Laparoscopy
What is laparoscopy ?
A laparoscopy is a minimally invasive surgical procedure, often referred to as keyhole surgery, that allows your specialist to examine the organs inside the abdomen and pelvis.
The procedure is performed using a thin camera called a laparoscope, which is inserted through a small incision near the umbilicus (belly button). Additional small incisions may be made if treatment is required.
Laparoscopy may be performed to investigate symptoms, confirm a diagnosis or treat a range of gynaecological conditions during the same operation.
Why might I need a laparoscopy?
A laparoscopy may be recommended to investigate or treat conditions affecting the pelvis.
Common reasons include:
- persistent pelvic pain
- painful or heavy menstrual periods
- suspected endometriosis
- pelvic adhesions (scar tissue)
- ovarian cysts or other pelvic masses
- assessment of infertility.
Depending on the findings, treatment can often be carried out during the same procedure. This may include removal of ovarian cysts, treatment of endometriosis or division of adhesions.
Your specialist will explain why laparoscopy has been recommended and what is planned in your individual case.
What are the alternatives?
In some situations, similar surgery can be performed through a larger abdominal incision, known as a laparotomy.
A laparotomy is generally associated with:
- a larger incision
- a longer hospital stay
- increased discomfort after surgery
- a longer recovery period.
However, for some conditions, open surgery remains the safest and most appropriate option. Your specialist will discuss this with you if relevant.
How is a laparoscopy performed?
A laparoscopy is performed under a general anaesthetic.
Once you are asleep:
- an examination is performed
- instruments may be placed into the vagina or rectum if required
- a small incision is made in or just below the umbilicus
- the abdomen is gently inflated with carbon dioxide gas to create space
- the laparoscope is inserted to examine the pelvic and abdominal organs
- additional small incisions may be made if treatment is required.
At the end of the procedure, the instruments are removed and the small incisions are closed with sutures.
The operation usually takes around 30 minutes or longer, depending on the complexity of the procedure. Your total time in theatre and recovery will be several hours.
What should I do before the procedure?
Before your laparoscopy:
- complete any investigations arranged during your pre-operative consultation
- continue your regular medications unless advised otherwise
- stop smoking if possible, as this reduces the risk of complications
- contact your specialist if you become unwell before your surgery.
Bowel preparation
Some laparoscopic procedures require bowel preparation.
If this is recommended, you should:
- consume only clear fluids during the 24 hours before surgery
- take the prescribed bowel preparation exactly as directed.
Your specialist will let you know if bowel preparation is required for your procedure.
What should I do on the day of the procedure?
Unless advised otherwise, you should stop eating and drinking:
- from midnight before a morning procedure, or
- from 6.00 am before an afternoon procedure.
Your hospital will provide specific fasting instructions before surgery.
What should I bring?
Please bring:
- your usual medications
- any recent scans or imaging
- toiletries
- comfortable clothing
- underwear
- sanitary pads.
What should I expect after the procedure?
After the procedure, you will recover in the recovery area before returning to the ward.
Many laparoscopic procedures are performed as day surgery, although some people may require an overnight stay depending on the complexity of the operation.
It is normal to experience:
- mild abdominal discomfort
- bloating
- shoulder tip pain caused by the gas used during surgery
- light vaginal bleeding.
If required, your specialist will prescribe pain relief. Otherwise, simple pain medication is often sufficient.
After you go home
You should:
- eat and drink normally
- remain gently active
- use sanitary pads rather than tampons if required
- shower as normal
- remove dressings after 24 hours unless instructed otherwise
- gently wash the wounds with soap and water.
For a short period after surgery, you should avoid:
- sexual intercourse for approximately two weeks
- heavy lifting or strenuous exercise for one week
- driving until you can safely perform an emergency stop and are no longer taking strong pain medication
- unsupervised activities on the day of surgery because of the anaesthetic.
Most people return to work within a few days, although recovery varies depending on the procedure performed.
Dissolvable sutures are commonly used and usually do not require removal.
What are the risks?
Every surgical procedure carries some risk, although serious complications following laparoscopy are uncommon.
Anaesthetic risks
As with any procedure performed under general anaesthesia, there is a small risk of complications related to the anaesthetic.
Surgical risks
Potential surgical complications include:
- injury to the bladder
- injury to the ureters (the tubes connecting the kidneys to the bladder)
- bowel injury
- injury to major blood vessels
- bleeding requiring blood transfusion or further surgery
- conversion from keyhole surgery to an open operation (laparotomy) if this is the safest option.
Recovery-related risks
Potential complications during recovery include:
- wound infection
- infection involving the bladder, abdomen or lungs
- blood clots affecting the legs or lungs
- delayed wound healing
- variable postoperative pain
- nausea or vomiting requiring overnight observation.
Your specialist will discuss any risks that are particularly relevant to your individual circumstances before surgery.
What if I have any problems?
Contact your healthcare provider promptly if you experience:
- fever or feel generally unwell
- increasing redness, swelling or discharge from your wounds
- offensive-smelling vaginal discharge
- heavy vaginal bleeding
- persistent nausea or vomiting
- difficulty emptying your bladder or bowels
- severe abdominal pain.
What can I expect?
Laparoscopy is one of the most commonly performed gynaecological operations and has largely replaced open surgery for many conditions.
Because only small incisions are required, most people experience less pain, a shorter hospital stay and a quicker recovery than with traditional open surgery.
Your specialist will discuss the findings with you after the procedure and explain whether any treatment was performed during the operation.
What to remember
Laparoscopy allows your specialist to both diagnose and treat many gynaecological conditions through minimally invasive surgery.
Although every operation carries some risk, laparoscopy is generally associated with a quicker recovery than open surgery and often allows treatment to be completed during the same procedure.
Further information
Additional information about laparoscopic surgery is available through the Australasian Gynaecological Endoscopy & Surgery Society (AGES).
This article is intended for educational purposes only and should not replace personalised medical advice, diagnosis or treatment. Every article is written by a qualified specialist clinician and independently reviewed by a second specialist clinician to help ensure clinical accuracy and reflect current evidence-based practice.
