Gynaecological Laparoscopy

Laparoscopy is a minimally invasive surgical approach during which the operation is performed through small incisions in the abdominal wall instead of the large ones used for open surgery. These are used to insert the distension medium (CO2) into the peritoneal cavity which creates the space needed for the operation. The main incision is usually made below the umbilicus, is 1cm long and is used to insert a thin telescope (laparoscope). The remaining incisions (2-3) are typically smaller and are used to insert the laparoscopic instruments.

Laparoscopy can be diagnostic (to investigate chronic pelvic pain or infertility and/or to examine the peritoneal cavity and take biopsies if gynaecological malignancy is suspected) or operative.


Laparoscopic operations

  • Tubal ligation
  • Removal of intraperitoneal adhesions
  • Drainage of pelvic abscesse
  • Management of an ectopic pregnancy
  • Removal of benign ovarian cysts
  • Removal of ovaries / fallopian tubes
  • Removal of uterine fibroids
  • Hysterectomies for benign disease
  • Hysterectomies for early endometrial and cervical cancer
  • Lymphadenectomy for gynaecological cancers


Advantages of laparoscopic surgery compared to open

  • Shorter hospital stays
  • Faster recovery (usually 2 weeks compared to 6 for open surgery)
  • Better aesthetic result
  • Less postoperative pain
  • Lower risk for postoperative complications due to the smaller incisions and quicker mobilization
  • Lower risk for postoperative adhesions


Contraindications to laparoscopy

  • Very enlarged uterus
  • Previous laparotomies and / or extensive intraperitoneal adhesions which cannot be safely removed laparoscopically
  • Severe respiratory disease
  • Tubo-ovarian or primary peritoneal cancer
  • Suspected uterine sarcoma
  • Radical operations for gynaecological cancer recurrence