Diagnostic Laparoscopy for Adnexal Masses

What is a diagnostic laparoscopy?

A diagnostic laparoscopy is a procedure in which the doctor uses a laparoscope to observe your ovaries and fallopian tubes for tissue growths. A laparoscope is a thin metal tube with a light and tiny camera. The ovaries are the organs that make and store eggs. The fallopian tubes bring eggs to the uterus. The area in the pelvis where the ovaries and fallopian tubes are located is called the adnexal area.

When is it used?

This operation may be performed because you have pain in the pelvic area. Adnexal masses are growths in the ovaries or tubes.

Diagnostic laparoscopy is always preceded by a pelvic exam and usually radiological procedures such as ultrasound or CT scans.

As an alternative you could choose not to have treatment. You should ask your doctor about your choices.

How do I prepare for a diagnostic laparoscopy?

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

Follow instructions provided by your doctor. 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 a general anesthetic, which relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

Your peritoneal cavity will be inflated with carbon dioxide gas. This will expand your peritoneal cavity like a balloon and help the doctor see your organs. The doctor 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. The laparoscope is guided to look at the ovaries and tubes. If the doctor finds a growth that should not be there, the other instrument may be used to take a sample of the growth or remove it. The sample is sent to the lab for analysis.

What happens after the procedure?

You may stay in the hospital several hours or overnight to recover. The anesthetic may cause a little sleepiness or grogginess for a while. You may have some shoulder pain, feel bloated, or find 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) for a few days. You should avoid heavy activity such as lifting. You should ask your doctor how much you should lift.

Ask your doctor what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

This minor surgical procedure may help the doctor make a more accurate diagnosis. Certain problems may be treated surgically at the time of laparoscopy. Many times the mass can be removed through the laparoscope, so a more extensive operation, with several days in the hospital, is avoided.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• The abdominal organs, glands, intestines, or blood vessels may be damaged. The doctor may perform 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 develop an infection or bleeding.
• There may be some pain after the procedure.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.
• You develop chest pains.
• You experience nausea and vomiting.
• You become short of breath.
• You have abdominal pain or swelling that gets worse.

Call the doctor during office hours if:

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