What Is Laparoscopic Surgery?

Medically Reviewed by Zilpah Sheikh, MD on December 20, 2023
7 min read

Laparoscopy is a type of surgery that gets its name from the laparoscope, a slender tool that has a tiny video camera and light on the end. When a surgeon inserts it through a small cut into your body, they can look at a video monitor and see what’s happening inside you. Without those tools, they’d have to make a much larger opening. Thanks to special instruments, there’s less cutting, and your surgeon doesn’t have to reach into your body, either.

Keyhole surgery

Laparoscopic surgery is used in the abdominal and pelvic areas. It is sometimes called keyhole surgery because a surgeon uses two to four small cuts, which are usually no more than a half-inch long, in your belly or pelvic area. Then they use flexible tubes to insert a lighted video camera and special tools into your body.

Laparoscopy vs. laparotomy 

Before the laparoscopic method came along, a surgeon who operated on your belly or pelvic area had to do open surgery called laparotomy, where a 6- to 12-inch-long cut was made through the abdominal wall. This larger opening gave the surgeon enough room to see what they were doing and reach whatever they had to work on inside your body.

Laparoscopy is known as a minimally invasive surgery (MIS) because it uses smaller cuts. Doctors first used it for gallbladder surgery and gynecology operations. Then it came into play for the intestines, liver, and other organs. While a laparoscopy has a shorter recovery time than a laparotomy, it can take longer and require special training and tools. In some cases, such as an emergency, a laparotomy might be more appropriate.

A variety of surgeries can be done laparoscopically, including:

  • Adrenal gland removal
  • Appendectomy
  • Biopsies
  • Bladder removal
  • Cancer
  • Cyst, fibroid, stone, and polyp removals
  • Ectopic pregnancy removal
  • Endometriosis surgery
  • Esophageal surgery
  • Gallbladder removal
  • Gastric bypass surgery
  • Hernia repair surgery
  • Kidney removal
  • Prostate removal
  • Rectal prolapse repair
  • Rectum removal
  • Removal of part of the bowel
  • Removal of part of the liver
  • Small tumor removals
  • Spleen removal
  • Stomach removal
  • Testicle correction surgery
  • Tubal ligation and reversal
  • Urethral and vaginal reconstruction surgery

Doctors also use laparoscopic surgery to help diagnose patients if the results of imaging tests such as CT, MRI, and ultrasound aren’t clear. The laparoscopy allows doctors to take a better look at an area of concern. They can also use it to look for the cause of belly or pelvic pain.

Your doctor will let you know what’s required before your laparoscopy. Share all the medications you are taking with your doctor. You may need to stop taking certain medications before surgery. Some of these medications include:

  • Anticoagulants, such as blood thinners
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin (Bufferin) or ibuprofen (Advil, Motrin IB)
  • Other medications that affect blood clotting
  • Herbal or dietary supplements
  • Vitamin E

Because the small incisions will be around your waist, plan to wear loose-fitting clothes that won’t rub or irritate as you heal after surgery. You also can’t eat or drink for 8 hours before the surgery.

Before your laparoscopy, you might have to take imaging or blood and urine tests. You’ll have an IV inserted into a vein so you can receive fluids, pain medications, and anesthesia during the procedure. Doctors will also put a breathing tube down your throat to make sure your airway stays open. You might have a urinary catheter inserted, and then your skin will be cleaned with a disinfectant solution.

To begin the procedure, your surgeon will make the necessary small cuts in your belly or pelvic area, and tubes will be placed for the camera and tools. A drain might also be placed.

In some operations, the surgeon can put the camera and the surgical tool through the same opening in the skin. It might mean less scarring, but it’s trickier for your surgeon because the instruments are so close together.

In other cases, your doctor may decide to use a device that lets them reach in with a hand. This is called “hand-assisted” laparoscopy. The cut in the skin must be more than half an inch in length, but it still can be smaller than the one made in traditional surgery. This method has made it possible to use laparoscopic surgery for the liver and other organs.

Next, carbon dioxide will be pumped in to separate your abdominal wall from your organs. This will make it easier for the surgeon to see your organs. Finally, your doctor can put a camera and tools through the tube or tubes, and they can complete the procedure guided by images on a video monitor.

Robotic laparoscopic surgery

Technology can help the medical team be more precise. In the robotic version of laparoscopic surgery, the surgeon first cuts into the skin and inserts the camera, as usual. Instead of taking hold of the surgical instruments, they set up a robot’s mechanical arms. Then they move to a computer nearby.

With robotic surgery, the monitor gives the surgeon a 3D, high-resolution, magnified image inside the body. As they watch the screen, they use hand controls to operate the robot and surgical instruments. This lets the surgeon be more exact, and it can mean less impact on your body and less bleeding. You may also have less discomfort after the operation. Robotic surgery is especially helpful for gynecology and urology surgeries. Most prostate removal operations use robots.

After your procedure, the gas will be removed from your belly. If a surgical drain was used, it might be removed, or it might stay in place to allow fluid to continue to drain. Your incisions will be closed. Your breathing tube and IV will come out, and you will be moved to a recovery room and observed until the anesthesia has worn off. Some laparoscopic procedures are outpatient, but others require you to stay for a night or two in the hospital. For outpatient surgery, you will need someone to drive you home from the hospital. You will likely take home a prescription for pain medication and recommendations for safe over-the-counter pain medication.

You may feel some discomfort after laparoscopic surgery, and this is normal. Here's what you might experience as you recover:

  • Nausea. Your doctor may recommend you drink clear liquids until the nauseous feeling passes. Avoid carbonated beverages for a few days. You can then move on to soft foods and resume your regular diet after your doctor’s approval.

  • Shoulder pain. As you recover, you might notice pain in your shoulders. It's caused by the carbon dioxide used to inflate your abdomen during the surgery. The leftover gas can press on a nerve, which directs pain to your shoulder area. The discomfort should stop in 1-2 days.

  • Incision pain. You’ll receive instructions on how to care for your incisions before you leave the hospital. However, if your wounds become red, swollen, or painful, or if you have discharge or bleeding, call your doctor right away. If you still have a drain in place, you will need to keep the tubing clear and might need to empty the collected fluids a few times a day.

  • Abdominal or pelvic pain. You should start to feel better after a few days, but if it starts to get worse, call your doctor.

  • Constipation, tiredness or soreness, and trouble sleeping. Talk to your doctor if any of these side effects of surgery bother you.

How long does it take to recover from a laparoscopy?

Recovery time depends on the type of surgery. You should be completely recovered from a minor surgery in 3 weeks. Recovery from a major surgery can take up to 12 weeks.

Laparoscopic surgery has several advantages over traditional surgery. Because it involves less cutting:

  • You have smaller scars.
  • You get out of the hospital quicker.
  • You'll feel less pain while the scars heal, and they heal quicker.
  • You get back to your normal activities sooner.
  • You may have less internal scarring.
  • You’ll have a reduced risk of wound infection.
  • You’ll have a reduced risk of hemorrhage.
  • You’ll need less pain medication.

Here’s an example. With traditional methods, you might spend a week or more in the hospital for intestinal surgery, and your total recovery might take 4-8 weeks. If you have laparoscopic surgery, you might stay only two nights in the hospital and recover in 2 or 3 weeks. And a shorter hospital stay generally costs less.

Even though laparoscopic surgery is less invasive, it still can cause complications:

  • Trocar injuries can happen when the sharp-pointed instrument (trocar) used to puncture the skin during a laparoscopy causes damage. They are rare but can cause blood vessel injury, bowel injury, nerve injury, and port-side hernia.

  • Insufflation complications are caused by reactions to the carbon dioxide used during the surgery. Insufflation is the act of blowing something, like carbon dioxide, into a body cavity. Complications can include carbon dioxide retention, a collapsed lung, air trapped under your skin or in your chest cavity, or hypothermia if the carbon dioxide isn’t warmed up.

  • General surgical risks, which are possible with any surgery, include an allergic reaction to anesthesia, adhesions that happen when scar tissue sticks two or more organs together or an organ and the abdominal wall together, excessive bleeding, and infected wounds.

There might be reasons laparoscopic surgery isn’t right for you. You might not be a candidate for this type of surgery if:

  • You’ve already had surgery in the same area and have scars and adhesions
  • You have excessive body mass in the surgical area
  • You have an infection or are bleeding
  • You have certain cardiopulmonary conditions