Laparoscopy — often called keyhole or closed surgery — allows gynecologic surgeons to see and treat the abdominal and pelvic organs through incisions of just a few millimetres. For women struggling to conceive, it is often both a diagnostic breakthrough and a treatment in a single session.
How Is Laparoscopy Performed?
- Anaesthesia: the procedure is performed under general anaesthesia, so the patient feels nothing.
- Small incision: a cut of roughly 0.5–1 cm is made just below the navel; one or two additional small incisions may be added in the lower abdomen.
- Insufflation: carbon dioxide gas is introduced through a fine (Veress) needle, lifting the abdominal wall away from the organs to create working space.
- The laparoscope: a thin tube carrying a light source and a high-resolution camera is inserted, projecting a magnified image of the pelvic organs onto a monitor.
- Instruments: fine surgical instruments (scissors, forceps, cautery) enter through the other incisions, and the surgeon operates while watching the screen.
- Closure: the gas is released and the tiny incisions are closed with cosmetic sutures or adhesive strips.
When Is Laparoscopy Recommended?
Diagnosing and Treating Infertility
- Endometriosis (chocolate cysts): endometriosis implants, adhesions and endometriomas can be diagnosed and removed or ablated in the same operation. Read more about the condition in our article on endometriosis and fertility.
- Blocked or damaged fallopian tubes: tubal patency can be assessed and, in selected cases, repaired. In hydrosalpinx (fluid-filled tubes), removing the tube before IVF significantly improves success — see our guide on options when the tubes are blocked.
- Uterine fibroids (myomectomy): fibroids that distort the uterine cavity or block the tubal openings can be removed laparoscopically.
- Ovarian cysts: endometriomas, dermoid cysts and other pathological cysts are excised while preserving as much healthy ovarian tissue — and fertility — as possible.
- Pelvic adhesions: scar tissue from past infections, surgery or endometriosis can be released to restore normal tubal and ovarian anatomy.
- PCOS and ovarian drilling: in selected patients, tiny punctures on the ovarian surface can trigger ovulation — though this is not a first-line treatment for every patient.
Other Gynecologic Indications
Laparoscopy is also used to investigate chronic pelvic pain, to treat ectopic pregnancy while preserving the tube where possible, to perform hysterectomy, to remove ovaries or tubes when necessary, to correct pelvic organ prolapse with suspension procedures, and to take diagnostic biopsies from suspicious tissue.
Advantages Over Open Surgery
- Millimetre-scale incisions instead of a large abdominal cut — with far better cosmetic results
- Less postoperative pain and lower painkiller requirements
- Faster recovery — often same-day or next-day discharge
- Less blood loss and a lower risk of infection
- Fewer postoperative adhesions, which matters greatly for future fertility
- Superior visualisation: the magnified camera image lets the surgeon detect and treat even tiny lesions with precision
Recovery After Laparoscopy
Most patients go home the same day or the next day. Mild pain — including shoulder pain caused by the residual gas irritating the diaphragm — is normal and short-lived. The small incisions need only simple care; watch for signs of infection such as redness, swelling, discharge or fever. Light walking can start almost immediately, while heavy lifting, strenuous exercise and intercourse should wait as advised by your surgeon. Most patients return to work within 3–7 days (up to two weeks after more extensive procedures), and normal eating resumes within hours of surgery. A follow-up visit completes the process.
What Does It Mean for Your Fertility?
By removing endometriosis, fibroids, cysts and adhesions, laparoscopy restores normal pelvic anatomy and can substantially increase the chance of natural conception. Before IVF, treating hydrosalpinx or large fibroids prepares the uterus for embryo transfer and improves treatment success. And in unexplained infertility, direct visualisation of the pelvis often reveals the answer that other tests could not.
At Ankara IVF Center, endoscopic operations are performed by Prof. Dr. Mehmet Çınar, who has nearly 20 years of experience in minimally invasive gynecologic surgery. Most procedures are day cases, with patients discharged within 24 hours. Contact us to discuss whether laparoscopy is the right step in your fertility journey.