Laparoscopy is a type of surgical procedure that allows a surgeon to access the inside of the abdomen (tummy) and pelvis without having to make large incisions in the skin.

This procedure is also known as keyhole surgery or minimally invasive surgery.

Large incisions can be avoided during laparoscopy because the surgeon uses an instrument called a laparoscope.

This is a small tube that has a light source and a camera, which relays images of the inside of the abdomen or pelvis to a television monitor.

The advantages of this technique over traditional open surgery include:

• a shorter hospital stay and faster recovery time
• less pain and bleeding after the operation
• reduced scarring

When laparoscopy is used

Laparoscopy can be used to help diagnose a wide range of conditions that develop inside the abdomen or pelvis. It can also be used to carry out surgical procedures, such as removing a damaged or diseased organ, or removing a tissue sample for further testing (biopsy).

Laparoscopy is most commonly used in:

• gynaecology – the study and treatment of conditions affecting the female reproductive system
• gastroenterology – the study and treatment of conditions affecting the digestive system
• urology – the study and treatment of conditions affecting the urinary system

How laparoscopy is carried out

Laparoscopy is carried out under general anaesthetic, so you won’t feel any pain during the procedure.

During laparoscopy, the surgeon makes one or more small incisions in the abdomen. These allow the surgeon to insert the laparoscope, small surgical tools, and a tube used to pump gas into the abdomen. This makes it easier for the surgeon to look around and operate.

After the procedure, the gas is let out of your abdomen, the incisions are closed using stitches and a dressing is applied.

You can often go home on the same day of your laparoscopy, although you may need to stay in hospital overnight.

Safety

Laparoscopy is a commonly performed procedure and serious complications are rare.

Minor complications

Minor complications are estimated to occur in 1 or 2 out of every 100 cases following laparoscopy. They include:

• infection
• minor bleeding and bruising around the incision
• feeling sick and vomiting

Serious complications

Serious complications after laparoscopy are estimated to occur in 1 out of every 1,000 cases. They include:

• damage to an organ, such as your bowel or bladder, which could result in the loss of organ function
• damage to a major artery
• complications arising from the use of carbon dioxide during the procedure, such as the gas bubbles entering your veins or arteries
• a serious allergic reaction to the general anaesthetic
• a blood clot developing in a vein, usually in one of the legs (deep vein thrombosis or DVT), which can break off and block the blood flow in one of the blood vessels in the lungs (pulmonary embolism)

Further surgery is often required to treat many of these more serious complications.

Diagnosing conditions

It’s often possible to diagnose a condition using non-invasive methods, such as an ultrasound scan, computerised tomography (CT) scan or magnetic resonance imaging (MRI) scan. Sometimes, however, the only way to confirm a diagnosis is to directly study the affected part of the body using a laparoscope.

Laparoscopies are now widely used to diagnose many different conditions and investigate certain symptoms. For example, they may be used for:

• pelvic inflammatory disease (PID) – a bacterial infection of the female upper genital tract, including the womb, fallopian tubes and ovaries
• endometriosis – where small pieces of the womb lining (the endometrium) are found outside the womb
• ectopic pregnancy – a pregnancy that develops outside the womb
• ovarian cyst – a fluid-filled sac that develops on a woman’s ovary
• fibroids – non-cancerous tumours that grow in or around the womb (uterus)
• female infertility
• undescended testicles – a common childhood condition where a boy is born without one or both testicles in their scrotum
• appendicitis – a painful swelling of the appendix (a small pouch connected to the large intestine)
• unexplained pelvic or abdominal pain

Laparoscopy can also be used to diagnose certain types of cancers. The laparoscope is used to obtain a sample of suspected cancerous tissue, so it can be sent to a laboratory for testing. This is known as a biopsy.

Cancers that can be diagnosed using laparoscopy include:

• liver cancer
• pancreatic cancer
• ovarian cancer
• cancer of the bile duct
• cancer of the gallbladder

Treating conditions

Laparoscopic surgery can be used to treat a number of different conditions, including:

• removing an inflamed appendix – in cases of appendicitis where there’s a high risk of the appendix bursting
• removing the gallbladder – often used to treat gallstones
• removing a section of the intestine – often used to treat digestive conditions, such as Crohn’s disease or diverticulitis, that don’t respond to medication
• repairing hernias – such as those found in the groin
• repairing burst or bleeding stomach ulcers
• performing weight loss surgery
• removing some or all of an organ affected by cancer – such as the ovaries, prostate, liver, colon, kidney or bladder
• treating ectopic pregnancy – it’s usually necessary to remove the embryo to prevent damage to the fallopian tubes
• removing fibroids
• removing the womb (hysterectomy) – sometimes used to treat pelvic inflammatory disease (PID), endometriosis, heavy periods or painful periods