At a glance
Endoscopic surgery is a surgical technique in which a doctor operates inside the body through one or more small openings, using a thin flexible or rigid tube called an endoscope that carries a camera and a light source.
The camera sends a live picture to a monitor, so the surgeon can see and work without making a large incision (cut). Tiny instruments pass through channels in the endoscope, or through additional small cuts nearby, to cut, remove, repair, or seal tissue. Because the outer wounds are small, the body heals faster than after open surgery.
Medical Condition
Endoscopic surgery is used across many organ systems because the endoscope can be guided to almost any part of the body through natural openings or small incisions. The specific conditions it treats depend on which organ is targeted, but all share one feature: the problem can be reached and fixed without opening the body widely.
- Gallstones or gallbladder disease requiring removal of the gallbladder (laparoscopic cholecystectomy)
- Polyps (small growths) or early tumours in the colon, stomach, or oesophagus
- Gastro-oesophageal reflux disease (GERD, chronic acid rising from the stomach into the throat) not controlled by medication
- Appendicitis (inflammation of the appendix) requiring removal
- Hernias, including inguinal (groin) and hiatal (stomach pushing through the diaphragm) hernias
- Endometriosis (uterine lining tissue growing outside the uterus) and uterine fibroids
- Joint problems such as torn ligaments or cartilage damage treated by arthroscopy (endoscopy of a joint)
- Sinus disease, nasal polyps, and skull-base conditions treated through the nose
- Urinary tract stones or blockages treated through the ureter (the tube connecting kidney to bladder)
- Lung or chest conditions approached through small cuts between the ribs (thoracoscopy)
Endoscopic surgery is not always the right choice. Your surgical team will weigh up whether it is suitable for you based on several factors.
- Very advanced or large tumours that require wide surgical access
- Severe scarring inside the body from previous operations, which makes navigation with the endoscope unsafe
- Active, heavy bleeding that needs to be controlled immediately through an open approach
- Certain heart or lung conditions that prevent safe use of the gas used to inflate the abdomen during laparoscopic (keyhole abdominal) surgery
- Obesity or body anatomy that makes instrument placement technically impossible
Risks & Complications
Endoscopic surgery is generally safer than open surgery, but like all operations it carries recognised risks, and the specific risks vary depending on which organ is being treated.
- Pain, bruising, or swelling around the small entry wounds
- Infection at the skin incision sites or, less commonly, inside the body cavity
- Bleeding during or after the procedure, which in some cases requires conversion to open surgery
- Accidental injury to nearby structures, such as blood vessels, nerves, or the bowel, during instrument manipulation
- Conversion to open surgery if the endoscopic approach cannot be completed safely
- Gas embolism (a bubble of the gas used to inflate the abdomen entering a blood vessel), which is rare but serious
- Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), particularly after longer procedures
- Shoulder or upper-body aching from the gas used to inflate the abdominal cavity, which usually fades within a day or two
- Anaesthesia-related reactions, including nausea, allergic responses, or breathing difficulties
- Hernia at the entry wound site, developing weeks or months after surgery
Preparation & Procedure
Preparation for endoscopic surgery usually begins several days before the procedure and covers what you eat and drink, which medications are adjusted, and what tests the medical team needs to complete.
You will normally be asked to stop eating solid food at least six hours before surgery and to stop drinking clear fluids two hours before. If the procedure involves the colon or lower digestive tract, a bowel preparation, meaning a laxative given the day before, is usually required to clear the intestine. Smoking reduces the blood supply to healing tissue, so surgeons usually ask patients to stop for as long as possible before the date. Alcohol thins the blood and interacts with anaesthesia, so it is usually avoided for at least 24 to 48 hours beforehand.
Blood thinners, anti-inflammatory painkillers, and certain diabetes medications are commonly paused before surgery. Your doctor will give you a specific list based on what you take. Never stop any regular medication without medical guidance.
Pre-operative tests are ordered to confirm that the body can handle the operation safely. Common tests include:
- Blood tests, including a full blood count, clotting profile, kidney and liver function
- Imaging such as CT (computed tomography scan), MRI (magnetic resonance imaging), or ultrasound to map the area to be treated
- A chest X-ray and ECG (electrocardiogram, a recording of the heart's electrical activity) to check heart and lung fitness for anaesthesia
- A pre-anaesthesia consultation with the anaesthetist (the doctor who manages sedation and pain during surgery)
On the day of surgery, the procedure follows a sequence that varies by organ and hospital, but typically includes these steps:
- 1. The patient changes into a hospital gown and an intravenous (IV) line is placed in the arm for fluids and medication.
- 2. General anaesthesia (full sleep) or, in some procedures, sedation (a relaxed, drowsy state) is given.
- 3. The surgical site is cleaned and, for abdominal procedures, carbon dioxide gas is pumped in through a small needle to create space for the instruments to move.
- 4. The endoscope is inserted through a natural opening or through a small incision, usually less than one to two centimetres wide.
- 5. Additional small incisions, called ports, are made if more than one instrument is needed.
- 6. The surgeon watches the monitor and carries out the repair, removal, or biopsy (tissue sampling) as planned.
- 7. The instruments and endoscope are removed, the gas is released from the abdomen if used, and the small wounds are closed with stitches, staples, or adhesive strips.
- 8. The patient is moved to a recovery area while the anaesthesia wears off.
Aftercare
Recovery after endoscopic surgery is usually faster than after open surgery, but the timeline depends heavily on which organ was treated and how complex the procedure was. Straightforward procedures often allow discharge the same day or the following morning, while more involved operations may require a hospital stay of several days.
- Monitoring: Immediately after surgery you are observed in a recovery room until your breathing, blood pressure, and pain are stable. Nursing staff check the small wounds and watch for signs of bleeding or infection.
- Pain: Discomfort around the entry wounds is common for several days and is managed with prescribed painkillers. Shoulder aching from residual gas in the abdomen typically eases within 48 hours.
- Diet: Most patients start with clear liquids and progress to soft foods before returning to a normal diet, following their surgical team's specific guidance.
- Activity: Light walking is usually encouraged from day one to reduce the risk of blood clots. Heavy lifting, strenuous exercise, and driving are restricted for a period your surgeon will specify, commonly one to four weeks depending on the procedure.
- Wound care: The small entry sites are kept clean and dry. Dissolvable stitches need no removal; non-dissolvable ones are taken out at a follow-up visit, usually within one to two weeks.
- Bathing: Showering is generally allowed once the wounds are sealed, but soaking in a bath or swimming pool is avoided until the wounds have fully healed.
- Follow-up appointments: A clinic visit is normally scheduled one to two weeks after surgery to check wound healing and review any pathology results. Further check-ups depend on the underlying diagnosis.
- Warning signs: Increasing redness, swelling, or discharge from a wound, fever, severe abdominal pain, difficulty breathing, or a swollen painful leg should prompt immediate medical attention.
- Lifestyle: If the procedure was done to treat a condition linked to diet, smoking, or weight, your doctor will discuss long-term changes to reduce the risk of recurrence.
Cost & What Determines It
The cost of endoscopic surgery varies widely because the term covers dozens of different operations, from a short gastric (stomach) procedure done as a day case to a multi-hour thoracoscopic (chest) or laparoscopic (abdominal) surgery requiring an intensive care stay. No single price applies across that range.
- Type and complexity of the procedure: removing a small gallbladder polyp costs far less than a laparoscopic resection (removal) of part of the colon or a complex gynaecological reconstruction.
- Organ and surgical approach: procedures inside the chest or deep in the pelvis are technically more demanding and usually priced higher than straightforward upper-digestive or joint procedures.
- Hospital class and country: a private international hospital in a major city charges differently from a regional hospital, and costs differ substantially between countries.
- Length of hospital stay: day-case procedures cost less than those requiring two to five nights, and any unplanned extension adds to the bill.
- Disposable instruments and devices: many endoscopic procedures use single-use instrument packs, staplers, or mesh implants (for hernia repair) that carry a significant per-case cost.
- Anaesthesia type and duration: general anaesthesia for a longer procedure carries higher fees than short sedation.
- Pre-operative tests: CT, MRI, blood panels, and specialist consultations are often billed separately from the surgery itself.
- Post-operative medications: prescription antibiotics, blood thinners, or acid-suppressing drugs after the procedure add to the total.
- Pathology: if tissue is removed and sent for laboratory analysis (biopsy or histology), that examination is usually a separate charge.
Hospital packages for endoscopic surgery typically bundle the surgeon's fee, operating room time, anaesthesia, nursing care during the stay, and standard post-operative drugs. What is commonly billed separately includes pre-operative imaging and blood tests, specialised disposable instruments, pathology, outpatient follow-up visits after discharge, and any additional specialist consultations needed during the hospital stay.
BPJS Kesehatan and most Indonesian private health insurance policies do not cover treatment received outside Indonesia, so patients travelling abroad for endoscopic surgery generally pay out of pocket. Some international private insurance plans do provide coverage for overseas procedures, but the reimbursement conditions vary and require pre-approval. Before booking travel or surgery, ask the hospital for a detailed written cost estimate that lists every component, so there are no unexpected charges when the final bill arrives.
Frequently Asked Questions
How long does endoscopic surgery take?
Most endoscopic procedures take between 30 minutes and 2 hours, though the exact time depends on which part of the body is being treated and how complex the problem is. Your surgeon will give you a clearer estimate once they have reviewed your scans and medical history.
What kind of anaesthesia is used and will it be painful?
Endoscopic surgery is usually performed under general anaesthesia, meaning you will be fully asleep and will not feel pain during the procedure. Afterwards, most people experience mild soreness or discomfort around the small incisions rather than the intense pain associated with open surgery, and doctors typically manage this with pain relief medication.
How long is the recovery time after endoscopic surgery?
Because the incisions are very small, most patients recover faster than they would after traditional open surgery, with many returning to light daily activities within one to two weeks. Full recovery varies depending on the organ or tissue involved, and your surgeon will give you a personalised timeline based on your specific procedure.
How much does endoscopic surgery cost?
The cost depends on several factors, including the part of the body being operated on, the complexity of the condition, the class of hospital you choose, and the length of your stay. Requesting a written estimate directly from the hospital is the most reliable way to get a figure that reflects your exact situation.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
