Laparoscopy for Peritoneal Fluid

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What is a laparoscopy?

A laparoscopy is a way to look at the organs inside your belly. A tool called a laparoscope is used to look at the organs. A laparoscope is a thin tube with a light and tiny camera. It is placed through a very small incision (cut), usually in the belly button. The camera shows a view of the abdominal organs on a TV monitor.

When is it used?

Your peritoneal cavity contains fluid that should not be there. The peritoneal cavity is the space that holds your abdominal and pelvic organs. Your healthcare provider may do this procedure to better understand what is causing the fluid and what should be done about it.

Some examples of alternatives to this procedure are:

• having open abdominal surgery (making a larger cut in your belly)
• having an ultrasound, which is a scan with high-frequency sound waves that shows a picture of the inside of your abdomen on a screen
• having a CT scan of the abdomen, which is an X-ray scan of your abdomen
• removing some of the fluid with a needle for examination in the lab
• choosing not to have the procedure, recognizing the risks of not having the information it might provide.

You should ask your healthcare provider about these choices.

How do I prepare for a laparoscopy?

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

Follow your 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.

If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your healthcare provider if you need to stop taking it before the procedure.

Follow any other instructions provided by your healthcare provider. 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, puts you to sleep, and keeps you from feeling pain.

Your provider makes a small cut (incision) in or just below your bellybutton. Your peritoneal cavity is inflated with carbon dioxide gas. This expands it like a balloon and helps your healthcare provider see your organs. Your provider then puts a laparoscope through the cut. Your provider may put other tools through other small cuts in your abdomen. The laparoscope is used to look at the abdominal organs and tissues and to guide other tools.

A sample of abdominal fluid may be obtained and sent to the lab for tests. If your provider finds a growth that should not be there, he or she may take a sample of the growth for lab tests. If a growth is found, you may need to have a larger incision (open abdominal surgery). Talk to your provider about this possibility,

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. You may stay longer if an open procedure is necessary. The anesthetic may cause sleepiness or grogginess for a while. You may feel bloated or have a change in bowel habits for a few days. You may have some shoulder pain from the carbon dioxide gas used to inflate your peritoneal cavity. You may not be able to urinate right away and may have a catheter placed into your bladder to drain urine. A catheter is a small tube that can be placed into the bladder through the urethra, which is the passageway from the bladder to the outside.

You may need to avoid heavy activity such as lifting for 3 to 6 weeks. Ask your healthcare provider when you can start lifting again and how much you can lift.

Your healthcare provider will discuss with you what was found, what was done, and if anything else is needed. You should ask your provider what other steps you should take, and when you should come back for a checkup.

What are the benefits of this procedure?

This procedure may help your healthcare provider make a more accurate diagnosis and determine the best treatment.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• The intestines, other 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.
• Fluid may continue to leak from the small cuts in your abdomen.
• You may develop an infection or bleeding.
• You may have some pain after the procedure.

You should 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 small cuts in your abdomen.
• 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.

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