Laparoscopy (Key Hole Surgery)

Laparoscopy, commonly known as keyhole surgery, is a minimally invasive surgical technique used to examine and treat conditions affecting the abdomen and pelvis.

During a laparoscopy procedure, a thin surgical telescope called a laparoscope is inserted through a small incision, usually near the belly button. This allows your gynaecologist to view the pelvic organs and, when necessary, perform surgery using specialised instruments inserted through additional small incisions.

Gynaecological laparoscopic surgery may be recommended to investigate symptoms such as persistent pelvic pain or to diagnose and treat conditions including endometriosis, ovarian cysts and fibroids.

A laparoscopy can be used for both diagnosis and treatment. Your gynaecologist may recommend the procedure when symptoms or previous investigations suggest a condition that requires further assessment or surgical treatment.

Depending on your individual circumstances, laparoscopy may be used for:

• investigating persistent or unexplained pelvic pain
• diagnosing and treating endometriosis
• assessing or treating ovarian cysts
• removing fibroids
• investigating some causes of infertility
• removing an ovary or fallopian tube
• performing some types of hysterectomy.

The reason for recommending surgery will depend on your symptoms, medical history, previous investigations and treatment goals.

A laparoscopy procedure is usually performed under general anaesthetic, meaning you will be asleep during the surgery.

A small incision is typically made near the belly button, and carbon dioxide gas is used to gently inflate the abdomen. This creates space for your surgeon to clearly see the pelvic organs.

A laparoscope containing a light and camera is then inserted through the incision. Additional small incisions may be made so specialised surgical instruments can be used if treatment is required.

Once the procedure is complete, the instruments are removed, the gas is released and the small incisions are closed.

One of the main benefits of laparoscopic surgery is that it uses smaller incisions than traditional open abdominal surgery.

Depending on the procedure, potential benefits can include:

• less pain after surgery
• smaller scars
• a shorter hospital stay
• faster recovery
• an earlier return to normal activities.

In some cases, laparoscopy also allows your gynaecologist to diagnose and treat a condition during the same procedure.

However, keyhole surgery is not appropriate for every patient or every condition. Your gynaecologist will discuss whether it is the most suitable surgical approach for you.

Yes. Laparoscopy for endometriosis can be used to examine the pelvis and identify areas of suspected endometriosis. Where appropriate, endometriosis may also be surgically treated during the procedure.

Whether surgery is recommended depends on factors including your symptoms, previous treatments, fertility plans and the suspected extent of the condition.

If you are experiencing pelvic pain or symptoms that may be associated with endometriosis, an assessment with your gynaecologist can help determine whether further investigation or treatment is appropriate.

Laparoscopy for pelvic pain may be considered when a gynaecological condition such as endometriosis, ovarian cysts or adhesions is suspected.

However, chronic pelvic pain can have many possible causes, and not all causes can be identified or treated through surgery. Your gynaecologist will usually consider your symptoms, examination findings and previous investigations before recommending a laparoscopy.

In some cases, other investigations or treatments may be more appropriate before considering surgery.

As with any operation, there are potential risks of laparoscopy. Most procedures are completed without serious complications, but it is important to understand the possible risks before deciding whether surgery is right for you.

Potential complications can include:

• bleeding
• infection
• blood clots
• complications associated with anaesthesia
• damage to nearby organs, nerves or blood vessels
• the need to convert to open surgery in some circumstances.

Your individual risk will depend on factors such as the type and complexity of surgery, your medical history and your general health.

Your gynaecologist will explain the specific benefits and risks of your procedure so you can make an informed decision about your care.

Laparoscopy scars are generally smaller than those associated with open abdominal surgery because the procedure uses several small incisions rather than one larger incision.

Incisions are commonly made around the belly button and lower abdomen, although their number and location depend on the procedure being performed.

Scars typically change and fade as they heal, but the appearance of scars varies between individuals.

Laparoscopy recovery varies depending on whether the procedure was performed for diagnosis or treatment and the complexity of the surgery.

After surgery, you may experience discomfort around the incisions, abdominal bloating or shoulder pain caused by the carbon dioxide gas used during the procedure. These symptoms generally improve as you recover.

Some patients can return home on the same day, while more complex gynaecological laparoscopic surgery may require a hospital stay.

Before you leave the hospital, you will receive individual advice about caring for your wounds, managing pain, returning to work, driving, exercise and other normal activities.

If you’re weighing up whether a laparoscopy is the right option for you, get in touch with your gynaecologist to talk through your situation in detail. They can walk you through the benefits and risks specific to you, what the procedure involves, and what recovery looks like, so you can make an informed decision with confidence.