Keyhole surgery: safety, risks and when to seek legal advice

Keyhole surgery (laparoscopic or minimally invasive surgery) is generally regarded as safer than open surgery, but with important caveats depending on the condition of the patient and the surgeon’s expertise.

What is laparoscopy?

Laparoscopy is a minimally invasive surgical technique that allows surgeons to view and operate on structures within the abdomen or pelvis through small incisions, typically using a camera‑equipped instrument called a laparoscope. The procedure is performed under general anaesthetic and is widely used in many surgical specialties, including gynaecology, because it offers excellent visibility while avoiding the larger wounds associated with open surgery.

By inserting a camera and fine instruments through keyhole‑sized entry points, surgeons can diagnose conditions, remove diseased tissue, or perform complex therapeutic interventions with reduced trauma to the patient’s body.

Laparoscopy is performed for a wide range of reasons. In gynaecology, it may be used to investigate pelvic pain, confirm (or treat) endometriosis, remove ovarian cysts, manage ectopic pregnancy, or perform procedures such as hysterectomy or sterilisation.

Outside of gynaecology, it is commonly used for gallbladder removal, appendectomy, and diagnostic exploration of abdominal symptoms when non‑invasive tests are inconclusive.

The minimally invasive nature of the approach generally results in quicker recovery times, less post-operative pain, and shorter hospital stays, which is why it has become the standard of care for many conditions.

What are the recognised risks and complications of laparoscopy?

As with any surgical procedure, laparoscopy carries recognised risks and potential complications. These include bleeding, infection, injury to organs such as the bowel, bladder, or blood vessels, complications from anaesthesia, and post-operative issues such as hernia formation at incision sites.

Specific risks arise from the process of inserting instruments into the abdomen and from the use of gas insufflation to create working space. Although serious complications are uncommon, they are well recognised in surgical literature and should be clearly explained to patients as part of the consent process.

Gynaecological complications can arise during laparoscopy for several reasons. The pelvic anatomy is intricate, with reproductive organs lying close to the bladder, bowel, ureters, and major blood vessels, making accidental injury possible even in the hands of competent surgeons. Adhesions from prior surgery, a distorted anatomy from underlying disease, or unexpected bleeding can increase the technical difficulty of the procedure.

Some injuries may occur at the very start of the operation – such as during initial entry into the abdomen – while others may develop during dissection or removal of tissue. Crucially, certain complications are known to occur even when the surgeon performs the procedure with appropriate skill and care.

When is a complication of laparoscopy considered negligent?

Whether a complication is regarded as negligent depends on whether the surgeon’s actions fell below the standard expected of a reasonably competent practitioner in that field of medicine. Some recognised complications, such as bowel or ureteric injury during difficult pelvic surgery, can occur despite best practice and are therefore not, in themselves, evidence of negligence.

Negligence is more likely to be considered where there has been a failure to perform the procedure to an acceptable professional standard, such as incorrect instrument placement, inadequate visualisation, failure to identify obvious anatomical structures, or failure to recognise and manage an injury during or after the procedure. Similarly, inadequate consent, meaning the patient was not properly informed of material risks, may also be considered negligent, even if the surgical technique was otherwise appropriate.

Pursuing a claim for negligence following laparoscopy

When medical negligence solicitors are investigating both surgical and gynaecological claims, they will consider and advise on whether the surgical or gynaecological team acted in a way that no responsible body of clinicians would do in the same circumstances.

This would be either by doing something that they should not or failing to do something that they should (the test for negligence), and then whether that failure caused an injury that would not otherwise have occurred or made the consequences more severe (the test for causation of damage).

We would be happy to talk to you to see whether starting a medical negligence investigation is merited following laparoscopy. For further information, please contact us on freephone 0800 328 9545, email clinnegspecialist@penningtonslaw.com or complete our online assessment form.