Laparoscopic Surgery in Campbelltown: What Is Keyhole Surgery and How Does It Work?
General information only: This article provides general educational information about laparoscopic (keyhole) surgery. It does not replace assessment or personalised advice from your GP or surgeon. Whether laparoscopic surgery is appropriate for your individual situation depends on your diagnosis, anatomy and overall health. Discuss your specific circumstances with your surgeon at consultation. |
Keyhole Surgery in Campbelltown — What Does It Mean?
If you have been told you need surgery — whether for a hernia, gallbladder problem, reflux, bowel condition or weight loss — there is a good chance your surgeon has mentioned laparoscopic surgery, also known as keyhole surgery. For many patients, the word ‘surgery’ brings to mind a large incision, a long hospital stay and a slow recovery. Laparoscopic surgery is a very different experience.
Laparoscopic surgery is a minimally invasive approach to abdominal and pelvic operations in which the surgeon operates through several small incisions — typically between 5mm and 12mm — using a miniature camera and long, slender instruments. The camera transmits a magnified, high-definition view of the operative field to a monitor in the operating theatre, allowing the surgeon to perform complex procedures with precision through incisions a fraction of the size used in traditional open surgery.
Dr Devesh Kaushal is a specialist general surgeon performing laparoscopic surgery in Campbelltown and South Western Sydney, including laparoscopic cholecystectomy, hernia repair, anti-reflux surgery, bariatric surgery, appendicectomy and colorectal procedures.
Laparoscopic Surgical Consultations — Campbelltown Contact the rooms to discuss current availability | (02) 7906 8312 | drdeveshkaushal.com.au |
From Open to Keyhole — A Brief History
Before laparoscopic surgery became widely available in the late 1980s and early 1990s, virtually all abdominal operations were performed as open surgery — through a single large incision in the abdomen. While open surgery remains necessary in certain situations, laparoscopic surgery transformed abdominal surgery by demonstrating that most common procedures could be performed safely with a fraction of the tissue disruption, resulting in dramatically better patient experience and faster recovery.
Laparoscopic cholecystectomy — keyhole gallbladder removal — was among the first procedures to be widely adopted laparoscopically and remains one of the most commonly performed laparoscopic operations in Australia. Since then, the technique has been extended to cover the majority of general surgical procedures, including complex operations such as bowel resection, bariatric surgery, and major anti-reflux surgery.
How Does Laparoscopic Surgery Work? — Step by Step
Understanding how keyhole surgery works helps patients feel more informed and prepared before their procedure. The following explains the essential steps involved in a laparoscopic abdominal operation.
1 | General anaesthesia Laparoscopic surgery is performed under general anaesthesia — you are fully asleep and feel nothing during the procedure. A specialist anaesthetist manages your anaesthesia throughout the operation. A pre-operative assessment is performed beforehand to ensure you are fit for general anaesthesia. |
2 | Small incisions (ports) The surgeon makes several small incisions in the abdomen — typically 3 to 4, each between 5mm and 12mm. These are sometimes called port sites. A small tube called a trocar is inserted through each incision. The trocars provide the entry points through which the camera and instruments are passed. |
3 | Carbon dioxide insufflation Carbon dioxide gas is gently introduced into the abdominal cavity through one of the trocars. This inflates the abdomen — creating a working space between the abdominal wall and the internal organs — and allows the surgeon a clear view. The gas is completely absorbed and expelled by the body after surgery. Residual gas can occasionally cause temporary shoulder tip discomfort in the first 24 to 48 hours after surgery. |
4 | Laparoscope (camera) insertion A laparoscope — a thin, rigid telescope with a high-definition camera at its tip — is inserted through one of the trocars. The camera transmits a real-time, magnified image of the inside of the abdomen to a monitor in the operating theatre. The magnification often allows the surgeon to see anatomical structures in greater detail than is possible in open surgery. |
5 | Surgical instruments Long, slender surgical instruments — including graspers, scissors, dissectors, clip applicators and energy devices — are passed through the remaining trocars. The surgeon controls these instruments from outside the body, guided entirely by the camera image on the monitor. The instruments are designed to allow precise tissue handling, cutting, haemostasis and suturing through the small incisions. |
6 | The procedure The surgical procedure itself varies depending on the operation being performed — whether gallbladder removal, hernia repair, anti-reflux surgery, or another procedure. The steps of the operation are the same as in open surgery; only the access method is different. The operating time depends on the complexity of the procedure. |
7 | Closure At the end of the procedure, the carbon dioxide gas is released, the instruments are removed, and the small incisions are closed — usually with dissolvable stitches under the skin and small adhesive strips or dressings on the surface. No stitches to remove are required in most cases. |
Laparoscopic vs Open Surgery — Key Differences
The table below compares laparoscopic and open surgery across several factors relevant to patients considering surgery in Campbelltown and South Western Sydney.
Factor | Laparoscopic (Keyhole) | Open Surgery |
Incisions | 3–4 small incisions (5–12mm each) | One large incision (8–20cm depending on operation) |
Hospital stay | Day surgery or 1–2 nights for most procedures | 3–7 days depending on the operation |
Post-op pain | Usually mild to moderate — managed with oral analgesia | More significant — may require stronger pain relief |
Return to desk work | Typically 1–2 weeks | 3–6 weeks |
Return to physical work | Typically 4–6 weeks | 6–8 weeks or longer |
Scarring | 3–4 small scars, usually fading to thin lines | One longer scar — size varies by operation |
Infection risk | Lower — smaller wounds | Higher — larger wound surface area |
Blood loss | Generally less | Generally greater |
Visualisation | Magnified HD camera view — excellent detail | Direct vision — dependent on incision size and depth |
Anaesthesia | General anaesthesia | General or regional anaesthesia |
Important: The comparison above reflects general tendencies and does not apply in every case. For some patients and some conditions, open surgery is the safer or more appropriate choice. The decision is always individualised based on your diagnosis, anatomy, previous surgery and overall health. Dr Kaushal discusses the most appropriate approach for your specific situation at consultation. |
Which Operations Can Be Performed Laparoscopically?
The range of procedures performed laparoscopically has expanded substantially over the past three decades. The following outlines the laparoscopic procedures available through Dr Kaushal’s practice in Campbelltown:
Gallbladder:
- Laparoscopic cholecystectomy — Keyhole removal of the gallbladder. The most commonly performed laparoscopic procedure in Australia. Typically performed as day surgery with discharge the same day or the following morning.
Hernia:
- Laparoscopic inguinal hernia repair — Keyhole repair of groin hernia. Mesh is placed behind the abdominal wall to reinforce the defect. Particularly suited to bilateral (both sides) hernia repair and recurrent hernia after previous open repair.
- Laparoscopic umbilical and incisional hernia repair — Keyhole repair of belly button or surgical scar hernias. Mesh is placed from the inside of the abdominal cavity.
Upper GI and anti-reflux:
- Laparoscopic fundoplication — Anti-reflux surgery for gastro-oesophageal reflux disease (GORD) not controlled by medication. The upper stomach is wrapped around the lower oesophagus to recreate the anti-reflux valve.
- Laparoscopic hiatus hernia repair — Repair of the diaphragmatic defect through which the stomach has herniated, performed alongside fundoplication when appropriate.
Bariatric (weight loss) surgery:
- Laparoscopic gastric sleeve (sleeve gastrectomy) — Approximately 75 to 80 percent of the stomach is removed laparoscopically, leaving a narrow sleeve. Reduces stomach capacity and alters gut hormones affecting appetite and metabolism.
- Laparoscopic Roux-en-Y gastric bypass — The stomach is divided to create a small pouch, which is connected directly to the small intestine. Both restrictive and malabsorptive effects contribute to weight loss.
Appendix:
- Laparoscopic appendicectomy — Keyhole removal of the appendix. The standard approach for appendicitis in Australia. Typically performed as an emergency or semi-urgent procedure.
Colorectal:
- Laparoscopic colonic resection — Removal of a segment of the colon for cancer, diverticular disease or other pathology. A technically complex procedure requiring specialist laparoscopic training.
Not all procedures are suitable for a laparoscopic approach: Some conditions and some patients are better served by an open operation. Previous abdominal surgery, significant inflammation, obesity, or unexpected intraoperative findings may lead the surgeon to recommend or convert to an open approach. This is a clinical decision made in the patient’s best interest, not a complication. |
Before Laparoscopic Surgery — What to Expect
Once a decision has been made to proceed with laparoscopic surgery, the following pre-operative steps typically apply:
- Pre-operative consultation with Dr Kaushal — review of your history, examination, investigation results, and discussion of the procedure, risks, benefits and alternatives
- Consent — written informed consent is obtained before any operation. You have the right to ask questions, take time to consider, and decline
- Pre-operative blood tests and ECG — depending on your age and medical history
- Anaesthetic review — for patients with significant medical conditions, a pre-operative anaesthetic assessment may be arranged
- Fasting — you will be asked to fast from food and fluids for a specified period before surgery. Follow the instructions provided by the hospital and Dr Kaushal’s rooms
- Medication review — some medications need to be paused before surgery, including blood thinners and certain supplements. Your GP and Dr Kaushal will advise
- Arrange transport and a support person — you cannot drive yourself home after general anaesthesia. A responsible adult must drive you and remain with you for the first night
After Laparoscopic Surgery — Recovery
Recovery after laparoscopic surgery varies depending on the procedure performed, the patient’s age and overall health, and whether any unexpected findings were encountered at the time of surgery. The following outlines the general recovery pattern for most laparoscopic abdominal procedures:
In the recovery room:
- You will wake in the post-anaesthetic care unit (recovery room), monitored by nursing staff
- Mild to moderate pain and nausea are common immediately after surgery and are managed with medications
- Shoulder tip pain from residual carbon dioxide gas is common and usually settles within 24 to 48 hours
- You will be able to have sips of water and light fluids once awake and tolerating them
Discharge:
- Most laparoscopic procedures are performed as day surgery — patients go home the same day
- Some procedures (including larger hernia repairs, anti-reflux surgery, and bariatric surgery) may require an overnight or two-night stay
- Discharge is when the nursing staff are satisfied you are stable, comfortable, and have someone to take you home
At home — first week:
- Rest is important. Avoid strenuous activity, heavy lifting or vigorous exercise for the first week
- Gentle walking is encouraged from day one — it reduces the risk of blood clots and aids recovery
- Keep wounds dry and covered per the discharge instructions — showering is usually permitted after 48 hours
- Pain is managed with paracetamol and anti-inflammatory medication as prescribed — avoid NSAIDs if you have had gastric bypass or gastric sleeve surgery
- Diet varies by procedure — a soft or low-fat diet in the first week is typical for most abdominal procedures. Specific dietary instructions will be provided at discharge
Return to normal activity:
- Desk or office work — typically 1 to 2 weeks after most laparoscopic procedures
- Driving — when you can perform an emergency stop without pain, usually 5 to 10 days after surgery
- Manual work and heavy lifting — typically 4 to 6 weeks
- Return to gym and sport — as advised by Dr Kaushal at your post-operative appointment
Post-operative follow-up: A follow-up appointment with Dr Kaushal is arranged after surgery — typically at 2 to 4 weeks for most procedures, or sooner if indicated. Attend this appointment even if you feel well. Any concerns about wounds, pain, symptoms or recovery should be raised at this appointment or by contacting the rooms. |
Risks of Laparoscopic Surgery
Laparoscopic surgery is associated with lower complication rates than open surgery for most procedures. However, as with all operations under general anaesthesia, risks exist and should be understood before proceeding. Dr Kaushal discusses the specific risks relevant to your procedure at the pre-operative consultation.
General risks of all laparoscopic surgery:
- Bleeding — intraoperatively or post-operatively
- Infection — wound infection or internal infection (less common than with open surgery)
- Injury to surrounding structures — bowel, bladder, blood vessels or bile duct, depending on the operation
- Blood clot (deep vein thrombosis or pulmonary embolism) — risk reduced with early mobilisation and, where indicated, anticoagulation
- Anaesthetic complications — reaction to anaesthetic agents, cardiovascular or respiratory events
- Conversion to open surgery — in a proportion of cases, conversion is required for safety. This is a clinical decision, not a complication
- Hernia at port site — rare, occurs at the incision used to introduce instruments
Procedure-specific risks:
Each laparoscopic procedure has its own additional risks — for example, bile duct injury in cholecystectomy, dysphagia after fundoplication, or anastomotic leak after gastric bypass. These are discussed in detail at the pre-operative consultation for the specific procedure you are having.
Informed decision: Understanding the risks of a procedure is an essential part of giving informed consent. Dr Kaushal provides a thorough explanation of risks, benefits and alternatives at consultation, and you are encouraged to ask questions before agreeing to proceed with any operation. |
When Is Open Surgery the Better Choice?
Laparoscopic surgery is not appropriate for every patient or every condition. Open surgery may be recommended — or conversion from laparoscopic to open surgery may become necessary during an operation — in the following circumstances:
- Significant previous abdominal surgery resulting in dense intra-abdominal adhesions (scar tissue) that make laparoscopic dissection unsafe
- Severe acute inflammation — for example, perforated appendicitis or gangrenous cholecystitis — where the anatomy is distorted
- Very large tumours or complex anatomy where laparoscopic access is insufficient
- Emergency situations requiring rapid access to control bleeding or repair injury
- Patients who cannot safely tolerate carbon dioxide insufflation due to cardiorespiratory conditions
- Intraoperative findings — unexpected anatomy, bleeding, or injury — discovered during a laparoscopic procedure that require open management
Conversion from laparoscopic to open surgery is not a failure — it is a sound clinical judgment made to prioritise patient safety. Surgeons with extensive laparoscopic experience convert rarely; however, the decision to convert when necessary is a sign of good surgical judgement, not a complication.
Frequently Asked Questions
Will I be awake during keyhole surgery?
No. Laparoscopic surgery is performed under general anaesthesia — you are completely asleep throughout the procedure and do not feel or hear anything during the operation. You will wake in the recovery room once the procedure is complete.
How many incisions will I have and where?
The number and position of incisions depends on the operation being performed. For most laparoscopic abdominal procedures, three to four small incisions are made — each typically between 5mm and 12mm. One is usually at or near the belly button (umbilicus), where the camera is placed. The others are positioned to give optimal access to the operative site. Dr Kaushal will explain the expected incision placement for your specific procedure at the pre-operative consultation.
What is the shoulder tip pain I have heard about after keyhole surgery?
Shoulder tip pain — typically felt at the tip of one or both shoulders — is a recognised and common side effect after laparoscopic abdominal surgery. It is caused by residual carbon dioxide gas remaining in the abdominal cavity after the operation, which irritates the diaphragm. Referred pain from the diaphragm is felt at the shoulder tip via the phrenic nerve. This discomfort usually settles spontaneously within 24 to 48 hours as the gas is absorbed.
Is keyhole surgery always better than open surgery?
For the majority of patients and the majority of common abdominal procedures, laparoscopic surgery offers advantages over open surgery — including less pain, faster recovery, smaller scars and lower infection risk. However, this is not universal. Some patients and some conditions are better served by an open approach. The surgical technique is chosen based on the individual clinical situation — the goal is always the safest and most appropriate operation for each patient, not simply the least invasive one.
I am overweight — can I still have keyhole surgery?
Obesity does not automatically preclude laparoscopic surgery. Many patients with obesity undergo laparoscopic procedures successfully, including bariatric surgery itself. However, obesity can increase the technical difficulty of laparoscopic surgery, may require specialised equipment, and increases the general anaesthetic risk. The suitability of a laparoscopic approach in an overweight patient is assessed individually at the pre-operative consultation, taking into account the specific procedure, the degree of obesity, abdominal anatomy, and overall health.
How do I know if I need keyhole surgery or open surgery?
Your surgeon will advise you on the most appropriate operative approach for your condition and individual circumstances. In most cases, if a procedure can be safely performed laparoscopically, it will be — but the final decision takes into account your diagnosis, previous abdominal surgery history, imaging findings, and your overall health. This is discussed in detail at the pre-operative consultation, giving you the opportunity to ask questions before consenting to any procedure.
Laparoscopic Surgery in Campbelltown — Consultations
If you have been referred for a laparoscopic procedure — or would like to discuss whether a condition you have may be suitable for keyhole surgery — Dr Kaushal provides specialist surgical consultations at 4 Hyde Parade, Campbelltown. A GP referral is recommended and required for Medicare rebates.
Specialist General Surgeon | Upper GI and Bariatric Surgery 4 Hyde Parade, Campbelltown NSW 2560 Phone: (02) 7906 8312 Email: [email protected] | drdeveshkaushal.com.au Office Hours: Monday – Friday, 9:00 AM – 5:00 PM Current hospital appointments and accreditations include: Sydney Southwest Private Hospital Liverpool | Campbelltown Public Hospital | Campbelltown Private Hospital | The George Hospital Medicare rebates and private health insurance benefits may apply depending on the service, referral and individual policy. Please contact the rooms and your insurer regarding fees and potential out-of-pocket costs. |
General information only: This article provides general educational information about laparoscopic surgery. It does not replace assessment or personalised advice from your GP or surgeon. Whether laparoscopic surgery is appropriate depends on your individual diagnosis, anatomy and health. Discuss your specific circumstances with your surgeon. |