Pearl obstetrics | gynaecology

The advantages of keyhole surgery

laparoscopy or keyhole surgery

There are two main types of keyhole surgery used in gynaecology.


in this type of operation, a narrow telescope is passed into the womb. Problems inside the womb are therefore able to be treated without any cuts on the outside at all.

Typical operations include:

  • exploratory operations
  • biopsies
  • removal of polyps (small growths)
  • removal of small fibroids
  • reshaping the interior shape of the womb; which improves fertility
  • sterilisation procedures.

Recovery is very rapid, and potential complications are few. They will be discussed with you at the the time of booking during the informed consent process.


In this type of operation, a small camera is passed, usually through the tummy button. This allows us to see inside the abdomen and pelvis. This scar usually heals very well – often becoming invisible with time.

Additional small 5 mm incisions are made in the lower part of the abdomen – normally between one and three. These additional incisions allow operations to be performed using a variety of sophisticated technologies, and remove any specimens that may be needed.

Keyhole surgery is more difficult to perform than traditional open surgery but, because of the magnification, things are much clearer and the surgery is more precise. Recovery is much faster, and it’s very common for women to walk out of the hospital after a few hours after quite significant procedures, with only a week to fully recover.

Common operations performed at laparoscopy include:

  • hysterectomies
  • removal of ovarian cysts
  • removal of the fallopian tubes
  • removal of fibroids
  • treatment of endometriosis
  • removal of adhesions and scar tissue
  • infertility surgery

Overall, 95% of Dr Sillender’s surgeries are performed using keyhole methods. There are some conditions which require traditional techniques with bikini-line or midline abdominal incisions, but the default technique is nearly always a minimal access or keyhole surgery method.

The risks of this type of keyhole surgery are important to mention. Fortunately serious complications are extremely uncommon. The most important risk is that of damage to bowel or a major blood vessel at the time the laparoscope is inserted at the start of the operation. This is said to occur in about 1:1000 cases. Other risks are infection, bruising, bleeding, and specific complications of the particular operation. For instance, removal of fibroids can lead to bleeding, scar tissue forming afterwards and slight weakening of the womb during pregnancy. Possible complications will all be discussed at the time of taking informed consent before booking the operation.

Any surgical or invasive procedure carries risks. Before proceeding, you should do your own research. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. For instance, your GP’s opinion will be very helpful.

Dr. Mark Sillender. Consultant obstetrician & gynaecologist