Laparoscopy
Written by Rhiana Devadasan
Laparoscopy: a surgical procedure (a type of minimally invasive surgery - MIS) in which a fibre-optic instrument (laparoscope) is inserted through the abdominal wall to view the organs in the abdomen OR to perform small-scale surgery.
(sometimes called keyhole surgery)
Procedure:
- A cut/incision is made in the abdomen. In laparoscopic surgery, several small cuts are made (each one no more than half an inch long).
- A tube (called a TROCAR) is inserted into each opening and the camera & surgical instruments (graspers, scissors, clip appliers) are passed through those.
- Each surgical instrument goes into its own incision site, but they are all orientated towards the surgical objective.
- Then the surgeon performs the operation/diagnosis.
Two formats:
- DA VINCI SURGICAL SYSTEM
- multiple incisions are required
- uses a console located away from the patient, with the surgeon controlling a camera, vacuum pump, saline cleansing solution, cutting tools, etc.
- each located within its own incision site, but oriented toward the surgical objective
- THE "BONATI SYSTEM"
- uses a single 5-function control
- so that a saline solution and the vacuum pump operate together when the laser cutter is activated
- A camera and light provide feedback to the surgeon, who sees the enlarged surgical elements on a TV monitor.
- The Bonati system was designed for spinal surgery and has been promoted only for that purpose.
Benefits (over traditional surgery)
- Smaller scars.
- Get out of the hospital quicker.
- Less pain felt while the scars heal, and they heal quicker.
- You get back to your normal activities sooner.
- May have less internal scarring.
Indications & Examples
SYMPTOMS:
- Undiagnosed chronic abdominal pain
- Infertility
- Undiagnosed acute abdominal pain
CONDITIONS:
- Gallbladder surgery
- Gynecology operations
- Intestinal, liver & other organ surgery
- Cholecystectomy
- Appendicectomy
- Adhesiolysis
- Salpingectomy
- Oophorectomy
- Tubal ligation
- Total Laparoscopic
- Hysterectomy (TLH)
- Hernia repair
Contraindications
Absolute
- Surgeon's lack of skills
- Inadequately equipped operating room
- Shock
- Markedly increased intracranial pressure
- Retinal detachment
Relative
- Compromised cardiopulmonary status
- Ventriculoperitoneal shunt
- Pregnancy
- Large pelvic masses