Keyhole surgery

Keyhole surgery, also called laparoscopic or minimally invasive surgery, lets a surgeon look at and operate on the inside of the tummy (abdomen) or pelvis through small cuts. A thin tube with a camera and light (a laparoscope) is passed in and shows the inside on a screen. It can be used to find the cause of a problem or to treat it, for example by removing the appendix or gallbladder.

Doctors use it to look for the cause of tummy or pelvic pain when scans have not given the answer, to take a small tissue sample (biopsy), and to treat many problems: removing the appendix or gallbladder, repairing a hernia, treating an ectopic pregnancy, endometriosis or fibroids, and some weight loss surgery. It is often chosen because it usually means less pain, smaller scars, a shorter stay and faster recovery than open surgery. It does not suit every person or problem.

Your hospital will give you instructions for your own operation.

You usually have a general anaesthetic, so you are asleep and feel no pain. A keyhole operation goes like this:

1. A small cut is made near the belly button, and the tummy is filled with gas to make room.
2. The laparoscope goes in, and the pictures appear on a screen.
3. For an operation, a few more small cuts are made for the instruments.
4. At the end the instruments and most of the gas are removed, and the cuts are closed and dressed.

A check usually takes 30 to 60 minutes, and an operation longer. Sometimes the surgeon has to make a larger cut and finish with open surgery.

You rest in a recovery room with medicine for pain and swelling. Most people go home the same day or the next. Feeling sick, tiredness, bloating, cramps, bruising around the cuts and shoulder pain from the gas are common for a few days. Walk about often, drink plenty of fluids, and keep the wounds dry for the first 24 hours. You are usually told not to drive or drink alcohol for at least 48 hours. Recovery takes up to about 10 days after a check and up to 6 to 8 weeks after an operation.

Get urgent advice for a high temperature, continuous vomiting, worsening tummy pain or bloating, a swollen, red or leaking wound, or a swollen painful leg. Chest pain, a very fast heartbeat or severe breathing difficulty needs emergency care.

Keyhole surgery is generally safe and serious problems are uncommon. They include bleeding, infection, damage to an organ (such as the bladder or bowel) or a blood vessel, blood clots in the leg veins that can travel to the lungs, a hernia at one of the cuts, a serious allergic reaction to the anaesthetic, and needing open surgery with a larger cut. Each operation also has its own risks, which your surgeon will explain.

What the surgeon found or did is explained afterwards. A diagnostic laparoscopy can often give a very accurate diagnosis. If a tissue sample was taken, ask when the result will be ready. After an operation, recovery is usually faster than after open surgery, and follow-up depends on what was done.