Laparoscopy is a small operation to look inside your tummy (abdomen). Doctors use it to find out if cancer of the food pipe (oesophagus) has spread.
Your surgeon puts a thin tube with a light and a camera (laparoscope) through a small cut in your abdomen. They’ll check the area around the oesophagus and take tissue samples (biopsies).
You’re more likely to have a laparoscopy if the cancer is low down in your oesophagus, near where it joins the stomach. Or you could have it if the results of some of your other tests are unclear.
Before your laparoscopy
You usually have an appointment before your laparoscopy to check that you’re fit enough for the procedure. A nurse weighs you and takes your blood pressure, pulse and temperature.
You might also have:
- blood tests
- a heart trace (ECG)
- a chest x-ray
You can ask any questions you might have and sign the consent form.
Preparing for your laparoscopy
Tell your doctor if you’re taking medicine that changes how your blood clots. These medicines include:
- arthritis medicine
- direct acting oral anticoagulants (DAOCs) such as rivaroxaban
Your doctor tells you if you need to stop your medicines or change the dose before the laparoscopy.
You can’t eat for 6 hours before the operation. You might be able to have water for up to 2 hours beforehand. The hospital staff will give you instructions about this.
Tell your doctor if not eating could be a problem for you, for example if you have diabetes.
Your doctor will explain what they are going to do and you’ll sign a consent form. This is a good time to ask any questions you might have.
You usually have a laparoscopy as a day case, so you can go home later the same day.
You have the operation while you're asleep (under general anaesthetic). It takes about half an hour.
The surgeon usually makes 2 or 3 small cuts:
- one in or near your tummy button
- on one or both sides of your abdomen
They put gas (carbon dioxide) into your abdomen. This makes it easier for the surgeon to see your organs, including the liver, stomach and gallbladder.
Your surgeon puts a thin tube with a light and camera (laparoscope) through one of the cuts. They can see the pictures on a TV screen. They put surgical instruments through the other cuts.
They look for signs of cancer in the:
- lining of your abdomen
- surface layer of organs in your abdomen
They take samples of tissue (biopsies) and fluid to send to the laboratory to check for cancer cells.
Then your surgeon removes the tube and instruments. They close the small holes with stitches.
After the laparoscopy
You wake up in the recovery area and then go back to the ward. You might have fluids through a drip in the back of your hand or arm. Once you’re awake and drinking, your nurse takes the drip out. You should be able to eat and drink normally once you feel able to.
You might have some pain in your:
- abdomen for a few days
- shoulder for a day or two due to the gas in your abdomen
You usually have paper stitches over the wounds (Steri-Strips) or dissolvable stitches. You also have a waterproof dressing over them or a type of special skin glue.
You can soak off the dressing and paper stitches 5 days after your operation if they haven’t fallen off already.
Don’t drive for 24 hours after your general anaesthetic. Ask someone to drive you home from the hospital and stay with you overnight.
Most people won’t have problems from this type of operation. Your doctor makes sure the benefits of having it outweigh the risks, which include
- a wound infection – this is treated with antibiotics
- bleeding during or after surgery – you might need a blood transfusion or another operation
- a blood clot in your legs (deep vein thrombosis or DVT) – you get up shortly after your operation to reduce the risk of blood clots
- a small hole (perforation) in your bowel wall – this is extremely rare and is treated with antibiotics and fluids through a drip, or surgery to repair the hole
Your nurse will tell you what to look out for. They’ll also give you a number to contact if you have any problems.
When to contact your GP
Contact your GP or the hospital if you have
- a high temperature or feel unwell
- redness or swelling around your wound or it’s leaking fluid
- pain in your abdomen that is getting worse
- pain or swelling in one or both legs
Getting your results
You should get your results within 1 or 2 weeks. You normally get them at your next clinic appointment.
Waiting for test results can be worrying. You might have contact details for a specialist cancer nurse. You can get in touch with them for information and support if you need to. It may help to talk to a close friend or relative about how you feel.