Laparoscopy (from Ancient Greek (lapara), meaning "flank, side", and (skope), meaning "to see") is an operation performed

ed in the abdomen or pelvis through small incisions (usually 0.51.5 cm) with the aid of a camera. It can either be used to inspect and diagnose a condition or to perform surgery. There are two types of laparoscope: (1) a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or (2) a digital laparoscope where the charge-coupled device is placed at the end of the laparoscope, eliminating the rod lens system. The laparoscope allows doctors to perform both minor and complex surgeries with a few small cuts in the abdomen. There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time. In gynecology, diagnostic laparoscopy may be used to inspect the outside of the uterus, ovaries and fallopian tubes, for example in the diagnosis female infertility. Usually, there is one incision near the navel and a second near to the pubic hairline. For gynecological diagnosis a special type of laparoscope can be used, called a fertiloscope. A fertiloscope is modified to make it suitable for trans-vaginal application. A dye test may be performed to detect any blockage in the reproductive tract, wherein a dark blue dye is passed up through the cervix and is followed with the laparoscope through its passage out into the fallopian tubes to the ovaries. Laparoscopy for an Ectopic Pregnancy: An Introduction Laparoscopy is a tool used for diagnosing and treating several different conditions by actually looking inside the body with a specialized camera. There are a number of different types of laparoscopic procedures, such as:
Laparoscopic appendectomy (removal of the appendix) Laparoscopic cholecystectomy (removal of the gallbladder) Laparoscopic gastric bypass.

This article will discuss laparoscopy for an ectopic pregnancy, which is a procedure used to look inside a women's abdomen (stomach) to help diagnose and treat a possible ectopic pregnancy. Laparoscopy offers many advantages over traditional surgery. With laparoscopy, people usually have shorter hospital stays and quicker recovery times because it is a simpler, less invasive procedure. Preparing for the Laparoscopy Laparoscopy for an ectopic pregnancy is usually performed on an outpatient basis, meaning you will go home the day of your surgery. Depending on your particular situation, you will be given specific instructions as to where and when to arrive at the medical facility, how to prepare for your surgery, and what to expect the day of and the days following your laparoscopy. Laparoscopy for an Ectopic Pregnancy: The Surgery As part of laparoscopy for an ectopic pregnancy, a small incision, or cut, will be made in or just below your navel. A tube, called a trocar, will then be inserted into your abdomen. The laparoscope will then be inserted. Through this, your doctor will view the inside of your abdomen on a video screen. The laparoscope can also take pictures and videotape the procedure. During the laparoscopy, your doctor will be looking for anything that appears abnormal, including an ectopic pregnancy.

Complications With Laparoscopy for an Ectopic Pregnancy No procedure is ever completely free of risk. However, laparoscopy has been performed for many years, with successful results and limited complications. Possible problems that can occur include but are not limited to:
Infection Bleeding Blood clots Nerve injury Remaining ectopic tissue Reactions to medication or anesthesia Other rare and unlikely events.

Final Thoughts Laparoscopy is an effective and safe alternative to open abdominal surgery for the treatment of ectopic pregnancy. It is associated with a shorter hospital stay and quicker recovery than open surgery, with similar results. As with all surgical procedures, there are risks and complications. However, overall, laparoscopy is a safe and well-proven procedure at diagnosing and treating gynecological problems. A Laparotomy is a surgical procedure involving a large incision through the abdominal wall to gain access into the abdominal cavity. It is also known as celiotomy. .the female reproductive organs (the uterus and ovaries) Abdominal exploration is surgery to examine the contents of the abdomen. Surgery that opens the abdomen is called a laparotomy. An abdominal exploration (laparotomy) is done while you are under general anesthesia, which means you are asleep and feel no pain during the procedure. The surgeon makes a cut into the abdomen and examines the abdominal organs. A biopsy can be taken during the procedure. Laparoscopy describes a group of procedures that are performed with a camera placed in the abdomen. If possible, laparoscopy will be done instead of abdominal exploration. Why the Procedure is Performed The abdomen contains many organs: Gallbladder Kidneys, ureters, and bladder Large intestine (colon) Liver Pancreas Small intestine (jejunum and ileum) Spleen Stomach Uterus, fallopian tubes, and ovaries (in women)

Some problems inside the abdomen can be easily diagnosed with imaging tests such as xrays and CT scans. However, many problems require surgery to get an accurate diagnosis. Abdominal exploration may be used to help diagnose and treat many diseases and health problems, including:

Cancer of the ovary, colon, pancreas, liver Endometriosis Gallstones Hole in the intestine (intestinal perforation) Inflammation of the appendix (acute appendicitis) Inflammation of an intestinal pocket (diverticulitis) Inflammation of the pancreas (acute or chronic pancreatitis)

Liver abscess Pockets of infection (retroperitoneal abscess, abdominal abscess, pelvic abscess) Pregnancy outside of the uterus (ectopic pregnancy) Scar tissue in the abdomen (adhesions)

Risks Risks of any anesthesia include the following: Severe medication reaction Problems breathing Risks of any surgery include the following: Bleeding Infection Additional risks include incisional hernia. After the Procedure The outcome from surgery depends upon the findings. Outlook (Prognosis) You should be able to start eating and drinking normally about 2 - 3 days after the surgery. How long you stay in the hospital depends on the severity of the problem. Complete recovery usually takes about 4 weeks. Alternative Names Laparotomy; Exploratory laparotomy Salpingectomy refers to the surgical removal of a Fallopian tube. Also called tubectomy. The procedure was first performed by Lawson Tait in 1883 in patients with a bleeding ectopic pregnancy; this procedure has since saved the lives of countless women. Other indications for a salpingectomy include infected tubes, (as in a hydrosalpinx) or as part of the surgical procedure for tubal cancer. A bilateral salpingectomy will lead to sterility, and was used for that purpose, however less invasive procedures have become available as tubal occlusion procedures. Salpingectomy has traditionally been done via a laparotomy; more recently however, laparoscopic salpingectomies have become more common as part of minimally invasive surgery. The tube is severed at the point where it enters the uterus and along its mesenteric edge with hemostatic control. Definition Salpingectomy is the removal of one or both of a woman's fallopian tubes, the tubes through which an egg travels from the ovary to the uterus. Purpose A salpingectomy may be performed for several different reasons. Removal of one tube (unilateral salpingectomy) is usually performed if the tube has become infected (a condition known as salpingitis). Salpingectomy is also used to treat an ectopic pregnancy, a condition in which a fertilized egg has implanted in the tube instead of inside the uterus. In most cases, the tube is removed only after drug treatments designed to save the structure have failed. (Women with one remaining fallopian tube are still able to get pregnant and carry a pregnancy to term.) The other alternative to salpingectomy is surgery to remove the fetus from the fallopian tube, followed by surgery to repair the tube. A bilateral salpingectomy (removal of both the tubes) is usually done if the ovaries and uterus are also going to be removed. If the fallopian tubes and the ovaries are both removed at the same time, this is called a salpingo-oophorectomy. A salpingooophorectomy is necessary when treating ovarian and endometrial cancer because the fallopian tubes and ovaries are the most common sites to which cancer may spread. Description

Regional or general anesthesia may be used. Often a laparoscope (a hollow tube with a light on one end) is used in this type of operation, which means that the incision can be much smaller and the recovery time much shorter. In this procedure, the surgeon makes a small incision just beneath the navel. The surgeon inserts a short hollow tube into the abdomen and, if necessary, pumps in carbon dioxide gas in order to move intestines out of the way and better view the organs. After a wider double tube is inserted on one side for the laparoscope, another small incision is made on the other side through which other instruments can be inserted. After the operation is completed, the tubes and instruments are withdrawn. The tiny incisions are sutured and there is very little scarring. In the case of a pelvic infection, the surgeon makes a horizontal (bikini) incision 4-6 in (1015 cm) long in the abdomen right above the pubic hairline. This allows the doctor to remove the scar tissue. (Alternatively, a surgeon may use a vertical incision from the pubic bone toward the navel, although this is less common.) Preparation The patient is given an injection an hour before surgery to encourage drowsiness. Aftercare Aftercare varies depending on whether the tube was removed by laparoscopy or through an abdominal incision. Even when major surgery is performed, most women are out of bed and walking around within three days. Within a month or two, a woman can slowly return to normal activities such as driving, exercising, and working. Risks All surgery, especially under general anesthesia, carries certain risks, such as the risk of scarring, hemorrhaging, infection, and reactions to the anesthesia. Pelvic surgery can also cause internal scarring which can lead to discomfort years afterward. Salpingo-oophorectomy Salpingectomy is commonly done as part of a procedure called a salpingo-oophorectomy, where one or both ovaries, as well as one or both Fallopian tubes, are removed in one operation (a Bilateral Salpingo-Oophorectomy (BSO) if both ovaries and Fallopian tubes are removed). If a BSO is combined with a hysterectomy, the procedure is commonly called a TAH-BSO: Total Abdominal Hysterectomy with a Bilateral Salpingo-Oophorectomy. Salpingostomy / Salpingotomy Salpingectomy is different from a salpingostomy and salpingotomy. The latter two terms are often used interchangeably and refer to creating an opening into the tube (e.g. to remove an ectopic pregnancy), but the tube itself is not removed.[1] Technically, the creation of a new tubal opening (os) by surgery would be a salpingostomy, while the incision into the tube to remove an ectopic is a salpingotomy.