Surgical approaches · Şişli / Istanbul
Minimally invasive gynecologic surgery: choosing the right approach
Laparoscopy, hysteroscopy and vNOTES use different routes and instruments to treat selected gynecological conditions. The priority is not simply to make the smallest incision; it is to choose an effective and safe procedure for your circumstances.
In brief: Minimally invasive gynecologic surgery is not a single operation. The surgical route depends on the location of the problem, the purpose of surgery, previous operations, your health and future pregnancy plans.
What procedures are included?
Laparoscopy uses small abdominal openings and a camera to access the pelvis. Hysteroscopy examines the inside of the uterus through the cervix, without abdominal incisions. vNOTES is an endoscopic technique using a transvaginal natural-orifice approach for selected operations. Each method solves a different clinical problem.
For example, a polyp within the uterine cavity may be suitable for hysteroscopy, while an ovarian cyst may be treated laparoscopically. When hysterectomy is appropriate, vaginal, laparoscopic, vNOTES and open routes may all need consideration.
Conditions that may be considered for surgery
- Selected ovarian cysts and endometriomas.
- Fibroids requiring surgical treatment, depending on their size and location.
- Some cases of endometriosis and pelvic adhesions.
- Endometrial polyps, certain submucosal fibroids or uterine cavity abnormalities.
- Selected benign conditions for which hysterectomy has been agreed upon.
Observation, medication and fertility-sparing alternatives should be considered before deciding that an operation is required.
How is the surgical route selected?
At my Şişli clinic, I review symptoms, gynecologic examination findings, ultrasound images and any relevant tests. Previous surgery, possible adhesions, the extent of disease, coexisting conditions and reproductive goals may change the recommended operation.
An agreed minimally invasive plan can occasionally require a different surgical route if safety demands it. This possibility belongs in informed consent, rather than being treated as an unexpected failure.
Benefits, limitations and potential complications
For well-selected patients, smaller abdominal incisions and some approaches may offer less early discomfort or a quicker return to everyday activities. These outcomes are not guaranteed. Potential complications include bleeding, infection, injury to nearby organs, anaesthetic problems, blood clots and further surgery.
Terms such as “scar-free,” “completely painless” and “same-day discharge for everyone” can mislead. A vNOTES procedure may avoid routine skin incisions while still involving internal surgery.
Preparation and recovery
The plan covers medication, anaesthesia, the proposed procedure, tissue analysis when needed and follow-up. Recovery after diagnostic laparoscopy, extensive endometriosis surgery and hysteroscopic polyp removal is different. See our laparoscopy recovery information in Turkish and hysteroscopy aftercare in Turkish; an English explanation can also be provided during consultation.
Related techniques and patient guides
Frequently asked questions
Is keyhole surgery always safer than open surgery?
No. Less invasive access may benefit a suitable patient, but complexity, disease extent and anatomy sometimes make open surgery a better option.
Are hysteroscopy and laparoscopy the same procedure?
No. Hysteroscopy examines the uterine cavity through the cervix; laparoscopy provides access to the pelvis through abdominal ports.
Will vNOTES leave a scar on my abdomen?
Standard vNOTES access avoids routine abdominal skin incisions, but conversion or an additional access route may occasionally be required.
Where are operations performed?
My operations and anaesthesia-based procedures are planned in hospital conditions at Memorial Şişli Hospital, following individual assessment.
Clinical references and editorial note
RCOG: Laparoscopy — recovering well; RCOG: Outpatient hysteroscopy (2025); PETKOZ: vNOTES national guideline (2026).
This page provides general patient education. It does not replace a clinical examination, imaging, anaesthetic assessment or individual informed consent. Medical content: Op. Dr. Alparslan Demir, Specialist in Obstetrics and Gynaecology.