• Any incision sites that become red or warm to the touch.
• Thick fluid, blood, or pus around any incision.
• An incision that becomes more tender, swollen, or pulls apart (separates).
• Not been able to eat or are vomiting. 
• Heavy vaginal bleeding, like using less than 1 pad each hour for more than 2 hours.

Follow-up

Your child will have a follow-up appointment within 2 to 4 weeks after the procedure. Call the office if you don't have one scheduled.

 Gynecologic Laparoscopy (PDF)

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