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Laparoscopic Surgery

Laparoscopic Surgery

Laparoscopic or minimally invasive surgery is a specialized technique for performing surgery.

Laparoscopic surgery was first performed in 1987 and is now considered the best technique for many abdominal operations. It is often referred to as “keyhole” surgery.
In the past, this technique was commonly used for gynaecologic surgery and for gall bladder surgery. Over the last 10 years the use of this technique has expanded into bowel surgery. In traditional “open” surgery the surgeon uses a single, large incision to enter into the abdomen. Laparoscopic surgery uses several 0.5-1cm incisions. Each incision is called a “port.” 

At each port a tubular instrument known as a trochar is inserted.  Specialized instruments and a special camera, or telescope, known as a laparoscope are passed through the trochars during the procedure. At the beginning of the procedure, the abdomen is inflated with gas to provide a working and viewing space for the surgeon. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors in the operating room. During the operation the surgeon watches detailed images of the abdomen on the monitor. This system allows the surgeon to perform the same operations as traditional surgery but with smaller incisions.

What are the advantages of laparoscopic surgery?

Compared to traditional open surgery, patients often experience less pain, a shorter recovery, shorter hospital stay, earlier return to full activities and less scarring with laparoscopic surgery. Bowel function usually returns faster when compared with traditional “open” surgery. There may also be fewer problems after surgery, particularly lung and wound problems. Finally, there may also be less internal scarring which may decrease the rate of long term problems.

What kinds of operations can be performed using laparoscopic surgery?

Bowel surgery using this technique is more complex than other operations, however with appropriate training, colorectal surgeons can perform laparoscopic bowel surgery with excellent results. Most bowel surgery can be performed using the laparoscopic technique. This includes surgery for Crohn’s disease, ulcerative colitis, diverticulitis, cancer, rectal prolapse and severe constipation.

In the past there had been concern raised about the safety of laparoscopic surgery for bowel cancer operations. Laparoscopic bowel cancer surgery is performed in the same way as the traditional “open” procedure, albeit with the inherent advantages of keyhole surgery. Recently several studies involving hundreds of patients have shown that laparoscopic surgery is safe for certain colorectal cancers and most importantly gives the same long term survival results as open surgery, something that is more important than short term pain control and hospital stay.

How safe is laparoscopic surgery?

Laparoscopic surgery is as safe as traditional open surgery. At the beginning of a laparoscopic operation the laparoscope is inserted through a small incision near the belly button (umbilicus). The surgeon initially inspects the abdomen to determine whether laparoscopic surgery may be safely performed.  If there is a large amount of inflammation or if the surgeon encounters other factors that prevent a clear view of the structures the surgeon may need to make a larger incision in order to complete the operation safely.
Any bowel surgery is associated with certain risks such as complications related to anaesthesia and bleeding or infectious complications. The risk of any operation is determined in part by the nature of the specific operation. An individual’s general heath and other medical conditions are also factors that affect the risk of any operation. You should discuss with your surgeon your individual risk for any operation.