What is laparoscopy?
Laparoscopy is a minimally invasive approach that uses a camera inserted through a small incision, usually near the navel, to examine or operate within the abdomen and pelvis. Additional small incisions may be used for instruments. It can be diagnostic, therapeutic, or both.
What is hysteroscopy?
Hysteroscopy uses a thin telescope passed through the vagina and cervix to view the inside of the uterus. There are usually no abdominal incisions. It may be used to diagnose a concern, take a targeted sample or treat selected problems within the uterine cavity.
How is minimally invasive surgery different from open surgery?
| Feature | Minimally invasive approach | Open surgery |
|---|---|---|
| Access | Small abdominal incisions for laparoscopy, or through the cervix for hysteroscopy | A larger abdominal incision |
| Possible benefits | May involve smaller wounds, less postoperative discomfort and faster recovery | May be preferred or required for certain large, complex or urgent conditions |
| Limitations | Not suitable for every patient or every condition; a procedure may occasionally need conversion | Longer incision and often a longer recovery, balanced against clinical need |
| Decision | Based on diagnosis, surgical complexity, health history, patient priorities and informed consent | |
Recovery and outcomes vary with the exact procedure, anaesthesia, complexity, individual health and unexpected findings.
How the need for surgery is decided
A scan finding alone does not always mean an operation is necessary. The assessment may consider:
- Severity, duration and impact of symptoms
- Examination and imaging findings
- Whether the finding is changing or appears concerning
- Age, general health and previous surgery
- Pregnancy and fertility goals
- Response to observation or medical treatment
- Likely benefit compared with procedural and anaesthetic risk
- Whether specialist or multidisciplinary input is needed
Laparoscopic procedures
Diagnostic and operative laparoscopy
- Diagnostic laparoscopy
- Chromopertubation or dye test for tubal patency
- Adhesiolysis
- Endometriosis excision or ablation
- Endometrioma surgery
- Ovarian cystectomy
- Oophorectomy and salpingo-oophorectomy
- Management of ovarian or adnexal torsion
- Ectopic pregnancy surgery, including salpingectomy or salpingostomy
- Fertility-preserving tubal surgery
- Laparoscopic myomectomy
- Total or subtotal laparoscopic hysterectomy
- Laparoscopic-assisted vaginal hysterectomy
- Ovarian drilling
- Laparoscopic sterilisation
- Removal of a migrated intrauterine device
- Laparoscopic prolapse surgery, including sacrocolpopexy
- Other indicated laparoscopic gynaecological procedures
Hysteroscopic procedures
Diagnostic and operative hysteroscopy
- Diagnostic hysteroscopy
- Directed endometrial biopsy
- Hysteroscopic polypectomy
- Hysteroscopic myomectomy for submucosal fibroids
- Hysteroscopic adhesiolysis for intrauterine adhesions or Asherman syndrome
- Uterine septum resection or hysteroscopic metroplasty
- Removal of retained or misplaced intrauterine devices
- Removal of retained products of conception
- Hysteroscopic tubal cannulation for proximal tubal block
- Endometrial ablation for heavy menstrual bleeding
- Removal of intrauterine foreign bodies
- Other indicated hysteroscopic gynaecological procedures
What to expect before a procedure
- Confirm the indication. Review symptoms, reports, images and whether alternatives are reasonable.
- Plan the procedure. Discuss the intended operation, possible additional steps, anaesthesia and whether tissue will be sent for examination.
- Assess readiness. Complete indicated blood tests, imaging, medical or anaesthetic review, fasting instructions and medicine adjustments.
- Give informed consent. Understand expected benefits, material risks, alternatives, recovery, the possibility of unexpected findings and when plans might change.
What to expect after a procedure
Recovery depends on the exact operation. The plan may include pain relief, wound or bleeding care, activity guidance, diet, medicines, pathology review and a follow-up visit. Some shoulder discomfort and bloating can occur after laparoscopy; light bleeding or cramping can occur after hysteroscopy. Your discharge instructions should specify what is expected for your procedure.
Seek urgent postoperative assessment for heavy bleeding, severe or increasing pain, fainting, breathing difficulty, chest pain, persistent vomiting, fever, increasing abdominal swelling, foul-smelling discharge, worsening wound redness or pus, or inability to pass urine. Follow the emergency instructions provided after the procedure.
Common questions about minimally invasive surgery
When is hysteroscopy recommended?
It may be recommended when symptoms or imaging suggest a problem within the uterine cavity, including abnormal bleeding, polyps, submucosal fibroids, adhesions, infertility, recurrent pregnancy loss or a retained device. The indication is decided after individual assessment.
What conditions can be treated through laparoscopy?
Ovarian cysts, endometriosis, ectopic pregnancy, fibroids, adhesions and other gynaecological conditions may be managed laparoscopically. Suitability depends on the diagnosis, anatomy, urgency and complexity.
Is laparoscopy always better than open surgery?
No. Laparoscopy offers potential recovery advantages for many procedures, but open surgery may be safer or more appropriate for certain large, complex, suspicious or emergency conditions. The best approach depends on the patient and the procedure.
How should I prepare for hysteroscopy?
Follow the instructions you are given about timing, pregnancy exclusion, medicines, fasting if anaesthesia is planned, investigations and transport home. Preparation differs between diagnostic and operative hysteroscopy.
Can I get a second opinion on a scan or proposed operation?
Yes. Bring the report, scan images where available, previous records, a medicine list and the proposed plan. A consultation can focus on the diagnosis, alternatives, timing and consent.
The exact procedure and approach are decided after individual assessment. This information does not replace a surgical consultation or informed consent.