Laparoscopic Surgery

Laparoscopic surgery, also called minimally invasive surgery (MIS), or keyhole surgery, is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5–1.5 cm) as opposed to the larger incisions needed in laparotomy.

Keyhole surgery makes use of images displayed on TV monitors to magnify the surgical elements.

Laparoscopic surgery includes operations within the abdominal or pelvic cavities. There are a number of advantages to the patient with laparoscopic surgery versus an open procedure, including reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time.

The key element in laparoscopic surgery is the use of a laparoscope. There are two types:a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or a digital laparoscope where the charge-coupled device is placed at the end of the laparoscope, eliminating the rod lens system. Also attached is a fiber optic cable system connected to a 'cold' light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm cannula or trocar to view the operative field. The abdomen is usually insufflated, or essentially blown up like a balloon, with carbon dioxide gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.

Laparoscopic surgery is used routinely by all the surgeons of the midland gut clinic where possible. This includes (relatively) simple procedures such as common (inguinal) hernia repairs where the laparoscopic approach allows a more rapid return to normal activities including work and reduced post-operative pain. More complex incisional hernias related to previous scars can also be dealt with in this way as well as complex bowel surgery including bowel cancer surgery, colitis and crohn's disease surgery and prolapse surgery. Sometimes it may not be advisable to opt for laparoscopic surgery due to previous scarring or other factors. This will be discussed with you by your surgeon.