Laparoscopy is keyhole surgery. A thin camera passed through a small cut near the belly button lets the surgeon see the womb, tubes and ovaries on a screen. It can confirm conditions such as endometriosis and often treat them in the same operation.
What it is
A laparoscope is a long, thin, lighted telescope. Carbon dioxide gas gently inflates the abdomen, lifting the wall away from the organs so the surgeon can see clearly and work more safely.
MedlinePlus describes the laparoscope as like a small telescope with a light and video camera. It goes in through a cut of about half an inch (1.25 cm) below the belly button, while other instruments pass through further small cuts.
| Type | Typical length (Cleveland Clinic) |
|---|---|
| Diagnostic laparoscopy | 30 minutes to 1 hour |
| Laparoscopic surgery | 1 to 3 hours |
Diagnosis and treatment can often be done in the same operation, so problems found can be treated straight away.
Who it's for
- Suspected endometriosis, especially with painful periods or pain during sex.
- Ovarian cysts that need removing.
- Scar tissue (adhesions) or suspected blocked or damaged fallopian tubes.
- Ectopic pregnancy, and some fibroids in selected cases.
Laparoscopy is often considered when symptoms or other tests point to a problem that needs a direct look. ASRM lists endometriosis, ovarian cysts, adhesions, fibroids and blocked tubes among the conditions it can diagnose, and many can be treated in the same operation.
MedlinePlus also lists chronic pelvic pain and checking an abnormal pelvic mass or ovarian cyst found on ultrasound.
Step by step
- AnaestheticYou are given a general anaesthetic so you sleep and feel no pain.
- First cutA small cut, usually under an inch, is made at or near the belly button.
- GasCarbon dioxide gently inflates the abdomen to create space.
- LookThe camera shows the womb, tubes and ovaries on a monitor. Dye may be passed through the cervix to check the tubes are open.
- TreatThrough extra small cuts, instruments can remove endometriosis, cysts or adhesions, or open a tube.
- Close and recoverThe gas is let out, the cuts are closed and you wake in the recovery area.
ASRM notes fertility laparoscopy is often scheduled soon after a period. Cleveland Clinic says up to three more small cuts may be made for instruments, besides the one near the belly button.
What it feels like
You will be sleepy at first and sore around the cuts. Leftover gas often causes discomfort in the shoulders, chest or abdomen; this is common and settles.
Shoulder pain is common. MedlinePlus explains the gas irritates the diaphragm; it fades over several days as the gas is absorbed, and lying down can help.
- ASRM: normal activities can usually resume within a few days; about 3 to 7 days after operative procedures.
- NHS: up to 10 days after a diagnostic laparoscopy; up to 3 weeks before returning to work after surgery.
- Larger operations can take longer; NHS notes 6 to 8 weeks for full recovery after some surgery.
- Small dressings cover the cuts; your team will explain wound care and when stitches dissolve or are removed.
Cleveland Clinic notes you are usually watched in recovery for about an hour, many people return to work around three days after surgery, and exercise can often resume after about a week.
MedlinePlus says most people go home the same day and return to normal activities within 1 to 2 days, but should avoid lifting more than about 10 pounds (4.5 kg) for 3 weeks.
How to prepare
- Fast as instructed, often from midnight before surgery.
- Tell your doctor about all medicines; some may need stopping.
- Wear loose clothing and arrange someone to take you home.
- Don't smoke in the run-up to surgery.
- Don't drive yourself home after the anaesthetic.
- Ask whether to stop blood-thinning medicines, and when.
- Tell the team if you have a cold, fever or other illness before surgery.
- Plan rest at home and help with lifting for the first weeks.
Ask your surgeon what is planned, how many cuts to expect, and when you can return to work, exercise and trying to conceive.
Risks and side effects
ASRM reports complications in 1 or 2 of every 100 women. The most common is a bladder infection. Others include bruising, infection, damage to the bowel, bladder or blood vessels, and blood clots. The risk of death is about 3 in 100,000.
| After surgery | What to do |
|---|---|
| Shoulder or neck pain | Common; lie down, it settles in days |
| Sore cuts | Follow wound care and pain relief advice |
| Vaginal bleeding, fever or vomiting | Contact your doctor |
| Severe abdominal pain | Seek urgent care |
Get urgent help for fever, worsening pain, redness or discharge from a wound, vomiting, or pain or swelling in a leg.
Adhesions can form after any pelvic surgery, but ASRM notes they are less likely after laparoscopy than after open surgery.
How DBN does it
At DBN, laparoscopy costs approximately 80,000 to 150,000 THB, with recovery of about 1 to 2 weeks. The first consultation is free and the price is confirmed at consultation.
Ask at your consultation whether laparoscopy is recommended for you, and what the surgery is expected to include.
When to see a doctor
- Periods so painful they stop daily life.
- Pain during or after sex.
- An ovarian cyst seen on ultrasound.
- Past pelvic infection or surgery and difficulty conceiving.
Questions & answers
Why does my shoulder hurt afterwards?
Gas left in the abdomen can irritate nerves that refer pain to the shoulder. It is common and fades as the gas is absorbed.
Will I have to stay overnight?
Many people go home the same day, but it depends on the operation and how you recover.
When in my cycle is it done?
ASRM notes fertility laparoscopy is usually performed soon after a period ends.
How big are the scars?
The cuts are small, usually less than an inch each, so scars are usually small. The number of cuts depends on what needs to be done.
Related DBN services
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Sources
- Laparoscopy (keyhole surgery) — NHS
- Laparoscopy — Cleveland Clinic
- Laparoscopy and Hysteroscopy patient education booklet — ASRM ReproductiveFacts
- Pelvic laparoscopy — MedlinePlus (U.S. National Library of Medicine)