Learn About Laparoscopy

What is History of Laparoscopy?

It is difficult to credit one individual with the pioneering of laparoscopic approach. In 1902 Georg Kelling of Dresden performed the first laparoscopic procedure in dogs and in 1910 Hans Christian Jacobaeus of Sweden reported the first laparoscopic operation in humans. In the ensuing several decades, numerous individuals refined and popularized the approach further for laparoscopy. The introduction of computer chip television camera was a seminal event in the field of laparoscopy. This innovation in technology provided the means to project a magnified view of the operative field onto a monitor, and at the same time freed both the operating surgeon’s hands, thereby facilitating performance of complex laparoscopic procedures. Prior to its conception, laparoscopy was a surgical approach with very limited application and used mainly for purposes of diagnosis and performance of simple procedures in gynecologic applications.

What is the Procedure of Laparoscopic Surgery?

Laparoscopic cholecystectomy is the most common laparoscopic procedure performed. In this procedure, 5-10 mm diameter laparoscopic instruments can be introduced by the surgeon into the abdomen through port and a seal to keep the CO 2 from leaking. Rather than a big incision as in traditional cholecystectomy, four incisions of 0.5-1.0cm will be sufficient to perform a laparoscopic removal of a gallbladder. Since the gall bladder is a balloon like structure that stores and releases bile, it can usually be removed from the abdomen by suctioning out the bile and then deflated gallbladder can easily be removed through the 1cm incision either at the patient’s navel or epigastric region. The length of postoperative stay in the hospital is very minimal, and same-day discharges are possible in many cases of early morning procedures.

How you remove big specimen in Laparoscopic Surgery?

In many advanced laparoscopic procedures where the size of the organ being removed would be too large to pull out through a port site,  an incision larger than 10 mm must be made or surgeon can use morcellator (A device which can cut the tissue in small pieces) in those circumstances. The most common of these procedures are removal of all or part of the uterus, or removal of the kidney (nephrectomy). A good laparoscopic surgeon perform these procedures completely laparoscopically, and some making the larger incision toward the end of the procedure for specimen removal, or, in the case of a colectomy, to also prepare the remaining healthy bowel for anastomosis.

Nowadays Hand assisted laparoscopic surgery is also common. Many surgeons feel that since they have to make a larger incision for specimen removal anyway at the end of surgery, they might use this incision to have their hand in the operative field during the procedure from the begining to aid as a hand assisted instrument as retractor, dissector, and to be able to have taktile feedback, as they would in open surgery. Since they will still be working with scopes and other laparoscopic instruments, CO2 will have to be maintained in the patient’s abdomen, so a device known as a hand access port (like lap disk or Hand port or Omni Port) must be used. Surgeons that choose this hand-assist technique feel it reduces operative time significantly vs. the straight laparoscopic approach, as well as providing them more options in dealing with unexpected adverse events that may otherwise require creating a much larger incision and converting to a fully open surgical procedure.

Which procedure can be performed by Laparoscopy?

The laparoscopic surgery is intended to minimise post-operative pain and speed up recovery times, while maintaining an enhanced visual field and magnified view for surgeons. Due to improved patient recovery, in the last two decades, laparoscopic surgery has been adopted by various surgical sub-specialties including gastrointestinal surgery, Gynecological procedures and and urology. Based on numerous prospective randomized controlled trials, the approach has proven to be beneficial in reducing post-operative morbidities such as wound infections and incisional hernias (especially in morbidly obese patients), and is now deemed safe when applied to surgery for cancers such as cancer of colon.

What is the drawback of this procedure?

There are many drawback of Laparoscopic surgery also like restricted vision, the difficulty in handling of the instruments (new hand-eye coordination skills are needed), the lack of tactile perception and the limited working area are factors which add to the technical complexity of this surgical approach. For these reasons, minimal Access surgery has emerged as a highly competitive new sub-specialty within various fields of surgery. Surgical residents and junior consultant who wish to focus on this area of advanced surgery gain additional laparoscopic training after completing their basic surgical residency.

What is the advantage of Laparoscopy?

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure.

1. Reduced blood loss in experienced hand, which reduces the risk of needing a blood transfusion
2. Smaller incision, which reduces pain and shortens recovery time.
3. Less pain, leading to less analgesic needed.
4. Hospital stay is less, and often with a same day discharge which leads to a faster return to everyday living.
5. Reduced exposure of internal organs to possible external contaminants thereby reduced risk of acquiring infections.

Which hospital is good for Laparoscopic Surgery?

 In India World Laparoscopy Hospital is best because it is dedicated for Laparoscopic Surgery. Address is

World Laparoscopy Hospital

Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India