Keyhole (laparoscopic) surgery

If surgery has been suggested, it is natural to want to know what it actually involves. Keyhole surgery allows many gynaecological operations to be performed through very small incisions, which usually means less discomfort and a quicker return to normal life than open surgery.

What it involves

Laparoscopic surgery is performed under general anaesthetic. Several small incisions, usually less than a centimetre, are made in the abdomen. A camera is passed through one of them, and fine instruments through the others.

The abdomen is gently inflated with gas to create space to work. The surgeon operates while watching a magnified view on a screen, which allows a high degree of precision.

Operations commonly performed this way

A wide range of gynaecological surgery can be carried out laparoscopically:

• Total laparoscopic hysterectomy — removal of the womb
• Removal of ovarian cysts
• Removal of ovaries or fallopian tubes
• Treatment of endometriosis
• Division of adhesions (internal scar tissue)
• Diagnostic laparoscopy to investigate pelvic pain

Recovery

Recovery varies with the operation and the individual, but keyhole surgery generally allows a faster return to normal activity than open surgery. Many women go home the same day or the following day.

It is common to have shoulder tip discomfort for a day or two afterwards, caused by the gas used during the operation. This settles by itself. You will be given clear guidance on lifting, driving, exercise and returning to work before you go home.

Being properly informed

All surgery carries risks, and keyhole surgery is no exception. Occasionally an operation that begins laparoscopically needs to be converted to an open procedure, and this is discussed beforehand.

Before agreeing to any operation you should understand why it is being recommended, what the alternatives are — including not operating — and what the specific risks are for you. If anything is unclear, please ask again.