Last updated: 11/24/2009

Before undergoing laparoscopic surgery, the patient should be prepared by the doctor for the procedure both psychologically and physically. It is very important that the patient receive realistic counseling before surgery and prior to giving informed...

consent. This includes discussion about further open abdominal surgery (laparotomy) that may be required during laparoscopic surgery, information about potential complications during surgery, and the possible need for blood transfusions. In the case of diagnostic laparoscopy for chronic pelvic pain, the procedure may simply indicate that all organs are normal and the patient should be prepared for this possibility. The surgery may be explained using pictures, models, videotapes, and movies. It is especially important for the patient to be able to ask questions and express concerns. It may be helpful, for the patient to have a family member or friend present during discussions with the doctor. Such conversations could understandably cause anxiety, and information relayed may not be adequately recalled under such circumstances.

There is usually a presurgical exam two weeks before the surgery to gather a medical history and obtain blood and urine samples for laboratory testing. It is important that the patient inform the doctor completely about any prior surgeries, medical conditions, or medications taken on a regular basis, including such nonsteroidal anti-inflammatory drugs (NSAIDs) as aspirin. Patients taking blood thinners like Coumadin or Heparin (generic name: warfarin) should not adjust their medication themselves, but should speak with their prescribing doctors regarding
their upcoming surgery. (Patients should never adjust dosage without their doctors' approval. This is especially important for elderly patients, asthmatics, those with hypertension, or those who are on ACE inhibitors.) If a tubal dye study is planned during the procedure, the patient may also be required to provide information on menstrual history. For some procedures, an autologous (self) blood donation may be suggested prior to the surgery to replace blood that may be lost during the procedure. Chest x rays may also be required. For some obese patients, weight loss may be necessary prior to surgery.

Immediately before to surgery, there are several preoperative steps that the patient may be advised to take. The patient should shower at least 24 hours prior to the surgery, and gently but thoroughly cleanse the umbilicus (belly button) with antibacterial soap and water using a cotton-tipped swab. Because laparoscopy requires general anesthesia in most cases, the patient may be asked to eat lightly 24 hours prior to surgery and fast at least 12 hours prior to surgery. Bowel cleansing with a laxative may also required, allowing the it to be more easily visualized and to prevent complications in the unlikely event of bowel injury. Those who are have diabetes or have hypoglycemia may wish to schedule their procedures early in the morning to avoid low blood sugar reactions. The patient should follow the directions of the hospital staff, arriving early on the day of surgery to sign paperwork and to be screened by the anesthesiology staff. Questions will be asked regarding current medications and dosages, allergies to medication, previous experiences with anesthesia (that is, allergic reactions, and previous experiences regarding time-to-consciousness), and a variety of other questions. It is often helpful for the patient to make a list of this information beforehand so that the information can be easily retrieved when requested by the hospital staff.