What is laparoscopic surgery?

Laparoscopic or “minimally invasive” surgery is a specialized technique for performing 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 trocar is inserted. Specialized instruments and a camera known as a laparoscope are passed through the trocars during the procedure. At the beginning of the procedure, the abdomen is inflated with carbon dioxide 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.

The benefits of laparoscopic surgery include:

• Less postoperative pain, since incisions are much smaller

• Shorter hospital times

• Quicker recovery times

• Earlier return to full activities

• Improved cosmetic outcome, since there are much smaller scars

• Less adhesions, or internal scarring, compared to standard open surgery

What conditions can be treated with laparoscopic surgery?

Please click here to go to 'Patient Info' section for the answer of this question.

For patient information brochures for some of these procedures, go to
http://www.sages.org/publications/patient_information/english.php

All cases of elective laparoscopic surgery are done in an operating room with general anesthesia. That means that the patient is completely asleep and will not feel or remember anything about the surgical procedure. The patient will need to be fasting past midnight the night before the procedure because of the need for general anesthesia.

The length of the hospital stay depends upon the type of procedure being performed:

• Most patients undergoing laparoscopic gallbladder or hernia surgery go home the same day.

• Patients undergoing surgery for reflux, splenectomy or adrenalectomy will spend 1-2 nights in the hospital.

• Laparoscopic surgery for stomach, intestinal, colorectal and pancreatic conditions and cancers generally require a 3 to 5 day hospital stay on average.

After discharge, most patients find they feel better every day until they are fully recovered.

Although some patients require no pain medications after going home, most patients will take a few pain pills over the first 2 to 3 days at home.

The length of time to recover enough to return to work varies based on the type of the procedure, and sometimes from person to person:

• For many surgical procedures such as gallbladder and hernia surgery, most patients can return to work in about 1 week.

• For other types of surgery such as reflux surgery, splenectomy, adrenalectomy and ventral hernias, most patients can return to work in about 2 weeks.

• For most stomach, colon and pancreatic surgery, patients can return to work within a 3-week period.

Laparoscopic surgery is as safe as traditional open surgery, when performed by a surgeon skilled in advanced laparoscopic techniques. At the beginning of a laparoscopic operation, the camera is inserted through a small incision near the belly button. The surgeon initially inspects the abdomen to determine whether laparoscopic surgery can be safely performed. If there is a large amount of scar tissue (or adhesions) from prior surgeries or significant inflammation that prevents a clear view of the anatomy, the surgeon may sometimes need to make a large incision and perform traditional open surgery. It is also possible that laparoscopic surgery may need to be converted to open due to intraoperative bleeding or technical challenges, in order to finish the surgery safely.

Any internal surgery is associated with certain risks, such as complications related to general anesthesia, bleeding or infection. The risk of any operation is determined in part by the nature of the specific operation. A patient’s general health and other medical conditions also affect the risk of any operation.

While there were earlier concerns about performing laparoscopic surgery for cancers, there is now significantly more scientific literature supporting the use of laparoscopy to surgically treat cancers of the colon, rectum, stomach and pancreas. In the last 15 years, laparoscopic surgery has radically changed the surgical landscape. Today we have innovative approaches informed by science, and state-of-the-art equipment, allowing more advanced and complex surgery to be performed laparoscopically, safely and with positive outcomes.

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