LAPAROSCOPY SURGERY: WHAT TO EXPECT DURING KEYHOLE SURGERY AND RECOVERY

In recent years, laparoscopic surgery – often referred to as keyhole surgery – has revolutionized how doctors treat various conditions. At Reem Hospital, we are proud to offer this state-of-the-art surgical method, providing our patients with a safer, quicker, and less painful alternative to traditional open surgery.

Whether you’re considering surgery yourself or supporting a loved one, understanding this technique can ease anxiety and help you make more informed decisions. So, let’s explore what laparoscopic surgery is, how it works, and what to expect before, during, and after the procedure.

What Is Laparoscopy?

Laparoscopy is a minimally invasive surgical procedure that involves inserting a thin, lighted tube with a camera known as a laparoscope through small incisions —usually no bigger than a centimeter— in the abdominal wall . This tool provides a magnified view of internal organs on a high-definition monitor, allowing surgeons to perform diagnostic evaluations and therapeutic procedures with great precision.

At Reem Hospital, laparoscopy is commonly used across multiple specialties such as gynecology, general surgery, and gastroenterology.

Benefits of Laparoscopic Surgery

Compared to traditional open surgery, laparoscopy offers patients:

• Safer outcomes
• Less postoperative pain
• Shorter hospital stays
• Quicker return to normal activities
• Minimal scarring and lower infection risks

Why Laparoscopy Is Performed

Laparoscopy is used for both diagnosis and therapeutic surgeries:

• Diagnostic: Helps find the cause of unexplained symptoms such as chronic pelvic pain, infertility, or abnormal bleeding.
• Therapeutic: Allows surgeons to treat identified conditions with less invasive techniques, promoting faster recovery. This technique is commonly used for procedures involving the abdomen or pelvis, such as:

Specialty	Surgery
Gynecology	1.Removal of ovarian cysts 2.Treatment of endometriosis 3.Hysterectomy (removal of the uterus/ womb)
General Surgery	1.Gallbladder removal (cholecystectomy) 2.Appendectomy (removal of the appendix) 3.Hernia repair
Bariatric (weight loss) surgery	1.Gastric sleeve 2.Gastric bypass 3.Mini gastric bypass

Diagnostic Procedures: How Laparoscopy Helps Find the Root Cause

Sometimes, the cause of symptoms like chronic abdominal pain, unexplained pelvic discomfort, or infertility isn’t clear—even after imaging tests like ultrasounds, CT scans, or MRIs. 

Laparoscopy procedure gives a clear, real-time view of your internal organs and tissues—something that imaging alone can’t always provide.

Doctors often use this approach when they suspect conditions such as:

• Endometriosis
  A common cause of pelvic pain and infertility in women, but one that’s notoriously difficult to diagnose without direct visualization.
• Pelvic inflammatory disease (PID)
  When the infection spreads to the upper part of the reproductive organs, laparoscopy can help confirm the diagnosis and assess damage.
• Ectopic pregnancy
  If a pregnancy develops outside the uterus (often in the fallopian tube), laparoscopy helps identify and address it quickly—potentially saving lives.
• Unexplained abdominal or pelvic pain
  When other tests don’t offer answers, a diagnostic laparoscopy can help uncover issues like adhesions (scar tissue), hernias, cysts, or tumors.
• Cancer staging
  In certain cases, laparoscopy helps determine how far cancer has spread and determine which treatment option is best.

What makes this method especially valuable is that it’s not just for looking—it can turn into treatment right away. For instance, if your doctor finds endometriosis or a cyst during the procedure, they may be able to treat it on the spot, avoiding the need for another surgery.

The Role of Endoscopy in Diagnosis

Endoscopy is a medical procedure that lets doctors look inside your body without making any cuts. Instead of surgery, they use a thin, flexible tube with a tiny camera and light at the end—called an endoscope. It’s usually passed through natural openings like the mouth, nose, ears, vagina, urethra, or rectum, depending on what part of the body needs to be examined.

Endoscopy isn’t just one procedure; it’s a whole family of tests that help doctors look inside different parts of the body to reach the correct diagnosis. Your doctor might recommend one of several endoscopic procedures:

• Gastroscopy (Upper Endoscopy): This involves gently passing the endoscope through your mouth and down your throat to check your esophagus, stomach, and the first part of your small intestine. It’s useful for finding ulcers, inflammation, acid reflux damage, or even early signs of stomach cancer.
• Colonoscopy: Here, the endoscope goes in through the rectum to examine your entire colon (large intestine). Colonoscopy is key for screening colon cancer, investigating unexplained bleeding, persistent diarrhea, or chronic abdominal pain. Doctors can also remove polyps or take small tissue samples (biopsies) during the procedure.
• Bronchoscopy: This test allows doctors to look inside your airways and lungs by inserting the endoscope through your nose or mouth. It’s often used when you have persistent cough, unexplained lung infections, or suspicious spots seen on chest X-rays.
• Cystoscopy: In this case, the endoscope is inserted through the urethra to view the inside of the bladder. It helps diagnose urinary tract problems like infections, bladder stones, or tumors.
• Hysteroscopy: This involves inserting a thin camera through the vagina to examine the inside of the uterus. It’s helpful for investigating abnormal bleeding, fibroids, or infertility issues.
• Ear and Nose Endoscopy: These specialized procedures use a thin scope inserted into the ear canal or nasal passages to closely examine the delicate structures within. Ear endoscopy helps diagnose chronic infections, ear drum problems, or blockages, while nasal endoscopy is vital for assessing sinus issues, nasal polyps, or persistent congestion.

What makes endoscopy so valuable is its ability to provide real-time images of your internal organs, allowing doctors to spot problems and plan the right treatment, sometimes even during the same procedure. Many endoscopic procedures are designed not just for diagnosis but also for treatment at the same session if possible.

Laparoscopic Surgery vs. Open Surgery vs. Endoscopy: What’s the Difference?

Understanding the differences between laparoscopic surgery and other techniques can help you make informed decisions.

Procedure	Incision Size	Hospital Stay	Recovery Time
Laparoscopy	Small (0.5–1cm)	Same day or 1 night	1–2 weeks
Laparotomy (Open surgery)	Large (5–10cm)	3–5 days	4–6 weeks
Endoscopy	No incision	Outpatient	Minimal, same day

General and Abdominal Surgery Applications

Procedure	Common Indications
Gallbladder Removal (Cholecystectomy)	Treats gallstones or gallbladder inflammation
Hernia Repair	Repairs inguinal or abdominal wall hernias
Appendectomy	Removes an inflamed or ruptured appendix
Liver or any other abdominal organs Biopsy	Collects tissue for further testing
Cyst Removal	Removes abdominal cysts such as pancreatic cysts causing symptoms like pain and indigestion.

Specialized Laparoscopy:

Procedure	Common Indications
Laparoscopic Nissen Fundoplication	Treats severe acid reflux or GERD by reinforcing the lower esophageal sphincter
Laparoscopic Colectomy	Removes part of the colon in conditions like colon cancer or diverticulitis
Laparoscopic Adrenalectomy	Removes one or both adrenal glands when tumors or hormone imbalances are present
Laparoscopic Bariatric Surgery	Weight-loss procedures like gastric bypass or sleeve gastrectomy for obesity

Common Gynecological and Fertility Procedures

Condition/Procedure	Purpose
Endometriosis	Removes endometrial tissue that have travelled outside of the uterus to relieve pain or aid fertility
Laparoscopic Myomectomy  Fibroids	Laparoscopic myomectomy (removal of the fibroid tissue) to preserve the uterus and eliminate unusual bleeding
Pre-IVF Assessment	Evaluates uterus and fallopian tube condition
Blocked Fallopian Tubes	Unblocks or removes non-functional tubes
PCOS – Ovarian Drilling	Promotes ovulation in women with PCOS (polycystic ovary syndrome) (will be linked to PCO blog)
Laparoscopic Hysterectomy	Removes the uterus with minimal disruption with or without removal of the fallopian tube and ovaries what’s called hysterectomy with bilateral salpingoopherectomy.

What to Expect: Laparoscopy Procedure

Laparoscopy is a streamlined, safe, and well-coordinated process that includes:

1. Pre-operative Preparation

• You’ll need to fast for at least 6–8 hours before surgery.
• Preoperative tests may include blood work, imaging, and a physical exam.
• Your care team will review the procedure, expected outcomes, and answer any last-minute concerns.

2. Anesthesia

• General anesthesia is used, meaning you’ll be asleep and won’t feel any pain during surgery.
• In case of Endoscopy only sedation will be provided as it’s simple and easy procedure doesn’t include cuts or pain.

3. Incisions and Instrumentation

• One to three small incisions are made.
• Carbon dioxide gas inflates the abdomen to provide a clear view.
• A laparoscope and other surgical instruments are inserted.

4. Surgical Treatment

• Depending on findings, your surgeon will treat the problem directly through these small incisions.

5. Closure and Recovery

• Gas is released, instruments are withdrawn, and the incisions are closed using dissolvable stitches or surgical glue.

Post-Surgery Wound Care

Proper wound care helps prevent infection and promotes faster healing.

• Gently wash the area with soap and water, pat dry.
• Avoid full submersion (e.g., baths, swimming) for 7–10 days.
• Do not apply lotions or powders unless prescribed.
• Watch for signs of infection: redness, warmth, pus, or spreading pain.
• Most stitches dissolve naturally; no removal is needed unless told otherwise.

Laparoscopy Recovery Time

While each patient’s recovery is unique, here’s a general guide:

Timeline	What to Expect
Day 1–2	Grogginess, shoulder pain from gas, light abdominal soreness
Day 3–5	Able to move around more comfortably, less bloating
Week 1	Wound healing begins, fatigue decreases
Week 2	Resume non-strenuous activities, attend follow-up
Weeks 4–6	Full recovery for more complex procedures

Side Effects and Risks

Common Side Effects:

• Mild pelvic or abdominal pain
• Shoulder pain from gas
• Light vaginal bleeding (if gynecologic)
• Temporary bloating or bruising

 Potential Complications:

• Infection at incision sites
• Organ or vessel injury (rare)
• Anesthesia-related reactions
• Blood clots (especially if immobile post-surgery)

Seek immediate care if you experience:

• Persistent fever over 38°C
• Worsening abdominal pain
• Trouble urinating or severe nausea
• Redness, swelling, or discharge from the incision

Who Shouldn’t Have Laparoscopic Surgery?

While laparoscopic (keyhole) surgery has many benefits, it’s not always suitable for everyone. Here are some situations where your doctor might recommend avoiding laparoscopic surgery:

1. Extensive Internal Scarring (Adhesions)

If you’ve had multiple abdominal surgeries in the past, your body may have formed internal scar tissue—called adhesions. These can make it harder (and riskier) to safely insert the laparoscopic instruments or see organs clearly. In such cases, your surgeon may decide that an open procedure is safer and more controlled.

2. Severe Obesity

Laparoscopic surgery is often still possible for people with obesity, and it’s even commonly used in weight-loss (bariatric) procedures. However, in some cases of morbid obesity, the extra layers of tissue can make it difficult to safely navigate the instruments or get a good view of internal organs. The decision depends on the type of surgery, overall health, and the surgeon’s experience.

3. Uncontrolled Bleeding or Blood Disorders

People with bleeding disorders or those who are actively bleeding internally may not be ideal candidates. Laparoscopy relies on a clear surgical field and controlled bleeding. If bleeding is heavy or unpredictable, open surgery gives surgeons quicker access and more control.

4. Widespread Infection or Emergency Situations

In urgent cases, like severe abdominal infections (peritonitis) or trauma, doctors might skip laparoscopy and go straight to open surgery. That’s because open surgery allows faster access to the affected areas and better visibility in emergency settings.

5. Very Large Tumors or Growths

If the problem involves a large tumor or mass, removing it through a small incision might not be possible. In some cases, surgeons may begin laparoscopically but switch to open surgery to safely remove the growth or fully treat the area.

6. Severe Cardiopulmonary Conditions

During laparoscopy, carbon dioxide is used to inflate the abdomen to create space for instruments. For people with serious heart or lung problems, this added pressure can strain their cardiovascular or respiratory system. In such cases, doctors may recommend open surgery or alternative treatments that put less stress on the body.

Conclusion

Laparoscopy has transformed how we approach diagnosis and treatment for a range of conditions. It offers a safer, less invasive option with a shorter recovery, and fewer complications than traditional surgery.

At Reem Hospital in Abu Dhabi, we pride ourselves on delivering expert care through cutting-edge techniques and a patient-centered approach. From preoperative support to post-surgery recovery, our experienced team is here to ensure your journey is smooth, informed, and successful.

If you’re experiencing symptoms or are considering laparoscopy, we invite you to book a consultation with our specialists. With early intervention and modern surgical care, you can get back to living with confidence and comfort.