LAPROSCOPIC SURGERY

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What is laparoscopic surgery

Laparoscopic surgery also referred to as minimally invasive surgery describes the performance of surgical procedures in the abdomen or chest cavity with the assistance of a video camera and several thin instruments. During the surgical procedure, few small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The abdomen cavity or chest is inflated with gas. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient. The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eyes in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure. Specific surgical instruments used in a laparoscopic surgery include: forceps, scissors, dissectors, hooks, retractors and more

Advantages of laparoscopy

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include

  • Reduced bleeding, which reduces the chance of needing a blood transfusion.

  • Smaller incision, which reduces pain and shortens recovery time, as well as less post-operative scarring.

  • Less pain, leading to lesser need of pain medication.

  • Although procedure times are usually slightly longer, hospital stay is less, and often with a same day discharge which leads to a faster return to work

What procedures can be done in laparoscopy?

Almost all gastrointestinal surgical procedures can be performed through laparoscopy. Commonly performed laparoscopic surgeries include surgery for

  • Groin or Umbilical Hernias

  • Appendicitis

  • Gall bladder calculus

  • Gastroesophageal reflux disease

  • Achalasia Cardia

  • Peptic Ulcer disease

  • Gallbladder surgery for gallbladder calculus, early gallbladder cancer

  • Stomach cancers

  • Esophagel cancers and/ or benign tumours

  • Pancreatic surgeries like distal pancreatectomy for cancer

  • Small intestinal resections

  • Colonic/ Large intestinal surgeries – Colorectal cancer

What preparation do I need to do?

As you will usually be under a general anaesthetic, your hospital should give you instructions about fasting before the operation. Depending on the reason for your operation, there may be more specific instructions. Your doctor will give you this information if necessary. You need to inform your doctor about medicines you have been on before surgery because some medicines like anticoagulants(blood thinners) may need to be stopped prior to surgery.

After a laparoscopy?

You may feel a little sore around the cuts (incisions). You may have some pain in your shoulder tip. This is caused by the gas which had been pumped inside irritating the diaphragm which has the same nerve supply as the shoulder tip. This pain soon passes off. A short period of post anesthetic care, injectable pain killers for a short period, tubes in the abdomen for a day or two after surgery form part of the postoprerative care. Most of the procedures require a short hospital stay of 2- 3 days, even less than 24 hours, while few procedures like stomach or colorectal cancer surgery might require a stay of a week’s time.

Are there any possible complications from a laparoscopy?

There may be some minor bleeding or bruising around the skin incisions. Otherwise, in most cases a laparoscopy just to look inside goes without any problem. Possible problems which may occur include the following:

  • Accidental damage to structures inside the tummy (abdomen), such as the intestines or certain blood vessels. This is rare but, if it occurs, an emergency traditional operation may be needed to correct the damage.

  • As with any operation, there is a small risk of complications of anaesthesia.

  • Occasionally, the incision becomes infected which may require a course of antibiotics.

If you have major laparoscopic surgery, the risk of complications usually depends on what operation was performed

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