Not too long ago, undergoing traditional surgery meant getting the skin cut open and stitched back after the procedure; however, laparoscopic surgery is now another option.
Laparoscopic surgery is also known as keyhole surgery as small incisions of only 0.5 to 1.5 cm are made on the abdomen or pelvic cavity. Plastic tubes called ports are then inserted into the incisions. A mini camera called a laparoscope and specially designed surgical instruments are then inserted through the ports. The camera projects an image of the internal organs onto a monitor screen outside the body. Essentially, the surgery is, therefore, done on a monitor screen. There are basically two formats: multiple incisions or single incision. In the multiple-incision format, the surgical instruments are controlled by a console similar to a Play Station. Laparoscopic surgery was first performed in 1902 by Dr Georg Kelling in dogs and in 1910, Hans Christian Jacobaeus of Sweden reported the first laparoscopic operation in humans.
Laparoscopic surgery offers several advantages to the patient as compared to an open procedure. These include:
* Less bleeding, thus reducing the chance of needing a blood transfusion.
* Smaller incision, with resultant shorter recovery time, as well as smaller post-operative scars.
* Less pain, leading to less medication needed.
* Shorter hospitalization and a faster return to everyday living.
* Lower risk of infections as internal organs are less exposed to the environment.
While laparoscopic surgery is clearly advantageous for the patient, from the perspective of the surgeon, there are several disadvantages:
* The surgeon’s range of motion is limited at the surgical site.
* Surgeons need special training.
* There is risk of damaging tissue by applying more force than necessary as the
surgeon is using tools.
*High cost of equipment and technology.
*Complicated surgery cannot be performed as vision is restricted.
*Patients with extensive scar tissue are usually ineligible.
The normal procedure in laparoscopic surgery is to create more space in the abdomen or pelvis by inflating it with cold carbon dioxide. During the procedure, patients can also experience considerable pain when breathing as the gas pushes the diaphragm up. There are certain risks in this type of surgery. Some patients have suffered damage to their blood vessels, bowel or ureter. Other patients have been burned in the inner tissues from electricity leaking from electrodes. Patients with lung problems may suffer from hypothermia, which is defined as a drop in body temperature. The use of heated carbon dioxide may reduce this risk. After surgery, patients will normally suffer from abdominal pain.
In recent years, however, improvements have been made in this field such as visual magnification and electromechanical damping of vibrations of surgical instruments.