What Is Laparoscopy?

People who have had laparoscopy often sound almost puzzled afterwards: the operation sounded major, yet they woke up with just a few small dressings on their abdomen. That gap between the seriousness of the work and the smallness of the cuts is exactly the point. Laparoscopy — often called keyhole surgery — lets a surgeon look inside the abdomen or pelvis, and operate there, through incisions so small they're usually closed with a stitch or two, working from a camera picture on a screen instead of a large open wound.

The short video at the top of this page shows the technique in its clearest form. "Diagnostic Pelvic Laparoscopy" (about a minute and a half) follows a surgeon examining the uterus, fallopian tubes and ovaries: you can spot a small fibroid appearing as a bulge on the uterus, and watch blue dye travel through the tubes and spill from their ends, confirming both tubes are open. Nothing is removed and nothing is repaired — the whole job of that procedure is to see. Many laparoscopies go further and treat what they find, but every one of them runs through the same basic steps, so let's walk through them in order.

Step one: you're asleep, and the team gets set up

Laparoscopy is done under general anaesthetic, so you'll be fully asleep and feel nothing. Once you're asleep, the team positions you, cleans the skin of your abdomen, and covers the area with sterile drapes, leaving only the small working area exposed. If you'd like the fuller picture first — why doctors reach for this technique, what the results can show, and where the risks sit — the chaptered explainer "What Is Laparoscopy?" (about four and a half minutes) breaks the topic into exactly those sections before you watch a real case.

Step two: small openings, a little gas, room to work

The surgeon makes a first small cut, commonly at or near the navel, and passes a hollow tube called a port through it. Carbon dioxide gas is gently pumped in through that port. That might sound odd, but it's the move that makes keyhole surgery possible: the gas lifts the abdominal wall away from the organs underneath, opening up a clear, well-lit space to work in — rather like inflating a collapsed tent. One or two further small ports are then placed for the working instruments. The cuts themselves are typically around half a centimetre to a centimetre and a half long.

Step three: the camera goes in, and the screen takes over

Through the first port slides the laparoscope — a slim tube carrying a camera and a light. From that moment the surgeon operates by watching a monitor, not by looking into the body directly. The camera can be angled and moved to inspect organs in turn: liver, gallbladder and bowel in the upper abdomen, or uterus, tubes and ovaries in the pelvis, as in the video above. That dye moment is worth pausing on, because it shows what a diagnostic laparoscopy can settle in minutes. Questions that scans left open — are the tubes blocked? is there a fibroid, and where exactly? — get direct, visual answers. It's one reason the technique features so often in fertility investigations, a connection our fertility hub explores from the patient's side.

Step four: looking can turn into doing

If the laparoscopy is purely diagnostic, the inspection is the whole procedure. But often the plan — agreed with you beforehand — is to treat anything suitable that's found, there and then, through the same small ports: slender instruments grasp, cut, seal small blood vessels, take tissue samples, or remove what's diseased. Whole operations you may have heard of are routinely done this way. Gallbladder removal is the classic example — our step-by-step guide to how a gallbladder is removed follows that operation in detail, and the gallbladder hub collects the wider picture. Appendix removal, hernia repair and many gynaecological operations are also commonly laparoscopic. Occasionally the surgeon finds that the safe way to finish is to convert to an open operation with a larger incision; that's not a failure or a complication in itself, just a judgement call in favour of safety, and the possibility is normally discussed with you before you sign the consent form.

Step five: waking up, and the first few days

At the end, the instruments and camera come out, the gas is released, and the small cuts are closed and dressed. Most people are surprised by two things in recovery: how little the wounds themselves hurt, and how odd the leftover gas can feel — a bloated sensation, sometimes with an ache that seems to sit oddly in the shoulder, which eases as your body absorbs the remaining gas over the following days. Because the cuts are small and the bowel is handled less than in open surgery, recovery is usually quicker and the hospital stay shorter, though the inside healing still deserves respect — a small scar on the skin doesn't mean the internal work was trivial. Our preparation guide on laparoscopy recovery walks through the first days at home, what to watch for, and when to call the team.

No operation is risk-free, and laparoscopy is no exception: bleeding, infection, injury to nearby structures such as bowel or bladder, and reactions to the anaesthetic are all recognised possibilities, which is why the consent discussion matters. What the keyhole approach changes is the scale of the wound and, for most people, the speed of getting back on their feet — not the need for a skilled team and a careful decision beforehand.

References & further reading

• NHS — Laparoscopy (keyhole surgery): https://www.nhs.uk/tests-and-treatments/laparoscopy/
• Johns Hopkins Medicine — Laparoscopy: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/laparoscopy
• American College of Obstetricians and Gynecologists — Laparoscopy FAQ: https://www.acog.org/womens-health/faqs/laparoscopy

Frequently Asked Questions

Is laparoscopy the same as keyhole surgery?

Yes — they're two names for the same approach. Laparoscopy is the medical term for operating in the abdomen or pelvis with a camera (the laparoscope) through small incisions; "keyhole surgery" and "minimally invasive surgery" describe the same idea in plain language.

Will I be awake during a laparoscopy?

No. Laparoscopy is performed under general anaesthetic, so you're fully asleep throughout and won't feel the procedure. You'll wake up in recovery once the camera and instruments have been removed and the small cuts closed.

Why does my shoulder ache after laparoscopy?

It's usually the carbon dioxide gas used to create working space. A little gas is often left behind at the end and irritates the diaphragm as your body absorbs it over the next day or two — and irritation there is commonly felt as an ache in the shoulder. It settles on its own; your team will tell you what pain relief to use and which symptoms should prompt a call instead.

What if the surgeon has to switch to open surgery?

Sometimes the safest way to finish an operation is to make a larger incision — for example if the view is poor or something unexpected is found. This is called converting to open surgery. It isn't a mistake; it's a safety decision, and the possibility is normally covered when you consent to the procedure.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Educational only — this article is general information about laparoscopy, not medical advice and not a diagnosis. Whether laparoscopy is right for you, and what it might show or treat, are decisions for your own surgical team, who know your history and your scans.