Laparoscopic Surgeon - Dr Prabal roy
Laparoscopy (also known as minimally invasive surgery or videoscopic surgery) has allowed surgeons to perform the same procedures as in traditional open surgery, using small incisions (keyhole surgery) instead of large abdominal incisions.
Functioning:
The key element in laparoscopic surgery is the use of a laparoscope. There are two types:
(1) A telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or
(2) A digital laparoscope where the charge-coupled device is placed at the end of the laparoscope, eliminating the rod lens system.
Also attached is a fiber optic cable system connected to a ‘cold’ light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm cannula or trocar to view the operative field. The abdomen is usually insufflated, or essentially blown up like a balloon, with carbon dioxide gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.
The advantages of laparoscopic surgery are:
Readily available diagnostic tool, replacing more expensive equipment as CT scan and NMR
Disadvantages of laparoscopy are:
Popular Laparoscopy Procedures:
Functioning:
The key element in laparoscopic surgery is the use of a laparoscope. There are two types:
(1) A telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or
(2) A digital laparoscope where the charge-coupled device is placed at the end of the laparoscope, eliminating the rod lens system.
Also attached is a fiber optic cable system connected to a ‘cold’ light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm cannula or trocar to view the operative field. The abdomen is usually insufflated, or essentially blown up like a balloon, with carbon dioxide gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.
The advantages of laparoscopic surgery are:
- Reduced hemorrhaging, which reduces the chance of needing a blood transfusion.
- Less pain, leading to less pain medication needed.
- Reduced exposure of internal organs to possible external contaminants thereby reduced risk of acquiring infections
- Reduced patient immobilization, hence shorter hospital stay for the patient and his relatives
- Reduced infection risk thanks to the absence of large incisions.
Readily available diagnostic tool, replacing more expensive equipment as CT scan and NMR
Disadvantages of laparoscopy are:
- The surgeon has limited range of motion at the surgical site resulting in a loss of dexterity
- Poor depth perception
- Relative technical sophistication of the technique (maintenance problems)
- Cost of the equipment: Equipment cost however can be contained by the use of reusable cannulas and trocars as well as by avoiding the use of stapling instruments which can be omitted provided advanced surgical manual techniques are used.
- Relatively sophisticated insufflator and video camera
Popular Laparoscopy Procedures:
- Gastric Bypass Surgery
- Lap Band
- Cholecystectomy or Removal of Gallbladder
- Hernia Repair
- GERD or Anti Reflux Surgery
- Treatment of Liver and Biliary Diseases
- Treatment of Hiatal Hernia
- Splenectomy and Treatment of the Spleen
- Intestinal and Colon Disorders
- Ulcer Surgery
- Small Bowel Obstruction
- Removal of Appendix
- Removal of Adrenal Gland
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