Laparoscopic surgery

Laparoscopic surgery  (LS) in the abdominal cavity is the most common form of minimally invasive surgery performed for gastrointestinal conditions. LS typically involves smaller instruments such as laparoscopes and endoscopes. A laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor.

Laparoscopy allows the surgeon to see inside your body in real time, without open surgery. Your doctor also can obtain  biopsy samples during this procedure.

The recovery is faster than in open surgery thanks to small incisions with consequent  less damage and scarring.

Your doctor may recommend laparoscopy to examine the following organs:

 

Our board-certified surgeons perform:

  • Laparoscopic gallbladder surgery, known as cholecystectomy
  • Laparoscopic appendicectomy
  • Diagnostic laparoscopy
  • Laparoscopic intestinal surgery for colorectal cancer, diverticutis, inflammatory bowel disease
  • Laparoscopic hernia repair
  • laparoscopic incisional hernia repair.
  • Laparoscopic splenectomy

 

FAQ

What is laparoscopy?

Laparoscopy is done to help your doctor determine what is wrong. Sometimes problems occur with a woman’s reproductive organs that cannot be detected by a physical exam, x-rays or ultrasound. In these cases a diagnostic surgery called laparoscopy may be performed. This surgery is done with a slender telescope-like instrument called a laparoscope that is inserted through a small cut just below the navel. Anesthesia is required and the procedure involves some discomfort afterwards. …
In laparoscopy, the surgeon makes one or more small incisions through which slender surgical instruments are passed. This technique eliminates the need for a large incision and creates less tissue damage. It is usually less painful and allows for a more rapid recovery.
Laparoscopy is a surgical procedure in which the surgeon makes a small incision in the patient’s abdomen which allows the insertion of an instrument called a laparoscope. Using this instrument allows the surgeon to see the inside of the abdomen.
Laparoscopy is an innovative way of performing a surgical procedure. A thin telescope is inserted through your navel and a small digital camera that is attached to the end of the scope shows the anatomical structures in a big screen or TV monitor. Three more incision ( 5mm each) are performed in your abdomen. Then your surgeon performs the procedure using special instruments that are inserted through the small holes. …
This is a technique to reach parts of the body without the use of large incisions. Instead, a narrow telescope and instruments are inserted through small incisions allowing surgery to be performed. The intention is to achieve the same results as would be obtained by conventional surgery.

What are the risks of laparoscopy?

While the risks are very rare, there is always some risk with any procedure. There are some risks when you have general anesthesia. There is chance of infection or bleeding. The abdominal organs, glands, intestines, or blood vessels may be damaged if surgeon is not experienced. The lining of the abdominal wall may become inflamed, which is known as peritonitis. A blood clot may enter the bloodstream and clog an artery in the lung, pelvis, or legs.

What exactly is Laparoscopy?

It’s a surgical technique in which the abdominal cavity (belly) is inflated with carbon dioxide gas (CO 2 ) and distended. A small (3-11mm thick) telescope (resembling a long and thin tube) is then inserted through the belly button, inside the abdominal cavity. This telescope called laparoscope has a light source at its end and a camera that allows the surgical team to watch on TV monitors, what is inside the belly under magnification and in great detail.

What are the advantages of laparoscopy?

Excellent visualization (exposure) of organs, minimal trauma to organs, Small incisions with less chances of wound infection or/and breakdown. Significantly less adhesion formation (scar tissue inside the abdomen that may cause pain, infertility or bowel obstruction). In addition shorter hospital stay and significantly faster recovery. This means faster mobilization of the patient, that hopefully minimizes postoperative complications.
With laparoscopy, it is not necessary to cut through the muscle. Surgery is done through small incisions. The surgeon is able to see the operative field using a television monitor. Advantages include a reduction in potential wound complications, less occurrence of hernias and a faster return to full activity. For gastric bypass patients in New York, this approach is ideal for appropriate candidates. It is important to emphasize that even when surgery is done through small incisions; it is still a major operation.
Laparoscopic surgery results in faster recovery with less scarring and pain. Patients heal more quickly, experience less discomfort, and can return to daily activities sooner.

What is laparoscopy or laparoscopic surgery?

Laparoscopy is an art of viewing the body cavities namely abdomen & thorax without actually opening it. One enters these cavities through small puncture wounds called ports. The camera for inside viewing & the instruments for surgery are introduced through these ports which at the end of the operative procedure appear no more than minute scratches.

What actually laparoscopy is?

Laparoscopy is an art of viewing the body cavities namely abdomen & thorax without actually opening it. One enters these cavities through small puncture wounds called ports. The camera for inside viewing & the instruments for surgery are introduced through these ports which at the end of the operative procedure appear no more than minute scratches.

How is laparoscopy performed?

A small telescope is inserted into the bellybutton and small instruments are placed to safely remove the gallbladder.
To carry out this operation we use a peridural blockade + intravenous sedation and rarely, general anaesthesia is employed. It starts by a little incision in the navel, through which a special needle (Veress needle) fills the abdomen with a gas (carbon dioxide) until a certain pressure is attained. Through the same incision a trocar is inserted (little pipe with valves) that measures 10-12 mm of diameter in average, although sometimes a trocar of less breadth can be used (5 or 2 mm).

What does laparoscopy involve?

The laparoscope allows visual inspection of the pelvic organs through a very tiny incision. Abnormalities that lead to infertility can be treated surgically through additional small incisions to remove scar tissue, laser, coagulate, or excise endometriosis, and repair tubes blocked at the fimbrial end. Many types of female reproductive surgery can be performed laparoscopically in the outpatient setting.

What is the purpose of a laparoscopy?

Laparoscopy provides a careful and detailed assessment of a woman’s pelvis. In our experience, it is very common during laparoscopy to find a problem related to infertility. Fortunately, many of these problems can be treated at the time of the laparoscopy. For many women, this can dramatically improve their chances of conceiving.

What is operative laparoscopy?

Operative laparoscopy is a procedure where an operation is performed with the help of laparoscope.

How will I feel following a laparoscopy?

Following any laparoscopic procedure, some discomfort is normal and to be expected. Patients commonly report pain in the shoulders, neck and abdomen. This may occur because gas used during the procedure to expand the abdomen cannot be fully removed. These symptoms usually resolve within 12-24 hours with bedrest. Nausea may occur and can be related to abdominal distention and/or manipulation of the bowel during the procedure. Some patients develop post-surgical nause from anesthesia.

What are the benefits of laparoscopy?

The recovery time in the immediate post operative period is quicker. Patients often go home after only 23 hours to recover in the comfort of their own home. The small incisions tend to be less painful and patients often need less postoperative pain medication as a result. Fewer wound infections occur. The cosmetic results are also appealing as the scar is limited to three or four skin incisions that are less then one half inch long.

What is diagnostic laparoscopy?

Diagnostic laparoscopy involves the insertion of a thin camera-tipped instrument called a laparoscope through a small incision to examine a patient’s abdomen or pelvis (including fallopian tubes, ovaries, uterus, small and large bowels, appendix, liver and gallbladder). This is typically done to confirm the presence or absence of a problem when noninvasive tests prove inconclusive, and helps the surgeon determine the proper course of treatment.

When is diagnostic laparoscopy necessary?

The procedure is often recommended when there is the suspected presence of endometriosis, ectopic pregnancy, pelvic inflammatory disease, cancer, cholecystitis (inflammation of the gallbladder) and appendicitis. Diagnostic laparoscopy can detect a number of problems of the abdomen, including: Ovarian cysts Abnormal union of body surfaces Endometriosis Uterine fibroids Tumors Pelvic inflammatory disease Appendicitis Cholecystitis Metastatic cancer Signs of traum.

How is diagnostic laparoscopy performed?

The procedure may be done in a hospital or surgical center, with local or general anesthesia. First, carbon dioxide gas is injected through a needle to create a work space; next, a tube called a trocar is inserted, and finally the laparoscope is inserted. If the surgeon requires the use of additional surgical instruments, other small incisions may be made.

What procedures can be done by laparoscopy?

Almost all surgeries being done in open surgery are nowadays being performed. The most common however are cholecystectomy (removal of the gall bladder), appendicectomy (removal of the appendix), tubal ligation (sterilisation), diagnostic laparoscopy, hernia repair.

What are the contraindications of emergency laparoscopy?

Relative contraindications to emergency laparoscopy is: The general anaesthesia and the pneumoperitoneum required as part of the laparoscopic procedure may increase risk in certain patient groups. Most surgeons would not recommend emergency laparoscopy in: Patients with cardiac diseases and COPD are not good candidate for emergency laparoscopy. Patients who have had previous extensive abdominal surgery, emergency laparoscopy may be difficult.

What is emergency laparoscopy?

It is the laparoscopic operation which should be performed without any delay in life threatening situations. The gynaecologists were the first to start laparoscopy in the diagnosis and treatment, but since 1990s a lot of general surgeons have started to use this technique in the abdominal urgency, especially: abdominal trauma, acute cholecystitis, acute appendicitis, perforated peptic ulcer or intestinal obstruction.

I have had my surgery in my abdomen before. Am I a candidate for laparoscopic surgery?

We often operate on patients who have had previous abdominal surgery. While you will be at a higher risk of being “converted” to an open operation, we believe that most patients deserve the opportunity to have a laparoscopic procedure. Some surgeons will not attempt laparoscopic surgery on patients with previous open abdominal surgery. With our experience, we have learned that many patients can be done laparoscopically.

Is the pain similar to open procedure?

Laparoscopic surgery is not “pain-less”, but rather “less-pain”. In traditional open surgery, often a large 6 to 8 inch incision is made on the abdomen. During laparoscopic surgery, 4 to 6 quarter-inch incisions are made on the abdomen. These incisions allow special instruments to be placed in to the abdominal cavity that will allow the surgeon to complete the case.

How do I take care of my incision?

Care of your incision does NOT require excessive scrubbing or washing. Simply let some soapy water run over the incision in the shower daily. Dry the area thoroughly. It is not necessary to cover the incision with a gauze unless you have a small amount of drainage (to protect your clothes). If you have a clear plastic dressing in place, you may remove this after 10 days. If you have an open incision, pack the area lightly with gauze. You do not need to shove this down deep into the incision. Over time, it will fill in from the bottom up (similar to how a scab heals). This may take about a month, depending on the size of the incision.

How long will my surgery be?

It depends. Most laparoscopic surgeries last between 1.5 and 3 hours. This does not include the time it takes to go to sleep, wake up, insert IV’s etcetera, so the actual time you spend in the operating room may be longer than this. Once the procedure is complete, your doctor will talk to your family in the waiting room.

What pain medicine will I be using after my surgery?

After abdominal surgery, patients receive a number of medications in the hospital and are discharged with a similar regimen. These medications are part of an enhanced recovery protocol, which has been researched extensively in the national literature. Specific medications include extra-strength Tylenol (or acetaminophen), Neurontin (or gabapentin), and possibly ibuprofen (Motrin, Aleve, etc…). These non-narcotic pain medications are designed to be taken on a regular schedule every six to eight hours. They prevent the buildup of pain over time. You may be prescribed a narcotic medication for breakthrough pain (oxycodone or Vicodin).