Laparoscopy for Removal of Fibroid Tumor

What is a laparoscopy?

A laparoscopy is a procedure in which your healthcare provider uses a laparoscope to help treat a problem with organs or tissue inside your abdomen. A laparoscope is a long, thin tube with a light and tiny camera.

When is it used?

This operation may be done because you have a fibroid tumor that needs to be removed from the uterus. Your provider can look at the uterus through the laparoscope and use another thin tube with a cutting instrument to remove the tumor if it is not too large.

A fibroid tumor is a growth of tissue that is usually noncancerous. It can become large enough to press on your bladder or rectum or fill up the abdominal cavity. The uterus is the muscular organ at the top of the vagina. Babies develop in the uterus, and menstrual blood comes from the uterus.

Examples of alternatives to this procedure are:

• shrinking the tumor with the hormone Lupron
• having more extensive abdominal surgery
• having a procedure called uterine artery embolization
• having a hysterectomy
• choosing not to have treatment.

Ask your healthcare provider about these choices.

How do I prepare for a laparoscopy?

Plan for your care and recovery after the operation. Allow for time to rest. Try to find other people to help you with your day-to-day duties.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

Follow any other instructions your provider gives you. If you are to have general anesthesia, 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 either a local anesthetic and sedative or a general anesthetic to prevent pain.

Your abdominal cavity is inflated with carbon dioxide gas. This helps your healthcare provider see your organs. Your provider makes a small cut in or just below your bellybutton, puts a laparoscope through this cut, and puts another tool through a second small cut in the lower abdomen to move organs around in order to better see the female organs. The laparoscope is used to look at the abdominal and pelvic organs and to guide the other tool to the uterus and locate the tumor. Your provider removes the tumor with a laser, electric current, or scissors.

When finished, your provider releases most of the gas through the tube of the laparoscope, removes the scope and any other tools, and sews up the cuts.

What happens after the procedure?

You may stay in the hospital several hours or overnight to recover. The anesthetic may cause sleepiness or grogginess for a while. You may have some shoulder pain, feel bloated, or have 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).

You should avoid heavy activity such as lifting. Ask your healthcare provider how much you can lift, what other steps you should take, and when you should come back for a checkup.

What are the benefits of this procedure?

The tumor can be removed with less pain, and without more expensive and extensive surgery. Your stay at the hospital and the time needed to recover will be shorter. You are less likely to develop a type of scar tissue called adhesions in the abdomen or pelvis, and other complications related to major surgery. You will also have smaller incisions.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your provider.
• The abdominal organs, glands, or blood vessels may be damaged. You may need 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.
• You may become unable to get pregnant if both ovaries are damaged.
• You may have infection or bleeding.
• You may have some pain after the procedure.

Ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever over 100°F (37.8°C).
• You have redness, swelling, pain, or drainage from the incisions.
• You become dizzy and faint.
• You have chest pain.
• You have nausea and vomiting.
• You become short of breath.
• You have abdominal pain or swelling that gets worse.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.