Laparoscopy for ovarian cancer

Laparoscopy is a small operation to look inside your tummy (abdomen). Doctors use it to find out if ovarian cancer has spread. You usually have it as a day case so you can go home on the same day. 

What is a laparoscopy?

Your surgeon puts a thin tube with a light and a camera (laparoscope) through a small cut in your abdomen. They’ll check your ovaries and the surrounding area and take tissue samples (biopsies). They send these to the laboratory and a specialist doctor (pathologist) examines them. 

It is also possible to remove the ovaries during this procedure, rather than having an operation with a large cut in your tummy. If the surgeon removes your ovaries, they will send them to the laboratory. A pathologist examines them for signs of cancer.

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:

• aspirin
• clopidogrel
• arthritis medicines
• warfarin or heparin
• apixaban or 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.

What happens

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 might use an ultrasound probe during the laparoscopy to see deeper into tissues.

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.

The carbon dioxide gas may make you feel bloated and uncomfortable at first, but it will gradually disappear over a couple of days.

Getting your results

You should get your results within 1 or 2 weeks. 

Waiting for results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact the doctor who arranged the test if you haven’t heard anything after a couple of weeks.

You might have contact details for a specialist nurse who you can contact for information if you need to. It may help to talk to a close friend or relative about how you feel.

Possible risks

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
• fluid leaking from your wound
• pain or swelling in one or both legs
• pain in your abdomen that is getting worse