Keyhole surgery is a minimally invasive surgery involving much smaller cuts. In this technique, the surgeon makes a small incision on the skin to perform a procedure on the body.
The surgeon uses a laparoscope, a small imaging instrument, during a laparoscopy. It consists of a small light source and a camera, which projects images of the abdominal cavity or pelvis to a monitor.
Surgeons may also insert other instruments through the tiny incisions to conduct other medical procedures.
Below is a more detailed, step-by-step illustration of a typical laparoscopy/keyhole surgery:
- Step 1: The surgeon makes a small cut of about 0.5 to 1.0 cm on the abdomen (usually near the belly button)
- Step 2: The surgeon inserts a small tube pumped with carbon dioxide gas. It inflates the abdomen, giving the surgeon more visibility into the organs. It also allows them more room to work.
- Step 3: The laparoscope is inserted through the tube. It provides clear imaging on a monitor for the surgeon.
- Step 4: After examination, the surgeon airs out the carbon dioxide from the abdominal area. They stitch the incisions together to close the cuts and apply a dressing afterwards.
2. Why Is Keyhole Surgery Done?
Laparoscopic or keyhole surgery is done to examine the abdomen and pelvis of a female. Doctors perform this surgery to determine the presence of and diagnose specific medical conditions.
Keyhole surgery is also done to take out damaged or deceased internal organs.
Compared to traditional open surgery, keyhole surgery allows the patient to recover faster. Potential scarring and haemorrhaging are also prevented, thanks to only minor cuts on the body.
3. Medical Conditions Diagnosed Through Keyhole Surgery
Patients undergo keyhole surgery to allow the surgeon to diagnose and treat several conditions. It’s often used in:
- Urology – This is a branch of healthcare dealing with diseases in the urinary tract (ureters, bladder, and urethra). A laparoscopy can help identify any benign or malignant tumours in these organs.
- Gynaecology – Gynecologic laparoscopy involves the examination of the pelvic region. Surgeons perform this to diagnose health conditions like endometriosis or fibroids. Doctors can perform ovarian cyst removal, tubal ligation, or a hysterectomy.
- Gastroenterology – A laparoscopy can also help diagnose digestive issues. It can help treat and study conditions affecting the digestive system.
Surgeons often resort to laparoscopy if non-invasive diagnostic techniques, like Computed Tomography (CT) scans or ultrasounds, don’t produce a conclusive diagnosis. Keyhole surgery can treat conditions such as:
- Female infertility
- Abdominal or pelvic pain
- Pelvic inflammatory disease
- Gallbladder inflammation
- Gallstones
- Ectopic pregnancy
Sometimes a keyhole surgery may be performed to allow the doctor to get a small tissue sample from a specific area. Through laboratory analysis, they can identify the presence of cancerous or non-cancerous growths.
4. Benefits Of Keyhole Surgery
Since skin openings heal much faster in keyhole surgeries than in invasive procedures, it presents multiple benefits to patients:
- Faster recovery times
- Less noticeable scars
It can be performed on almost any part of the body, including:
- Lungs
- Head and neck
- The base of the skull
- Spine
- Joints
- Pelvis
- Abdomen
5. How To Prepare For Keyhole Surgery
Keyhole surgery may seem daunting, especially for first-time patients. The surgical team will advise them on how to prepare, helping ease their minds on the operation.
The preparation for keyhole surgery varies, but in general, a patient is expected to:
- Avoid eating or drinking anything about 6 to 12 hours before the procedure.
- Don’t take blood-thinning medication or anticoagulants like aspirin or warfarin a few days beforehand. This is so that excessive bleeding is avoided during surgery.
- Stop smoking at least a few days beforehand. Smoking could cause a delay in the recovery process and possibly increase the risk of infection.
- Follow the surgeon’s advice on bathing or shaving before the day of the surgery.
- Don’t apply any makeup or perfume.
Any other concerns regarding a laparoscopy must be communicated with the surgeon. This is to ensure the procedure is as smooth-sailing as possible.
6. Keyhole Surgery Recovery
The recovery time for keyhole surgery varies. For instance, if the surgery was done for diagnostic purposes, a patient can expect to recover within 5 to 7 days.
However, if the surgery involved the removal of a portion of an organ, recovery may take between 2 and 12 weeks.
For keyhole surgery performed on the abdomen, patients may expect a slight discomfort in the shoulder and back area. This is due to the gas used to expand the abdominal cavity during the procedure. The pain will usually go away after a few days.
Soreness and fatigue at the incision site are also common. For example, a patient may experience a sore throat if the surgery involves passing a tube down their oesophagus. They may take sore throat relief medication, as advised by the surgeon.
You must report persisting pain or discomfort that lasts well beyond several days to the surgeon. There may have been complications in the surgery. It’s best to treat them early to prevent infections, bleeding, bruising, or organ damage.
7. Possible Complications After Keyhole Surgery
It’s advisable to seek immediate medical advice if you experience any of these symptoms within 24 hours after the operation:
- High fever of 38°C and above
- Chills
- Nausea and severe vomiting
- Abnormal vaginal discharge or bleeding
- Painful burning sensation when urinating
- Pain and bruising in the legs
- Recurring abdominal pain
Conclusion
A keyhole surgery or laparoscopy is a minimally invasive surgery involving tiny incisions on the body. It treats and diagnoses conditions in the abdomen, pelvis, spine, chest, and oesophagus.
While it does have a faster recovery time, there may be complications resulting from a laparoscopy. If you’re considering a laparoscopy over open surgery, consult with an experienced surgeon to discuss your other options.
For more information on laparoscopies and keyhole surgeries, contact Dr QM Leong. He is a professional colorectal surgeon in Singapore who specialises in treating hemorrhoids, colorectal cancer, gallstones, peptic ulcers, diverticular disease, and other changes in bowel habits.
Frequently Asked Questions About Keyhole Surgery
Patients undergoing a laparoscopic or keyhole procedure can often expect up to four 0.5 to 1.0 cm cuts on their skin.
No. Patients will be administered general anaesthesia to remain unconscious throughout the procedure.
After surgery, patients must take time to rest and recover to prevent tears and complications. They must avoid engaging in strenuous exercise and activities, such as:
- Lifting weights
- Riding bikes
- Jogging
- Driving a car
It depends. A keyhole or laparoscopic surgery may be better than open surgery for removing cysts and tumours. But an open surgery offers better treatment for chronic diseases that have caused significant tissue or muscle damage.
