by Dr Pandula Siribaddana

Created on: October 14, 2009

Laparoscopic surgery is a technique in which some of the abdominal, pelvic and thoracic surgeries are performed through a small incision by means of using an equipment called the laparoscope. In practice, the surgical technique is known in different names such as keyhole surgery, minimally invasive surgery...etc. It should also be stated that laparoscopic surgery falls into the broad category of surgeries known as endoscopic surgeries.

What are the advantages of laparoscopic surgery?

The laparoscopic technique gives several advantages for the patient including small incision, minimal bleeding and quick recovery time. But, in certain instances, laparoscopic surgery will not suite and 'open surgery' needs to be followed.

What is the procedure in performing a laparoscopic surgery?

The surgical procedure through a laparoscope will need several small incisions made on different sites of the abdomen or in the chest and will pave way for the rod like instruments to enter into the cavity. Each of these access points will be known as a 'port' and the instrument passed through the port will be known as a 'trochar'. One of the instruments passed in will be the visualizing source where a small camera and an illuminating light will be made use of in order to develop a clear visual field in a digital screen. The surgeon will be looking at the digital screen in performing the surgery. Another instrument will contain the tools required for the surgery such as for cutting, cauterizing as well as collecting the tissues.

The movement and manipulation of the instruments will depend on the surgeons skill and it takes a while for a surgeon to fully grasp the laparoscopic technique.

What is 'hand-assisted' surgery?

In certain situations, the surgeon will require another special port in a technique known as 'hand assisted surgery'. Even then the incision would be smaller than the one required for open surgery.

How do you inflate the surgical space?

At the time of the surgery, the abdomen or the cavity that the instruments are working will be inflated using CO2 gas and it will prevent the tissue planes from collapsing as well as creates a safe environment for the electric cauterizing devices to work.

What are the instances which makes use of laparoscopy?

The laparoscopic technique is being used most commonly for laparoscopic cholecystectomy and it has been used for other conditions such as bowel cancers, diverticular disease, endometriosis and pelvic related surgeries, crohns disease and ulcerative colitis.

New trends in laparoscopic surgery:

The new developments in laparoscopic surgeries are moving towards robot assisted surgeries and in these instances the surgeon will be operating in front of a 3D viewing platform few feet away from the patient and he will guide a robotic device to perform the surgery accurately as well as safely.

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