Laparoscopic Surgery

Laparoscopic surgery, which may be referred to (in the lay press) as “band-aid” surgery, or “keyhole” surgery, is the most modern way of operating on the intra-abdominal organs and diseases today. Although in the early 90’s it was considered “revolutionary”, today is commonplace. It is uncommon for a disease inside the abdomen not to be able to fix with a laparoscopic operation. However, there are still even today some conditions that are more effectively operated on with the traditional “open” technique, but their number is steadily decreasing.

What is laparoscopic surgery?

It is an operation inside the abdomen that can be performed through 3 or 4 very small incisions (0.5 or 1 cm), instead of one long incision (of 10-20 cm). The actual procedure within the abdominal cavity of course remains the same (i.e.: removal of the gallbladder, repair of a hiatal hernia, etc), but the access to the abdominal cavity and these particular organs is achieved using very small incisions and special long and thin instruments, one of which is a camera. In a nutshell, a laparoscopic operation prevents the patient from a long painful incision, while the actual same procedure inside the abdomen is performed.

Advantages of laparoscopic surgery

By far the most important advantage is the near absence of postoperative pain. In addition, the absence of a longer incision and intra-abdominal manipulation leads to biologic secretion of significantly smaller quantities of special hormones, which are associated with inflammation. This results to a significantly less postoperative “inflammatory reaction”. This is experienced by the patient as “feeling well” after a laparoscopic operation. It is mainly because of this, that the patient can get out of the hospital the same or the next day and return to normal activities in 3-4 days later. In addition, laparoscopic surgery is associated with far less frequent postoperative complications, such as wound infection, postoperative hernias, etc.

Indications for laparoscopic surgery

Today, given the surgeon’s advanced laparoscopic expertise, all intra-abdominal organs can be safely and efficiently operated on. Although the most common (and first widely performed) laparoscopic operation has been the removal of the gallbladder (cholecystectomy), now we can treat morbid obesity, hernias, hiatal hernia and esophagitis laparoscopically. In addition, removal of adrenals (because of a tumor), colectomy (because of diverticula, or a tumor), removal of a portion of the pancreas, or the liver are performed laparoscopically. Also, peritonitis because of ruptured appendicitis, or perforation of the duodenum is better treated with a laparoscopic operation. For the surgeon of the modern era, with a proven track record on advanced laparoscopy, the number and types of operations that cannot be performed laparoscopically has been rapidly decreasing.