Laparoscopic Surgery: What to Expect Before, During & After

Laparoscopic surgery — commonly called keyhole surgery — has transformed gynaecological care over the past three decades. Procedures that once required a large abdominal incision and weeks of recovery can now be performed through two or three small openings, allowing most patients to go home the same day and return to normal activities within one to two weeks. This guide explains what laparoscopic gynaecological surgery involves and what patients can expect at each stage.

What Conditions Are Treated Laparoscopically?

• Endometriosis — excision or ablation of lesions, release of adhesions
• Ovarian cysts — cystectomy (removal of the cyst, preserving the ovary)
• Uterine fibroids — myomectomy (removal of fibroids from the uterine wall)
• Blocked fallopian tubes — adhesiolysis, tubal surgery
• Ectopic pregnancy — removal of the ectopic implantation
• Hysterectomy — removal of the uterus
• Diagnostic laparoscopy — assessment of pelvic anatomy when imaging is inconclusive

Before the Operation

A pre-operative consultation is essential. Your surgeon will review your scans, explain the procedure in detail, discuss the risks and alternatives, and obtain your consent. Blood tests, an ECG (if required), and an anaesthesia review are performed. You will be asked to fast (no food or drink) for 6 hours before the procedure.

It is important to tell your team about all medications you are taking. Blood thinners, aspirin, and some herbal supplements need to be paused before surgery. You should also arrange for someone to accompany you home — you will not be able to drive on the day.

The Procedure

Laparoscopic surgery is performed under general anaesthesia. A small incision (approximately 1 cm) is made at or just below the navel, through which a thin, lighted camera (laparoscope) is inserted. Carbon dioxide gas is used to inflate the abdomen, creating space to work. One or two additional small ports are placed (usually 5 mm) for the operating instruments.

The surgeon views a magnified image of the pelvis on a monitor and performs the required procedure — excising endometriosis, removing a cyst, or reconstructing anatomy — with fine instruments. At the end, the gas is released, the ports are removed, and the incisions are closed with absorbable sutures or skin glue.

Operative time varies from 30 minutes for a simple diagnostic procedure to 2–3 hours for complex excision of severe endometriosis or a large myomectomy.

After the Operation — Recovery

You will spend 2–4 hours in the recovery room before going home (for day-case procedures). Pain is typically managed with regular paracetamol and an anti-inflammatory. Shoulder-tip pain — caused by residual gas irritating the diaphragm — is common for 24–48 hours and improves with walking.

Most patients can return to light activities within 3–5 days and to work within 7–14 days, depending on the extent of surgery. Driving is usually permitted after 5–7 days once you are comfortable performing an emergency stop. Strenuous exercise and heavy lifting should be avoided for 4–6 weeks.

A follow-up appointment is usually arranged at 4–6 weeks to review histology results (if a biopsy was taken), assess recovery, and discuss the findings and any implications for future treatment or fertility.

Risks and Complications

Laparoscopic surgery is generally very safe. Major complications — injury to bowel, bladder, or major blood vessels — occur in fewer than 1 in 1,000 procedures. Minor complications such as wound infection, urinary tract infection, or prolonged shoulder pain are more common but easily managed. Your surgeon will discuss the specific risks relevant to your planned procedure at the pre-operative consultation.

If you have been advised to have laparoscopic surgery, or are wondering whether it might be relevant to your gynaecological condition, a specialist consultation will help clarify what is involved and what you can expect.