Laparoscopic or “minimally invasive” surgery is a modern specialised technique for performing surgery. It is an advancement from traditional open surgery.
In traditional open surgery, the surgeon makes a long incision to enter into the abdomen to perform the operation.
In laparoscopic surgery, also known as keyhole surgery, the surgeon makes several small incisions of about 0.5-1cm long. Through these small incisions, or ports, the surgeon would then introduce a video camera and several thin instruments to perform the operation.
|In laparoscopic surgery, the surgeons' eyes are focused on the TV screen, while they use thin instruments to perform the operation.|
In the past, laparoscopic surgery was used mainly for gynaecological surgery. In the 1980s, a French surgeon used this technique to remove a gallbladder. Laparoscopic cholecystectomy was born, and very soon, surgeons all around the world adopted this technique.
At the beginning of the procedure, the abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the surgeon. The video camera, also called the laparoscope, is then introduced through a 1cm port. This port is usually placed at the belly button, but it can be place elsewhere depending on the operation. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors in the operating room. It acts as the surgeon’s eyes, allowing him to see the structures within. Then using various thin instruments, he performs the same operations as traditional surgery but with smaller incisions.
As the wounds are now significantly smaller, the advantages are:
- Less pain
- Faster recovery from the surgery
- Shorter hospital stay
- Smaller scars and better cosmetic results
- Less internal scarring
- Less likelihood of wound hernia
- Earlier return of bowel function
- Earlier return to work and social activities
- Less time off work which translates into less economic loss
For surgery to remove the gallbladder (cholecystectomy), patients who have laparoscopic surgery usually stay overnight in hospital after surgery, whereas patients who have had traditional open surgery usually stay 4 to 5 days.
It is usual for laparoscopic hernia repair and even some cases of laparoscopic cholecystectomy to be performed as Day Surgery. Following laparoscopic removal of the appendix, some patients only stay 1-2 nights.
Because of the advantages of laparoscopic surgery as mentioned above, laparoscopic surgery has expanded into many fields within the discipline of General Surgery:
- Repair of inguinal (groin) and ventral hernia
- Stomach operations
- Oesophagus operations
- Liver operations
- Removal of gallbladder and gallstones
- Removal of bile duct stones
- Pancreas operations
- Spleen operations
- Removal of the appendix
- Colon operations
- Rectum operations
- Adrenal gland operations
In the past, doctors were concerned if laparoscopic surgery could be used for cancer-related operations. Recently several studies involving hundreds of patients have shown that laparoscopic surgery is safe for certain colorectal cancers.
Today, laparoscopic operations have been use to treat:
- Stomach cancers
- Oesophagus cancers
- Liver cancers
- Pancreas tumours (selected types)
- Small intestine tumours
- Colon cancer
- Rectal cancer
- Kidney cancer
- Adrenal tumour
Special variations of laparoscopic surgery:
- Single-Incision Laparoscopic Surgery (SILS)
- Hand-Assisted Laparoscopic Surgery (HALS)
- Robotic Surgery
Should you require further assistance, please do not hesitate to contact Nexus Surgical Laparoscopic and MIS Centre.