Laparoscopic (keyhole) surgery: what it is, recovery and possible complications

A laparoscope is a thin, flexible tube with a camera and light. Patient.info explains that it is passed into the abdomen through a small cut so that the surgeon can see and magnify the structures inside. When fine instruments are passed through separate small cuts to operate, it is called laparoscopic surgery, keyhole surgery or minimally invasive surgery.

Patient.info says that, compared with traditional surgery, laparoscopic surgery usually has less pain afterwards, a lower risk of complications, a shorter hospital stay and quicker recovery, and a much smaller scar. The NHS adds that it can be used both to diagnose conditions and to treat them.

Patient.info says that, compared with traditional (open) surgery, laparoscopic surgery usually has less pain following the procedure, a lower risk of complications, a shorter hospital stay and quicker recovery, and a much smaller scar. It describes the key advantages as quicker recovery times and a reduced need for pain relief.

The NHS also says laparoscopy is often recommended because the recovery time is faster than other types of surgery. Your surgeon will explain why keyhole surgery is, or is not, suitable for your operation, and the NHS says a laparoscopy can sometimes end up needing open surgery through a larger cut.

The NHS says a laparoscopy can diagnose conditions such as appendicitis, pelvic inflammatory disease, endometriosis and some cancers including liver and ovarian cancer. It is also used for surgery, for example to remove organs such as the appendix or gallbladder, repair hernias or burst or bleeding stomach ulcers, remove organs affected by cancer, treat an ectopic pregnancy, remove the womb or fibroids, and perform weight loss surgery.

Patient.info adds that removing the gallbladder, which is sometimes called a laparoscopic cholecystectomy, is now the most common way for a gallbladder to be removed, usually for gallstones that cause pain.

The hospital will give instructions about preparation, which may include not eating or drinking, stopping certain medicines such as anticoagulants and stopping smoking. The NHS says you cannot drive after the operation, so you need someone to take you home.

In the operating theatre the surgeon makes a small cut, usually near the belly button, and air or gas is pumped into the tummy so the organs can be seen more easily. The laparoscope is passed in so video images are shown on a screen. If you are having surgery, more small cuts may be made for the surgeon’s tools. At the end the gas is released and the cuts are closed with stitches or clips and covered with a dressing. According to the NHS, a diagnostic laparoscopy usually takes 30 to 60 minutes and surgery takes longer.

The NHS says the hospital will give you information about how to prepare. Depending on why you are having the laparoscopy, you may be asked not to eat or drink, to stop taking certain medicines such as anticoagulants, and to stop smoking. Patient.info adds that, because you will usually be under a general anaesthetic, the hospital will give you instructions about not eating or drinking before the operation, with any more specific instructions depending on your medicines and the reason for the operation.

You cannot drive after a laparoscopy, so the NHS says you will need to organise for someone to drive you home.

After the operation you may feel sick or be sick, feel more tired than normal, have a sore throat, bloating, cramps, pain or discomfort in the tummy, shoulder pain and bruising around the wounds. Shoulder-tip pain is common because of the gas used to inflate the abdomen. Patient.info notes that it can take a day or up to a week to feel completely well after the general anaesthetic.

The NHS suggests taking paracetamol or ibuprofen for pain, drinking plenty of fluids, eating a healthy diet, wearing compression stockings if given, moving around as much as you can and doing foot and leg exercises while resting. Keep the wound dry for the first 24 hours, do not have a bath for the first 2 weeks or until the wound has healed, and avoid driving, flying and alcohol for 48 hours.

The NHS calls laparoscopy a common procedure in which complications are rare. They can include needing to have open surgery through a larger cut, a hernia, damage to an organ such as the bladder or to a blood vessel, a serious allergic reaction to the anaesthetic and blood clots such as DVT or pulmonary embolism.

It says to ask for an urgent GP appointment or call NHS 111 if you recently had a laparoscopy and have a high temperature or feel hot, cold or shivery, severe or continuous vomiting, worsening tummy pain or a bloated tummy, pain, swelling, bleeding, pus or redness around the wounds, unusual bleeding or discharge, pain and swelling in one leg, coughing up blood or breathlessness. Call 999 or go to A&E if you have a very fast heartbeat, chest pain or severe difficulty breathing.

On the NHS, a laparoscopy is arranged by a surgical or gynaecological team after a referral from your GP or an emergency or outpatient clinic. Hospitals give written instructions about preparation and recovery, and tell you who to contact if you have a problem after discharge.

Keyhole surgery is also available privately, usually with a consultant referral. The operation and the aftercare advice are broadly the same in both settings.