Laparoscopy is a minimally invasive surgical technique that uses small incisions and a camera to look inside the abdomen and pelvis. In gynecology, it is used to diagnose and treat conditions that affect the uterus, ovaries, tubes and pelvic peritoneum.
Through one small incision near the navel, the surgeon introduces a camera. Other small incisions are used for fine instruments. This allows precise work with less pain, smaller scars and faster recovery than traditional open surgery in many situations.
In Lisbon, Dra. Joana Faria performs and coordinates laparoscopic surgery for benign disease and infertility in Portuguese, English, French, and Spanish. She focuses on safety, clear communication and realistic expectations before and after surgery.
This page explains what laparoscopy is, when it can help and what to expect at each step. You can also read the pages on minimally invasive gynecologic surgery, benign diseases and infertility surgery, endometriosis and ovarian and tubal cysts and masses.
What it is
Laparoscopy is a surgical technique that uses a thin telescope with a camera (laparoscope) and long instruments introduced through small incisions. Carbon dioxide gas is used to gently inflate the abdomen so that the surgeon can see the organs clearly.
In gynecology, laparoscopy is used to:
- Diagnose and treat endometriosis and pelvic adhesions.
- Remove ovarian cysts and benign adnexal masses.
- Treat some fibroids on the outside of the uterus.
- Evaluate and treat tubal disease and hydrosalpinx in the context of infertility.
- Perform procedures such as salpingectomy, ovarian drilling or treatment of ectopic pregnancy in selected cases.
Laparoscopy can be purely diagnostic, but in most cases the goal is to diagnose and treat during the same procedure when it is safe to do so.
Main symptoms and when to worry
Laparoscopy is not a treatment by itself. It is a way to perform the procedures needed to treat specific diseases. Typical symptoms and situations that may lead to an indication for laparoscopy include:
- Chronic pelvic pain or very painful periods that raise the suspicion of endometriosis or adhesions.
- Infertility when tubal disease, endometriosis or adhesions are suspected.
- Ovarian cysts or pelvic masses that are persistent, symptomatic or suspicious on ultrasound or MRI.
- Hydrosalpinx or severe tubal damage detected during fertility investigations.
You should seek a gynecologic opinion if you have significant pain, repeated ovarian cysts, unexplained infertility or if exams show lesions that may benefit from surgical treatment. In consultation, the doctor will assess whether laparoscopy is appropriate and what the alternatives are.
You should seek urgent care if you have sudden intense abdominal pain, pain with fever and malaise, very heavy bleeding or vomiting with inability to stand upright. These can be signs of emergencies such as torsion, rupture, infection or ectopic pregnancy and may require urgent surgery.
Diagnosis: exams and what to expect before laparoscopy
Before proposing laparoscopy, a careful preoperative assessment is essential. The aim is to confirm that surgery is indicated, to plan the procedure and to reduce risks as much as possible.
The evaluation usually includes:
- Clinical history and physical examination
Discussion about symptoms, cycle, pregnancies, surgeries, family history, other illnesses and medicines. Pelvic examination helps to assess the uterus, ovaries and pain points. - Transvaginal ultrasound
Key exam to study the uterus, ovaries and tubes, to characterize cysts and masses and to look for signs of deep endometriosis. - Additional imaging
Pelvic MRI, hysterosalpingography or other exams may be requested to detail endometriosis, adhesions or tubal patency. - Laboratory tests
Blood tests evaluate haemoglobin, coagulation, kidney and liver function and, when needed, tumour markers and hormones. - Anesthesia consultation
You meet the anesthesiologist, who reviews your health, explains the anesthesia plan and answers questions about pain control and recovery.
You receive clear written instructions about fasting, medicines that should be stopped or adjusted and what to bring on the day of surgery. You will also know how long you are likely to stay in hospital and what support you may need at home in the first days.
Treatment options and realistic expectations
Laparoscopy is one of several options for treating benign gynecologic disease and infertility. Depending on your situation, it can be combined with medical treatment and, when relevant, with fertility treatment.
Main options include:
- Medical treatment alone
For some women, hormonal treatment and pain management provide good control of symptoms, and surgery can be avoided or postponed. - Laparoscopic surgery
Allows treatment of endometriosis, cysts, adhesions, fibroids and tubal disease through small incisions. It usually leads to less postoperative pain, shorter hospital stays and faster return to work and daily activities compared with open surgery. - Conventional surgery
In some cases, such as very large fibroids, complex adhesions or anatomy that is strongly distorted, open abdominal or vaginal surgery may be safer or more effective than laparoscopy. Your surgeon will explain when this is the case.
Realistic expectations are important. Laparoscopy can significantly reduce pain and treat many causes of infertility, but it does not guarantee pregnancy or complete disappearance of symptoms for every woman. Some diseases, such as endometriosis, can recur and may require ongoing follow up.
As with any surgery, there are risks, including bleeding, infection, injury to nearby organs and, rarely, the need to convert to open surgery. Your doctor will explain these risks in simple language and answer your questions before you decide.
How Dra. Joana Faria approaches laparoscopy
Dra. Joana Faria sees laparoscopy as a powerful tool that must be adapted to each woman. Her goal is to offer the safest and most effective approach for your specific situation.
In practice she:
- Starts from your story, your symptoms and your fertility plans, not only from imaging results.
- Explains plainly why laparoscopy is or is not recommended, and what could happen if you decide to wait.
- Plans conservative and fertility sparing surgery whenever possible, preserving healthy uterus and ovaries.
- Works with experienced anesthesiologists and surgical teams to reduce risks and improve comfort and recovery.
- Provides clear written instructions for preparation and follow up, including when you can drive, work, lift weights, exercise and have sexual intercourse.
The aim is that you feel informed, respected and supported at every step, with space to ask all your questions before and after laparoscopy.
