During the Procedure

With laparoscopy, tiny fiber-optic instruments are inserted into the body through small surgical openings (thus the name "keyhole"). A person may have three or more small incisions. A video camera is inserted into one opening, which guides the surgeon who is manipulating the instruments in the other two openings. On the ends of these instruments are such devices as scissors, surgical staplers, scalpels, and sutures (stitches). Abdominal laparoscopy involves the following steps:

• Once the patient is asleep, the surgeon makes a small cut near or at the navel and inserts a thin, hollow tube called a trocar. The tube extends from inside the abdomen to the outside.



• Carbon dioxide gas is injected into the abdomen to expand it and allow the doctor more room to view the organs.



• The laparoscope, a medical instrument with a high-intensity light and very tiny camera, is inserted into the abdomen through the trocar. The surgeon views a large image from the camera on a TV screen in the operating room.



• Other instruments are inserted into small incisions. The surgeon manipulates these to perform the procedure, whether it is removing an organ, taking a sample of tissue, or repairing an organ.



• When the surgery is finished, the surgeon removes the instruments.



• The incisions are stitched closed, and bandages are placed over them. Very small incisions may not require stitches, just small strips of sterile tape.

The patient is asleep and feels nothing during the procedure.