Laparoscopic Surgery

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Surgery

Surgery (from the Greek “hand”, and “work”), via Latin meaning “hand work”) is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum).

LAPAROSCOPIC SURGERY

• KEYHOLE SURGERY
• MINIMALLY INVASIVE SURGERY (MIS)
• MINIMAL ACCESS SURGERY (MAS)

WHAT OPERATONS CAN WE DO LAPAROSCOPICALLY

Diagnosis

• Crohn’s Disease
• Diverticulitis
• Rectal Prolapse
• Benign renal disease
• Gastric Obstruction
• Some Splenic disorders
• Gallstone
• Appendicitis
• Hernia
• Adhesions
• Perforated ulcer
• Hiatus Hernia
• Colorectal carcinoma
• Caecal carcinoma
• Colonic carcinoma
• Gastric carcinoma
• Oesophageal carcinoma

Operation

• Bowel resection
• Bowel resection
• Repair of Prolapse
• Nephroctomy
• Bypass
• Spleenectomy
• Cholecystectomy
• Appendicectomy
• Hernia repair
• Division of adhesions
• Closure of perforation
• Hiatus hernia repair
• Anterior resection/ APR
• Right Hemicolectomy
• Left/Sigmoid Colectomy
• Gastrectomy
• Oesophagogastrectomy

The list is endless!!!

Principle Differences between Laparoscopic and Open Surgery 

FOR THE PATIENT

• Post operative pain related to size of incision- smaller incisions =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
• No incision allows early return to more strenuous activities: driving, lifting, sport etc

Principle Differences between laparoscopic and open surgery

For the Surgeon

• Magnified view often better than obtained via an incision allows precise dissection
• Altered (but not absent) tactile response
• Two dimensional (flat screen) view
• Usually (but not always) longer operating time
• Need to develop entirely different operating technique
• Need to develop entirely different operating technique

Some Advanced Laparoscopic Procedures

• Adaptation of principles of open surgery to laparoscopic surgery
• Lap. Cholecystectomy
• Lap. Appendectomy
• Lap. Hiatal hernia repair
• Lap. hernia surgery (groin hernia, ventral hernia, incisional hernia)
• Lap. treatment of heartburn/reflux (Nissen, Toupet fundoplication)
• Lap. treatment of achalasia (Heller myotomy, Dor fundoplication)
• Lap. Bowel resection
• Lap. colorectal surgery (for diverticulitis, cancer, inflammatory bowel disease)
• Lap. stomach surgery
• Lap. splenectomy
• Lap. adrenalectomy
• Lap. lymph node biopsy
• Lap. weight loss surgery

Access and Port Placement

Cholecsyectomy

Nissen Fundoplication

Inguinal Hernia Repair

Appendicectomy

Some important procedures

• Appendectomy- An appendectomy is the surgical removal of the appendix, a small tube that branches off the large intestine, to treat acute appendicitis. Appendicitis is the acute inflammation of this tube due to infection.
• Carotid Endarterectomy- Carotid endarterectomy is a surgical procedure to remove blockage from carotid arteries, the arteries located in the neck that supply blood to the brain. Left untreated, a blocked carotid artery can lead to a stroke.
• Cesarean section- Cesarean section (also called a c-section) is the surgical delivery of a baby by an incision through the mother’s abdomen and uterus. This procedure is performed when physicians determine it a safer alternative than a vaginal delivery for the mother, baby, or both.
• Cholecystectomy- A cholecystectomy is surgery to remove the gallbladder (a pear-shaped sac near the right lobe of the liver that holds bile). A gallbladder may need to be removed if the organ is prone to troublesome gallstones, if it is infected, or becomes cancerous.
• Dilation and curettage (Also called D & C.)- A D&C is a minor operation in which the cervix is dilated (expanded) so that the cervical canal and uterine lining can be scraped with a curette (spoon-shaped instrument).
• Hemorrhoidectomy- A hemorrhoidectomy is the surgical removal of hemorrhoids, distended veins in the lower rectum or anus.
• Hysterectomy- A hysterectomy is the surgical removal of a woman’s uterus. This may be performed either through an abdominal incision or vaginally.
• Inguinal hernia repair- Inguinal hernias are protrusions of part of the intestine into the muscles of the groin. Surgical repair pulls the intestine back to its original location.
• Mastectomy- A mastectomy is the removal of all or part of the breast. Mastectomies are usually performed to treat breast cancer.
• Partial colectomy- A partial colectomy is the removal of part of the large intestine (colon) which may be performed to treat cancer of the colon or long-term ulcerative colitis.