Laparoscopic or "minimally invasive" surgery is a specialized technique for performing surgery. In the past, this technique was commonly used for gynecologic surgery and gall bladder surgery. Over the last 10 years, the use of this technique has expanded into intestinal surgery. In traditional "open" surgery, the surgeon uses a single incision to get entry 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 trochar is inserted. Specialized instruments and a special camera known as a laparoscope are passed through the trochars 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.

Advantages of laparoscopic surgery

Compared to traditional open surgery, patients often experience less pain, a shorter recovery period, and less scarring with laparoscopic surgery.

 

What kinds of operations can be performed using laparoscopic surgery?

Most intestinal surgeries can be performed using the laparoscopic technique. These include surgery for Crohn's disease, ulcerative colitis, diverticulitis, cancer, rectal prolapse and severe constipation.

In the past, there had been concern raised about the safety of laparoscopic surgery for cancer operations. Recently several studies involving hundreds of patients have shown that laparoscopic surgery is safe for certain colorectal cancers.

How safe is laparoscopic surgery?

Laparoscopic surgery in Kolkata is as safe as traditional open surgery. At the beginning of a laparoscopic operation, the laparoscope is inserted through a small incision near the belly button (umbilicus). The surgeon initially inspects the abdomen to determine whether laparoscopic surgery may be safely performed. If there is a large amount of inflammation or if the surgeon encounters other factors that prevent a clear view of the structures, the surgeon may need to make a larger incision to complete the operation safely.

Any intestinal surgery is associated with certain risks such as complications related to anesthesia and bleeding or infectious complications. The risk of any operation is determined in part by the nature of the specific operation. An individual's general health and other medical conditions are also some factors that affect the risk of any operation. You should discuss with your surgeon about your risk for any operation.

• Laparoscopic cholecystectomy: Removal of stones in the gallbladder. In a standard procedure, we make 4 small holes on the abdominal wall and remove the gallbladder with the stones. With advancement, now we also perform the procedure using 2 holes or sometimes with a single hole (SILS). We have the best laparoscopic cholecystectomy surgeon in Kolkata in our team.
• Laparoscopic appendicectomy: Removal of the appendix. We remove the appendix through 3 small holes in the abdominal wall.
• Laparoscopic CBD exploration: Removal of CBD stones. Patients who have stones in the common bile duct are in most cases subject to an ERCP. In this procedure, an endoscopy is passed through the mouth and the CBD stones are removed through the intestines. But nowadays, in some cases, we do the procedure by laparoscopy. The advantage of this is that the patient needs to undergo a single operation instead of two.
• Laparoscopic Fundoplication: For GERD and hiatus hernia. This is done for patients with reflux disease or symptomatic hiatus hernia. The valve at the gastroesophageal junction is tightened and the hernia is repaired.
• Laparoscopic Cardiomyotomy: For achalasia cardia. The obstruction at the GE junction is opened up.
• Laparoscopic hernia repair: For incisional hernia and inguinal hernia. In this procedure. the hernia is reduced and a special mesh is placed inside the abdomen and fixed with tackers.
• Laparoscopic-assisted small bowel resection: The intestine is examined and the position of the area to be resected is ascertained. Then the actual resection is done through a small incision in the abdominal wall.
• Laparoscopic-assisted colon resection (for selective cases): The large intestine is mobilized laparoscopically and the tumour is resected intracorporeally or extracorporeally. The bowel anastomosis may again be done either intracorporeally or extracorporeally.
• Laparoscopic surgery for hydatid cyst of the liver: The cyst is evacuated and cyst wall is removed and the cyst cavity is packed with omentum.
• Bariatric Surgery (sleeve gastrectomy and gastric bypass): In sleeve gastrectomy, a large part of the stomach is removed leaving a small portion, so that the patient can eat small quantities of food only. In a gastric bypass, not only the stomach capacity is reduced, but a significant length of the small intestine is also bypassed. As a result of this, the absorption of food is also decreased leading to further weight loss.

Laparoscopic splenectomy for ITP