Laparoscopic surgery (mini-invasive surgery)
Written by Rhiana Devadasan
Laparoscopic surgery: the process of cutting out tissue or part of an organ.
History:
Instruments & Equipment:
- Camera
- Light source
- TV monitor
- Telescope
- Light guide cable
- Insufflator
- Hasson cannula
- Veress needle
- Trocar (blade with a shaft and a body)
Principles:
- Post-op pain is related to the size of the incision, therefore smaller incision = less pain.
- Less handling of intestines results in little or no disturbance of normal function.
- Avoidance of the trauma of abdominal wall injury by the incision allows rapid return to normal activity.
- Reduce overall costs by shortening of hospital stay.
- Magnified view often better than obtained via an incision; it allows precise dissection.
Advantages:
- Minimal pain and ileus
- Improved cosmesis
- Shorter hospital stays, faster recovery and rapid return to work
- Non-muscle splinting incision & less blood loss
- Post op respiratory muscle function returns to normal more quickly
- Less wound complications
- Can be done as a day care surgery
Disadvantages
- Longer duration of surgery
- Loss of 3D view, impaired touch sensation
- Poor dexterity, fulcrum effect, risk of visceral injury may go unrecognised
- Long learning curve for surgeons
TYPES OF LAPAROSCOPIC SURGERY:
- Cholecystectomy (gallstone)
- Appendicetomy (appendicitis)
- Hernia repair
- Division of adhesions
- Closure of perforation
- Hiatus hernia repair
- Anterior resection/APR (colorectal carcinoma)
- Right hemicolectomy (caecal carcinoma)
- Left/sigmoid colectomy (colonic carcinoma)
- Gastrectomy (gastric carcinoma)