Keyhole surgery
Keyhole surgery treats problems in the womb, tubes and ovaries through tiny cuts or none at all, so recovery is quicker. Dr. Navdeep holds a fellowship and diploma in minimal access surgery.
With Datuk Dr. Navdeep Singh Pannu, FRCOG, at Alpha IVF & Women's Specialists, Kota Damansara
- Hysteroscopy
- Through the cervix, with no cuts
- Laparoscopy
- Through small cuts in the abdomen
- Stay
- Usually a day case, sometimes one night
- Recovery
- From a few days to about two weeks
What it is
In a hysteroscopy, a thin camera is passed through the cervix to look inside the womb. Polyps, fibroids that bulge into the cavity, scar tissue and a dividing wall (septum) can be removed at the same time. Because there are no cuts, most women go home the same day.
In a laparoscopy, a camera is passed through a small cut at the belly button, with one or two more small cuts for instruments. It is used to diagnose and treat endometriosis, remove ovarian cysts, release adhesions and check or treat the fallopian tubes.
Who it can help
- Polyps or fibroids inside the womb
- Endometriosis or endometriosis cysts
- Ovarian cysts
- Blocked or damaged fallopian tubes, including hydrosalpinx before IVF
- Scar tissue inside the womb
- Heavy or irregular bleeding
- Repeated miscarriage or failed embryo transfers
How it works
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Assessment
A scan, and other tests as needed, to find the problem and decide whether surgery will help.
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Planning
What will be done, the risks and benefits, and how it fits around your fertility plans and cycle.
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The operation
Under general anaesthesia or sedation. A hysteroscopy often takes under half an hour; a laparoscopy takes longer, depending on what is found.
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Recovery
Most women go home the same day. You will have mild cramps or shoulder-tip pain after a laparoscopy, which settles in a few days.
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Results and next steps
A review of what was found and done, and when to start trying or begin fertility treatment.
Good to know
Side effects and risks
- Bleeding or infection, which are uncommon
- Rarely, injury to the womb, bowel, bladder or blood vessels
- Risks from anaesthesia
- Surgery on the ovaries can reduce the egg reserve, so it is done only when it will help
Why it matters for fertility
Polyps, fibroids and scar tissue in the womb can stop an embryo implanting. A blocked, fluid-filled tube can lower IVF success, and removing or clipping it before IVF can help.
Timing
A hysteroscopy is usually done after your period and before you ovulate. Your plan will say when you can try for a pregnancy afterwards.
Before IVF
A hysteroscopy is sometimes advised before IVF, or after failed transfers, to check that the womb is ready.
Questions people ask
Will I have scars?
A hysteroscopy leaves none. A laparoscopy leaves small scars, usually under 1 cm each, which fade with time.
How soon can I go back to work?
Usually within a few days after a hysteroscopy, and one to two weeks after a laparoscopy, depending on what was done.
When can we try to conceive?
Often from the next cycle, but it depends on the procedure. You will be told at your review.
Is an open operation ever needed?
Rarely, for very large fibroids or complex surgery. This would be discussed with you beforehand.
Further reading
This page is general information and does not take your personal circumstances into account. Please speak to your doctor for advice that is right for you. Disclaimers