What is Laparoscopy?

Laparoscopy in simple terms

A laparoscope is a thin tube containing a light and a camera. The surgeon passes it through a small cut, usually near the navel, and sees a magnified view of the inside of the abdomen on a monitor. Further small cuts allow long, slim instruments to be used. The approach is often called keyhole surgery or minimally invasive surgery.

Laparoscopy can be used to find out what is causing a problem (diagnostic laparoscopy), to take a tissue sample, or to carry out a complete operation such as removing the gallbladder or the appendix.

How laparoscopic surgery works

1. Anaesthesia. Most laparoscopic operations are performed under general anaesthesia, so you are asleep. The anaesthetist assesses you beforehand.
2. Access. The surgeon makes a small cut and enters the abdominal cavity.
3. Insufflation. Carbon dioxide gas is usually introduced to lift the abdominal wall away from the organs, creating space and a clear view.
4. The operation. Additional small cuts, usually two to four, are used for instruments. The surgeon works while watching the monitor.
5. Closing. The gas is released, instruments are removed, and the small wounds are closed with stitches, clips or glue and covered with dressings.

How laparoscopy differs from open surgery

In open surgery the surgeon works through a single, larger incision with a direct view. In laparoscopy the same anatomy is reached through several small incisions, with the view provided by a camera.

• Incisions: several small cuts rather than one longer cut.
• Wound pain and scarring: often less with laparoscopy, though this varies between people and procedures.
• Hospital stay and return to activity: frequently shorter after laparoscopy for comparable operations, but not guaranteed.
• Operating time and equipment: laparoscopy needs specialised equipment and training, and some operations take longer.

Neither approach is universally better. Surgeons choose based on the diagnosis, the urgency, previous surgery and scar tissue, the person's overall health and the resources available.

Common reasons laparoscopy is performed

• Gallstones and gallbladder disease
• Appendicitis
• Hernias of the abdominal wall and groin
• Gynaecological conditions such as ovarian cysts, fibroids, endometriosis and some fertility investigations
• Unexplained abdominal or pelvic pain, when scans have not given a clear answer
• Taking biopsies or staging certain conditions
• Some bowel, stomach, kidney and urological operations

You can read more on the procedures overview.

General advantages

• Smaller wounds, which often means less wound pain and smaller scars
• A magnified view of the operative area for the surgeon
• Often a shorter hospital stay and earlier return to light activity
• Frequently less wound infection risk than a single large incision

Limitations and situations where it may not be suitable

• Extensive scar tissue from previous surgery, severe infection, very large masses or heavy bleeding can make laparoscopy difficult or unsafe.
• An operation started laparoscopically may need to be converted to open surgery. This is a judgement made for safety, not a complication in itself.
• Some heart and lung conditions may make the gas pressure and positioning less appropriate; the anaesthetist will assess this.
• It requires trained teams and equipment, which are not available everywhere.

What patients can generally expect

Before surgery you will usually have a consultation, blood tests and any imaging that is needed, plus fasting instructions. Afterwards, common experiences include soreness at the cut sites, bloating and shoulder-tip pain caused by residual gas, and tiredness for a few days. Most people are encouraged to walk soon after surgery.

Your own recovery plan — including diet, wound care, medicines, follow-up and when to resume work, driving and exercise — should come from your surgical team, because it depends on the procedure you had. See the patient guide and risks and complications.