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Advanced Gynecologic Surgery, Norwalk CT


What is laparoscopy?

Laparoscopy is a minimally invasive surgical procedure used to look inside the abdomen and pelvis. A small cut is made in the abdominal wall, usually at the belly button, and a thin, fiber-optic telescope attached to a light source and video camera is passed through into the abdomen. This telescope, called a laparoscope, can be used to look at abdominal organs, take tissue samples (biopsies) and remove abnormal tissue. The images picked up by the laparoscope are displayed on a television monitor so the surgeon can see what is happening in real-time.

Laparoscopy is usually performed when the patient is under general anesthesia (unconscious). However, it can be performed with other types of anesthesia that permit the patient to remain awake.

When is laparoscopy used?

You may need to have a laparoscopy to investigate symptoms such as pelvic or abdominal pain, or if an ultrasound or other imaging procedure has identified a problem in your abdomen or pelvis. Laparoscopy is also sometimes used to help surgeons see what they are doing during open surgery.

Dr. Garofalo uses laparoscopy for diagnosing or treating the following conditions:

  • Pelvic pain
  • Ectopic pregnancy (when an embryo becomes implanted in any tissue other than the uterine wall)
  • Myomectomy (removal of noncancerous fibrous growths from the uterus)
  • Endometriosis (a painful condition caused when uterine membrane tissue grows outside the uterus)
  • Ovarian cysts (abnormal, fluid filled cavities that form in or on the ovaries)
  • Removal of ovaries (for patients at high risk for ovarian cancer)
  • Hysterectomy (surgery to remove all or part of the uterus)
  • Pelvic organ prolapse (a condition which occurs when the pelvic organs slip out of place and push against the walls of the vagina)
  • Sterilization through salpingectomy

What risks are associated with laparoscopy?

When a laparoscopic approach fails to accomplish the surgical goal, a full abdominal incision may be made in order to allow traditional surgical access. Although this happens in only a few percent of cases, everyone undergoing laparoscopic surgery should be prepared for this possibility.

Certain women face an increased risk with any surgical procedure. These include women who smoke or use certain drugs, women who are overweight or in late-stage pregnancy or women who have pulmonary or cardiovascular diseases. If you think you may fall into any of these categories, be sure to discuss your surgical risks with Dr. Garofalo.

Although rare, bowel, urinary tract, and vascular injury may occur during laparoscopy (less than one percent of cases).

What is the recovery period following laparoscopy?

Laparoscopy usually results in relatively little pain and a quick recovery. Patients sometimes experience aches in the shoulders or chest following laparoscopy – this is from the carbon dioxide that is used to fill the abdominal cavity. Although prescription painkillers are usually prescribed, over-the-counter painkillers are usually adequate for pain relief after the first postoperative day.

Most patients are fully recovered and ready to return to full activity one week even after extensive laparoscopic procedures. As a general rule, you should feel better every day after the procedure.

After a laparoscopic procedure, you should follow these instructions:

  • Do not drive a car or operate hazardous machinery for at least 24 hours after the procedure, and not until you have discontinued the use of all pain medications.
  • Do not make important personal or business decisions for at least 24 hours after the procedure.
  • Abstain from alcoholic beverages for at least 24 hours after the procedure.
  • Eat light foods (jello, soups, etc.) as you can tolerate for the first six hours after the procedure and then advance to your usual diet as tolerated. Drink plenty of water and nonalcoholic beverages.
  • Use the prescribed pain medications as directed. Do not wait too long before taking pain medication, as this will make it more difficult for you to experience relief with the prescribed amount of medication. If you are not experiencing pain, you do not need to take pain medication.
  • If your bandages become stained or soaked with blood, you should change them as needed.
  • Do not immerse the incisions in water for 24 hours. Starting the day after the procedure, you can shower or bathe without the band-aids on.
  • Refrain from heavy lifting, heavy exercise, and sexual intercourse for two weeks.
  • A blue discoloration in the urine or around the vaginal tissues is normal for the first 48 hours after the operation.
  • Constipation is common after surgery and is usually caused by the use of pain medications. Use a stool softener or laxative if needed.
  • Call the office to schedule a follow-up office visit.

When should you call Dr. Garofalo?

When you leave the hospital you will receive personalized instructions about when to call Dr. Garofalo. Generally, you should feel better every day after a laparoscopy.  You should call Dr. Garofalo if you experience persistent nausea or vomiting, fever greater than 100.5, increasing abdominal pain, or increasing redness or pus around the incision sites.