Laparoscopic (keyhole) surgery: what it treats
Laparoscopic (keyhole) surgery uses two or three small cuts, each under a centimetre, instead of one large incision. A thin camera and fine instruments go in through these cuts, so the surgeon works looking at a screen rather than opening the abdomen. Smaller cuts generally mean less pain afterwards, a shorter hospital stay and a faster return to normal activity than open surgery — though exactly how much faster depends on the operation and on you.
What laparoscopic surgery is used for
At Pai Hospital, laparoscopy is the first-choice approach for most gynaecological operations that used to need a large abdominal cut. It is used to remove fibroids (myomectomy), remove the uterus (hysterectomy) when a vaginal approach on its own is not suitable, treat endometriosis, remove ovarian cysts, and free up adhesions (internal scar tissue). Each is a different operation for a different reason — the sections below explain each one in plain terms.
Endometriosis
Endometriosis is tissue similar to the lining of the uterus growing where it does not belong — usually on the ovaries, the fallopian tubes, or the lining of the pelvis. Every month this tissue responds to the same hormones as the uterine lining does, which is what causes the pain: period pain that is worse than usual, pain during sex, or pain that does not go away between periods. It can also make conceiving harder, which is why it often comes up during a fertility work-up as much as a surgical one.
Laparoscopy is used both to diagnose endometriosis — it is often the only way to see the deposits directly — and to treat it in the same operation, by removing or cauterising what is found. Surgery is not always the first step. Many women are managed first with pain relief or hormonal treatment, and laparoscopy is kept for pain that does not settle, or for deposits that may be affecting fertility.
Ovarian cysts
An ovarian cyst is a fluid-filled sac on the ovary. Most are simple, functional cysts that form and disappear on their own within a cycle or two, and need nothing more than a repeat scan to confirm they have gone. Laparoscopic removal (cystectomy) is kept for cysts that persist over several cycles, are large, look complex on scan, or are causing pain — including the sudden severe pain of a cyst twisting on itself, which needs urgent attention. The aim of a laparoscopic cystectomy is to remove the cyst while leaving the healthy ovary tissue in place.
Adhesions
Adhesions are bands of scar tissue that form inside the abdomen or pelvis after previous surgery, infection, or endometriosis, sticking organs together that should move freely. They can cause chronic pelvic pain, and if they involve the fallopian tubes, they can affect fertility. Laparoscopy is used to see exactly where the adhesions are and divide them (adhesiolysis), which is usually far less disruptive to the surrounding tissue than reopening the abdomen would be.
Hysteroscopy is not keyhole surgery
No cut is made anywhere for a hysteroscopy. A hysteroscope — a thin telescope — is passed through the vagina and the cervix, the same natural passage a period comes through, directly into the uterus. There is no abdominal incision at all, which is the key difference from laparoscopy. It is used to look inside the uterine cavity itself: to investigate abnormal bleeding, to check for polyps or fibroids bulging into the cavity, or to look for scar tissue inside the uterus. Many hysteroscopies are diagnostic and operative in the same short visit, and a large number are done as a day procedure with no overnight stay at all.
Confusing the two puts women off a genuinely simple investigation. If a doctor has suggested a hysteroscopy to find out why a period is heavy or irregular, it is worth understanding it separately from an operation that involves cuts — it is a much smaller step.
Recovery after laparoscopic surgery
Most laparoscopic gynaecological operations at Pai Hospital are a one- or two-night stay, sometimes day-care depending on the operation. Expect some shoulder-tip discomfort for a day or two — from the gas used to create room to work in, not from the surgery itself — along with mild soreness around the small cuts. Most women are back to light activity within a week or two, and to full activity within four to six weeks, though this varies with the operation and with how physically demanding your normal routine is.
When surgery is not the answer
Not every fibroid, cyst, or endometriosis diagnosis needs an operation. Small fibroids or cysts with no symptoms are often simply watched with a repeat scan. Endometriosis pain is frequently managed first with medication. Surgery is the right step when symptoms are significant, when a cyst or fibroid is behaving in a way that needs investigation, or when fertility is being affected — and deciding which of those applies to you needs an examination and your own scan, not a general rule.
Who operates
Dr. Mayur Pai (MBBS, MS Obstetrics & Gynaecology) has been a practising laparoscopic surgeon for 15 years and performs these operations himself, in the hospital's own operating theatre. The doctor you consult is the doctor who operates, and you know before you are admitted whose hands you are in.
For the uterus-removal route with no abdominal cut at all, see scarless (vaginal) hysterectomy. For fibroids specifically, see fibroids and myomectomy. For what affects the cost of surgery, see cost of laparoscopic surgery in Goa.
Call or WhatsApp +91 77989 73345This 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.