1. What is laparoscopic surgery?
 Laparoscopic
surgery consists of a group of operations that
allow for smaller incisions to treat damaged or diseased organs. Small tubes
called trochars are inserted through the incisions. Using long thin
instruments and a 5 millimeter camera many complex procedures can be
completed with less pain and a shorter hospital stay. The most
common procedures
include:
-
Gallbladder
removal and bile duct exploration
-
Inguinal
and ventral hernia repair
-
Intestinal
resection for problems like diverticulitis or tumors
-
Anti-reflux
operations for GERD
-
Appendectomy
2. Am I a
candidate?
Most
patients who are candidates for abdominal surgery are candidates for a
laparoscopic approach. One limiting factor includes the need to
avoid general anesthesia in a patient with significant medical problems
such as poorly controlled heart disease. Another problem occurs in
patients who have developed dense intra-abdominal scar tissue (called
adhesions) from multiple prior open abdominal procedures. There is
always a risk that an operation that is started laparoscopically would
have to be converted to a larger incision. When this decision is
made during an operation it is always for the benefit and safety of the
patient.
3. What do I need to get
ready?
Depending
on the surgery, most patients only need to eat nothing after
midnight until their surgery is done.
Patients undergoing laparoscopic bowel surgery may be asked to undergo
a bowel cleansing regimen. If other health problems exist
then a consultaton with a specialist may be requested. This may
include a:
-
Cardiologist
-
Pulmonologist
-
Endocrinologist
With
laparoscopic surgery many operations that once required a prolonged
hospital stay are now performed as day surgery. This means that
recovery is rapid and done in the privacy and comfort of your own
home.
4.
How is the surgery done?
There
are a variety of different operations
done using laparoscopy.
The
main concept is the use of plastic tubes called trochars that are
passed through small incisions in the abdominal wall to access the
abdominal cavity. The usual starting point is just below or
above the belly button. Carbon Dioxide gas is then pumped into
the abdomen to lift up the abdominal wall and create a working
space. A telescope is then passed through the tube below the
belly button to allow direct visualization of the inner abdomen.
Various other tubes are then placed. These tubes are from 1/2
inch to 1/8th of an inch in diameter. Special long,
slender instruments are passed through the tubes to perform the
operation. Once the operation is complete, the gas is released,
the tubes are removed and the small incisions are closed. Usually, the
incisions have been numbed to further reduce pain. The cuts
usually have internal absorbable sutures and are covered with tissue
glue so that there is no suture removal or dressing care
required.
5.
What
can I expect after surgery?
Once
again, laparoscopy has made recovery from surgery much quicker and less
painful. Most patients are released on the day of their
surgery. For procedures that require a hospital stay, the length
is usually from 1 to 3 days. Laparoscopic surgery usually reduces
hospital stays by 1 to 3 days, so a 2 day hospital stay after
laparoscopic surgery would have been a 4-5 day stay when a larger
incision is required. The main source of discomfort after surgery is the
incision around the belly button. This is usually well managed
with standard oral pain medications and tends to resolve significantly
after the first 48 to 72 hours.
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