Laparoscopy Techniques

Laparoscopic, or closed entry, surgery is both minimally invasive and more advantageous to the medical community and public. With the continued expansion of this technique, major surgeries including appendectomies, tubal sterilizations and many other abdominal surgeries are being performed.

History

• In the early 1980s doctors began inserting a lighted probe into womens' abdomens for tubal ligations. In 1985, the first laparoscopic gall bladder removal was performed in France. Shortly thereafter, surgeons began using the procedure to remove appendices and gallstones, examine patients for pelvic or abdominal trauma and, in the case of live organ donors, remove the kidneys and liver. Modernly, this procedure is even utilized in gastric bypass surgeries.

Advantages of the Procedure

• Laparoscopic surgery is identified as a minimal access surgery. This means that only small incisions are made and tools no larger than 10 mm are inserted inside the patient. Smaller incisions ensure a quicker recovery time for the patient and less overall pain. These smaller incisions also better protect the patient from postsurgical infection as the patient's body is able to heal from the incisions at a much quicker rate. Finally, the technique ensures minimal internal scarring overall.

Disadvantages

• In some cases, physicians may have to switch from laparoscopic techniques to traditional open-cavity surgery. If this is necessary, patients run the risk of organ punctures as the incisions are made. However, given that the laparoscopic procedure is done using a blind entry technique, organ puncture risks are still high. A study done by Dr. R. Garry in 1997 of the Gynecological Endoscopic Association revealed that the risk of minor complications was reduced by 40 percent, but the risk of major complications was identical to conventional surgery.

The Procedure

• During most procedures, general anesthesia is administered. Once the patient is asleep, a catheter is inserted into the bladder and, depending on the procedure, into the stomach via the nostril. A small incision is then made and a tube is inserted into the abdominal cavity. A tiny camera is the inserted through the tube. The abdomen is then filled with carbon dioxide gas to allow for greater freedom of movement. The necessary tools are then inserted through other small incisions and the procedure completed. Once complete, the tools are removed and the incisions stitched and bandaged.

Recovery

• While no pain is felt during the procedure, a patient may experience shoulder pain and increased urge to urinate after the procedure due to the pressure the carbon dioxide gas places on the bladder and diaphragm. Patients may also experience minor throbbing or soreness at the incision sites. If this occurs, a doctor can prescribe pain medications to ease the symptoms. Overall, most patients are back to regular life within one week. Always wait for a physician's approval before commencing strenuous activity after surgery.