腹腔镜手术是什么？

Laparoscopic surgery also known as Minimally Invasive Surgery or Keyhole surgery is one of the miracles of modern medicine. Instead of cutting open a patient completely, this procedure involves making small incisions in the stomach using a laparoscope. It is now the preferred procedure for surgeries of the abdomen.

Why it’s better than regular surgery?

First and foremost laparoscopy allows a patient to recover very quickly. Smaller incisions mean that there’s less pain and less chance of post-operative scarring. Because internal organs aren’t exposed to outside contaminants there’s less risk of acquiring infections. Usually, most people get a same day discharge. It’s also great in emergency cases where the patient can’t be shifted to an operation theatre and can double up as a bedside procedure.

How is the surgery conducted?

First the patient is given general anaesthesia. Following this a small cut of about 0.5 to1.5 cm is made at the navel. Through this hole gas (Carbon Dioxide) is administered inside the abdomen to bloat it up so that enough space is created inside the abdomen to move the instruments. Then a telescope (rod like instrument) is used to look inside the abdomen. It is attached to a camera on one end which conveys the image from the telescope to a monitor. Based on the picture they get on the monitor, additional ports are made to pass instruments inside and the surgery is performed. The surgery procedure is pretty similar to regular surgeries, the only true difference being that instead of cutting open the abdomen doctors perform it seeing the parts on the screen. The removed parts are delivered out through the umbilicus. If the removed part is swollen or is very big, the cut at the navel is extended to take it out.

What are the different kinds of operations that can be performed by this method?

Laparoscopic surgeries are essentially used in surgeries of the abdomen like surgery for the Gastrointestinal Tract (appendix, gall bladder), urinary tract system (kidney, ureter, urinary bladder), hepatobiliary system (liver, spleen), etc.

Gall bladder: The gall bladder stores and releases bile. During laparoscopic removal of a gallbladder the bile is suctioned out to deflate it. The deflated gall bladder is then removed from the abdomen through 0.5–1.0 cm incision.

Surgery for weight loss: Because of its advantages, laparoscopic gastric bypass surgeries are also being used widely in obese patients desiring significant and long-lasting weight loss. Candidates for such surgeries are

• Patients whose BMI is > 40
• Patients whose BMI is > 35 and have medical conditions like hypertension and diabetes

Gynecological problems: Laparoscopy is a commonly used procedure to diagnose and possibly treat some of the common gynecological problems like endometriosis, infertility due to fallopian tube blockage, ectopic pregnancy, cysts or tumors (fibroids), etc.

Who are eligible for the surgery?

There are two basic criteria which dictate whether a patient can get a surgery or not:

1. The patient should be fit for general anaesthesia

2. The patient shouldn’t have any bleeding disorders

Risks associated with the procedure

No procedure is 100% safe and the same rules apply for laparoscopy. Like any other surgeries, this technique also carries the general risks associated with anaesthesia. It’s always a good idea to tell your doctor all your health conditions to minimise any risk. The other risk is associated with the gas (carbon dioxide) which is used to bloat the abdomen. The gas tends to get absorbed over a period of time into the blood stream and is excreted through lungs. If it does not get absorbed or if its level increases in the blood, then the changes occurring in the body need to be closely monitored. Another major risk is the limited field of vision doctors have and restricted movements.

All said and done laparoscopy has immense benefits and has completely revolutionised surgery ever since its conception in 1910.