Mini (Low-impact) Laparoscopy 

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Smaller, 3mm incisions on the abdomen offer virtually scarless surgery, leading to excellent cosmetic results and patient satisfaction as compared to conventional laparoscopy.

 

Using this technique requires advanced laparoscopic skills. We are proud to be one of the few units in the UK to offer this treatment option to our patients.

 

Accessing the abdominal cavity through 3mm ports has:

 

• the cosmetic benefit of significantly reduced skin scarring

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• reduced level of tissue damage

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• virtually no risk of port-site herniation 

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• lower risk of wound infection

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• faster recovery

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• reduction in pain scores

 

When is the microlaparoscopy used?

 

Microlaparoscopy can be used to help diagnose a wide range of conditions that develop inside the abdomen or pelvis. It can also be used to carry out surgical procedures, such as removing a damaged or diseased organ, or removing a tissue sample for further testing (biopsy).

 

Diagnosing and treating conditions

 

Laparoscopies are now widely used to diagnose many different conditions and investigate certain symptoms, for example:

 

• pelvic inflammatory disease (PID) – a bacterial infection of the female upper genital tract, including the womb, fallopian tubes and ovaries

 

• endometriosis – where small pieces of the womb lining (the endometrium) are found outside the womb

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• scar tissue (adhesions) - from previous infection or surgery

 

• ectopic pregnancy – a pregnancy that develops outside the womb

 

• ovarian cyst – a fluid-filled sac that develops on a woman's ovary

 

• fibroids – non-cancerous tumours that grow in or around the womb (uterus)

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• female subfertility investigations

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• appendicitis – a painful swelling of the appendix (a small pouch connected to the large intestine)

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• unexplained pelvic or abdominal pain

 

Safety

 

Mini-laparoscopy carries similar risks to the conventional laparoscopy.

 

Minor complications are estimated to occur in 1 or 2 out of every 100 cases following laparoscopy. They include:

• infection

• minor bleeding and bruising around the incision

• feeling sick and vomiting

 

Serious complications after laparoscopy are estimated to occur in 1 out of every 1,000 cases. They include:

• damage to an organ, such as your bowel or bladder, which could result in the loss of organ function; this may require further surgery to repair the problem

• damage to a major blood vessel

• conversion to an open operation (using a bigger cut, similar to a caesarean scar)

• complications arising from the use of carbon dioxide during the procedure, such as the gas bubbles entering your veins or arteries

• a serious allergic reaction to the general anaesthetic

• a blood clot developing in a vein, usually in one of the legs (deep vein thrombosis or DVT), which can break off and block the blood flow in one of the blood vessels in the lungs (pulmonary embolism)

 

How is a mini-laparoscopy carried out

 

Laparoscopy is performed under general anaesthetic, so you'll be unconscious during the procedure and have no memory of it. You can often go home on the same day.

 

Preparation

 

You will usually be asked not to eat or drink anything for 6 to 8 hours beforehand.

 

If you are taking blood-thinning medication (anticoagulants), such as aspirin or warfarin, you may be asked to stop taking it a few days beforehand. This is to prevent excessive bleeding during the operation.

 

If you smoke, you may be advised to stop during the lead-up to the operation. This is because smoking can delay healing after surgery and increase the risk of complications such as infection.

 

Most people can leave hospital either on the day of the procedure or the following day. Before the procedure, you'll need to arrange for someone to drive you home because you'll be advised not to drive for at least 24 hours afterwards.

 

The procedure

 

During mini-laparoscopy, the surgeon makes a small cut (incision) of around 3-5mm, usually near your belly button. 

 

A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate your tummy (abdomen). Inflating your abdomen allows the surgeon to see your organs more clearly and gives them more room to work. A laparoscope is then inserted through this tube. The laparoscope relays images to a television monitor in the operating theatre, giving the surgeon a clear view of the whole area.

 

Two to three auxiliary incisions, of 3mm each are then made your tummy to enable the insertion of the instruments. Small, surgical instruments can be inserted through these incisions, and the surgeon can guide them to the right place using the view from the laparoscope. Once in place, the instruments can be used to carry out the required treatment.

 

After the procedure, the carbon dioxide is let out of your abdomen, the incisions are closed using stitches and a dressing is applied.

 

When a laparoscopy is used to diagnose a condition, the procedure usually takes about half an hour. It will take longer if the surgeon is treating a condition, depending on the type of surgery being carried out.

 

Recovery

 

After a laparoscopy, you may feel groggy and disorientated as you recover from the effects of the anaesthetic. Some people feel sick or vomit. These are common side effects of the anaesthetic and should pass quickly.

 

You'll be monitored by a nurse for a few hours until you're fully awake and able to eat, drink and pass urine.

 

Before you leave the hospital, you'll be told how to keep your wounds clean and when to return for a follow-up appointment.

 

For a few days after the procedure, you're likely to feel some pain and discomfort where the incisions were made, and you may also have a sore throat if a breathing tube was used. You will be given painrelief to help ease the pain.

 

Some of the gas used to inflate your abdomen can remain inside your abdomen after the procedure, which can cause bloating, cramps and shoulder pain, as the gas can irritate your diaphragm (the muscle you use to breathe), which in turn can irritate nerve endings in your shoulders. These symptoms are nothing to worry about and should pass after a day or so, once your body has absorbed the remaining gas.

 

Recovery times

 

The time it takes to recover from a laparoscopy is different for everybody. It depends on factors such as the reason the procedure was carried out (whether it was used to diagnose or treat a condition), your general health and if any complications develop.

 

If you've had a laparoscopy to diagnose a condition, you'll probably be able to resume your normal activities within 5 days.

 

The recovery period after a laparoscopy to treat a condition depends on the type of treatment. After minor surgery, such as endometriosis removal, you may be able to resume normal activities within 2 weeks. Following major surgery, such as removal of your ovaries or the uterus, the recovery time may be as long as 6 weeks.

 

We will provide you with more information about when you'll be able to resume normal activities, depending on your operation.

 

 

When to seek medical advice

 

It's usually recommended that someone stays with you for the first 24 hours after surgery. This is in case you experience any symptoms that suggest a problem, such as:

 

• a high temperature of 38C or above

 

• chills

 

• severe or continuous vomiting

 

• increasing abdominal pain

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• redness, pain, swelling, bleeding or discharge around your wounds

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• abnormal vaginal discharge or vaginal bleeding

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• pain and swelling in one of your legs

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• a burning or stinging sensation when urinating

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If you experience any of these symptoms during your recovery, you should contact either your GP or NHS 111 for advice.