Keyhole surgery for Gynaecology Procedures

Laparoscopic surgery is often referred to as “keyhole surgery”.  

The first laparoscopy performed on a human was over 100 years ago, in 1910. 

Through the 60s,70s and 80s laparoscopy was a popular technique, particularly in gynaecology for diagnostic purposes and simple surgical treatments. From around 1990 rapid improvements in medical device technology and instrumentation made previously major surgical procedures requiring large incisions possible by keyhole technique. 

Laparoscopy is now popular in most surgical fields including gynaecology.  

What is laparoscopy? 

Laparoscopy involves inserting a telescope through a small cut of your umbilicus (belly button). The telescope is attached to a camera which connects to large flat screens in the operating theatre. This gives around 7x magnification and superior illumination to open surgery with the naked eye.  

Following this, between one and four small cuts of around 1cm in length are made, enabling the insertion of various instruments for the surgeon to operate with.  

What gynaecology operations can be done with keyhole surgery? 

Gynaecologists use laparoscopy to help with diagnosing several different concerns. Some of the things we might be looking to diagnose via inspection of your pelvis and abdomen include:  

If a diagnosis is made, the appropriate surgical treatment can often be performed.

Common issues that can now often be treated laparoscopically include: 

  • The removal of ovarian cysts 
  • Treatment of endometriosis 
  • Hysterectomy is now routinely done laparoscopically 
  • Dividing scar tissue, which can be causing pain and pelvic organs to be stuck to each other is a common keyhole operation. 
  • Ectopic pregnancy 
  • Severe pelvic infections 

What are the advantages of keyhole surgery?  

Because the incisions (or surgical cuts) are very small, recovery is fast.  

Keyhole surgery allows many operations to be done as day surgery with patients usually going home to rest within a few hours of waking up from the anaesthetic. 

Often within a few days to a week, you can return to work and normal physical activity. The return to normal will depend on how major the surgery is: for example, hysterectomy will still require several weeks off work despite the more rapid initial recovery.  

For the surgeon, clearer magnified vision allows often finer more detailed work to be undertaken.  

Scars are very small giving a more satisfying cosmetic result compared to open surgery. 

Is there less pain post-operatively after laparoscopic surgery?  

Pain is generally of a lesser degree and shorter duration post laparoscopy. Often less painkilling medication (analgesics) are required compared with open surgery. As a patient, you’ll be up and about much faster. 

Are all operations suitable for keyhole surgery?  

No. There are still operations requiring a formal incision in the abdomen, known as a laparotomy. It may be that a pelvic mass is too large to safely remove by keyhole surgery, or you may have had multiple surgeries prior. There are also times when it is necessary for the surgeon to change from keyhole to open surgery throughout a procedure.  

As a part of your pre-operative planning consultation, we will discuss any risks associated with surgery. 

If you have any questions about a gynaecological procedure, please call the rooms for an appointment.

Author: Dr Peter England, Obstetrician and Gynaecologist.
Read more about Dr Peter England

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