Initially the woman undergoes a general anesthesia. Then the laparoscopy starts after a small incision is performed about an inch below the navel. Through this incision a thin needle is passed through, which inflates the abdomen with a suitable gas (carbon dioxide). Approximately 2 to 3 liters of this gas is inflated in the abdomen before the walls of the abdomen are adequetly distended. After the introduction of the gas, the abdomen is “blow-up” like a “balloon” so the internal organs become distant from the abdominal walls. This procedure decreases the possibility of damage to some internal organ by the insertion of a thin tube through which the laparoscope will pass. The laparoscope consists of a thin diameter tube 5 or 10 mm that contains a series of lenses and at one end applies a small camera.
When the laparoscope is inserted, the surgeon has the opportunity to examine the pelvic organs via a television monitor where the image is transferred through a small camera applied onto it. With laparoscopy, the doctor is able to see in detail all the organs located in the pelvis, including the uterus, the uterine ligaments, the fallopian tubes, the ovaries, the bladder, the peritoneum covering the pelvic organs. In addtion the liver and also the small and large intestine are visualised. After the laparoscopy, the gas originally introduced into the abdomen, is released and the abdominal wall returns to its normal size.
Laparoscopy except for diagnostic purposes, can be used for the performance of a laparoscopic surgery. In this case, while the belly is dilated after the introduction of gas, 2 or 3 thin tubes may enter the lower abdomen. Through these tubes, the surgeon may insert some surgical instruments (such as laparoscopic scissors, forceps and diathermy) and perform the appropriate operation.