Keyhole (laparoscopic) or open surgery: what is the difference?
In open surgery, the surgeon makes a cut of about 5 to 10 cm and operates with a hand inside the abdomen. Keyhole (laparoscopic) surgery uses a cut of about 1 cm for a camera and two or three half-centimetre cuts for instruments; the surgeon watches a screen. Most gynaecological operations can now be done this way, in Goa.
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This video is in Konkani; the guide on this page is in English.
Many people ask Dr Mayur Pai what is new in gynaecological surgery. His answer: it is not even that new. It is laparoscopic, or keyhole, surgery. In this short video, filmed in our operating theatre, he shows the equipment it needs and explains how it differs from an open operation.
What is keyhole surgery, and is it laser surgery?
Keyhole surgery is the everyday name for laparoscopic surgery. Some people even call it the ‘laser’ operation, but Dr Pai is clear in the video: it is not laser surgery. Its proper name is laparoscopic surgery, or keyhole surgery, and that is the name to ask your doctor about. The operation is done through a few small cuts, with a thin camera and fine instruments.
How was gynae surgery done before keyhole surgery?
Dr Pai explains the old way, open surgery, in three points:
- A big opening. Earlier, the surgeon had to make an opening of about 5 to 10 cm in the tummy, put a hand inside the abdomen and operate.
- A small open cut is a compromise. Some doctors do make a smaller open cut. But then the things inside cannot be seen properly: the view is poor and the access is poor.
- An assistant’s hand needs room too. Sometimes an assistant is needed. Both the assistant’s hand and the surgeon’s hand must fit inside the abdomen, so the cut has to be roughly 10 to 12 cm.
A big cut also means a big wound to heal, and with it come wound-related problems.
How is keyhole surgery different?
In laparoscopic surgery the cuts are small. The camera goes in through a cut of about 1 cm, and the fine instruments through two or three more cuts of about half a centimetre each. The full operation is done through these small cuts.
The camera sends a picture of the inside of the tummy to a display screen, so the surgeon works looking at the screen instead of through an open wound. Small cuts mean small wounds. Keyhole surgery is still an operation, though, and your own doctor will explain its risks for your particular case. What to expect afterwards is explained in recovery after keyhole surgery.
What is the laparoscopic tower?
In the video, Dr Pai turns his camera to the laparoscopic tower in our operating theatre. It is a trolley holding several machines, one above the other. Each machine does its own job, and everything comes together on the final display screen that the surgeon watches during the operation. He also points out the camera unit: the machine to which the camera used inside the abdomen is connected.
Which operations can be done by keyhole surgery?
Dr Pai lists the operations he does this way:
- removal of the womb (hysterectomy)
- ovarian cysts
- endometriosis
- fibroids
- adenomyosis, where the lining of the womb grows into its muscle wall
- other such growths, including some that can affect fertility
Dr Pai’s point is that most gynaecological operations that once needed a large cut can now be done by keyhole surgery. It does not suit every case, though. Whether it suits you is decided after an examination and your own scan, not from a general rule. When a problem is affecting the chance of pregnancy, an operation may be part of the plan, but no operation can promise a pregnancy. Each of these conditions is explained on our page about laparoscopic (keyhole) surgery.
Do I need to travel outside Goa for keyhole surgery?
No. Dr Pai’s point is simple: keyhole gynaecological surgery is done in Goa, and it is done here regularly. There is no need to travel to Mumbai or Bengaluru for it.
Who does the operation?
This guide is by Dr Mayur Pai, MBBS, MS (Obstetrics & Gynaecology), a fertility and laparoscopy specialist. He is qualified in laparoscopic surgery, has been doing these operations for many years, and performs them himself. Pai Hospital in Goa has its own operating theatre, so your scans, the operation and your stay are handled in one place, by one team. Free patient transport is available from across Goa and nearby areas.
How do I book a consultation?
If you have been advised an operation, or want to know whether keyhole surgery is possible for you, message us on WhatsApp at +91 77989 73345 with any scan reports you already have. Your first online consultation is free (one session). Consultations at the hospital are by appointment only, so please book before you come: call +91 77989 73345, or +91 95459 20817, or +91 75582 52088. For what affects the cost, see cost of laparoscopic surgery in Goa. This article is for education only and is not personal medical advice; please consult your doctor about your own situation.
Your questions
What is the difference between keyhole and open surgery?
In open surgery the surgeon makes a cut of about 5 to 10 cm and operates with a hand inside the abdomen. In keyhole (laparoscopic) surgery a camera and fine instruments go in through a few small cuts, and the surgeon operates watching a screen.
Is keyhole surgery the same as laser surgery?
No. Some people call it the laser operation, but it is not laser surgery. Its proper name is laparoscopic, or keyhole, surgery, and it is done through small cuts, using a camera and fine instruments.
How big are the cuts in laparoscopic surgery?
Small. There is one cut of about 1 cm for the camera, and usually two or three cuts of about half a centimetre for the instruments.
Why not just make a small open cut?
Because through a small open cut the surgeon cannot see or reach the organs inside properly: the view is poor and the access is poor. In keyhole surgery the camera shows the inside on a screen, and the instruments reach in through the small cuts.
Which gynaecological operations can be done by keyhole surgery?
Most, including removal of the womb (hysterectomy) and operations for ovarian cysts, endometriosis, fibroids and adenomyosis. Whether keyhole surgery suits you is decided after an examination and your scan.
Do I need to leave Goa for keyhole surgery?
No. Keyhole gynaecological surgery is done in Goa, and it is done here regularly. There is no need to travel to Mumbai or Bengaluru for it.
Or call +91 95459 20817 · +91 75582 52088 · 0832 251 3641
This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.