BODELI GENERAL HOSPITAL, Laparoscopy, Hospital, Baroda, Gujarat, India, Surgery

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What is Laparoscopy?

Laparoscopy was started by gynaecologists for tubal ligation (family planning) and diagnosis,and gradually surgeons also started doing laparoscopy. And now it has revolutionised the field of surgery.Almost all of the open surgeries of the abdomen are now being replaced by laparoscopy (key-hole surgery).The day is not far away when open surgeries of the abdomen will be obsolete.

Laparoscopy: In this a telescope is inserted in the abdomen through a 5mm or a 10mm incision to visualise the interior of the abdomen. A camera is attached to the telescope , through which the surgeon can visualise the interior of the abdomen on a monitor/TV. Gas is insufflated in the abdominal cavity to create a working space.Several small operating instruments are also inserted into the abdomen through other 5mm/3mm insicions which help in conducting the procedure.

Advantages of Laparoscopy:

1. Less injury to the body ,to reach the actual site of surgery. In open surgery there are actually two surgeries ( and therefore amount of injury) taking place, one to reach the site of surgery by incising and cutting the abdominal wall ( Skin, sub cutaneous tissue, fascia, muscles, etc) with large incisions, and then comes the actual surgery site like appendix, gallbladder,etc,where the actual surgery is conducted ; whereas in laparoscopy we directly reach the surgical site without causing any major injury to the abdominal wall through 5-10mm incisions.

2.Less painful and faster recovery: Due to less amount of injury, there is less post operative pain and a very fast recovery. Patients can be discharged the same day or the next day in most of the cases.

3.Early back to normal life.

4. Less complications of wounds: All the complications related to the cutting /incisions of the abdominal wall are not there with laparoscopy like wound infections,incisional hernia,etc

5. Less overall cost: Due to faster recovery and faster back to normal life, the overall cost is significantly reduced ( although the immediate operative cost is more due to sophisticated equipments and expertise)

6. Cosmesis: Better Cosmesis. There is almost no post operative scar on the abdomen in contrast to open surgery, where there remains a large and ugly scar on the abdomen.

Disadvantages of laparoscopy:

1.Highly sophisticated and costly equipments are required for setup and maintenance.

2.Dedicated centre of laparoscopy with a team is required , with specialized training.

3.Long learning curve for surgeons.

4.All surgeries are still not possible with laparoscopy.

5.Many complicated surgeries need to be converted into open surgery . So every surgery beginning with laparoscopy need not end up with laparoscopy.

6.Overall complication rate related to specific surgery are similar to open surgeries.

What are the surgeries possible with laparoscopy:

Appendicectomy, cholecystectomy, hernia surgeries, diagnostic laparoscopy, infertility management, Ovarian cysts, ectopic pregnancy, myomectomy, hysterectomy (TLH/LAVH) ,GERD,cancer surgeries of the abdomen , Prostate (TURP) , Urinary bladder and ureteric stones (ureteroscopy , cystoscopy) ,obesity surgeries ,etc.


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