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Laparoscopic surgery Safe & comfortable alternative

With the advent of laparoscopy, long incisions, as well as, the pain and prolonged recovery associated with surgery, have become a thing of the past

Laparoscopic surgery Safe & comfortable alternative

The word surgery usually arouses a fear in an individual's mind whenever it is suggested to him/her. This fear is mainly due to the pain of large incisions (cuts) and the associated prolonged recovery period in the hospital. However, with the advent of laparoscopy (in common language 'micro-surgery') long incisions, as well as, the pain and prolonged recovery associated with surgery have become a thing of the past.

Laparoscopy was introduced in India long back, in the early 90s, however, for most part of the decade only simple procedures like cholecystectomy (gall bladder removal) and appendicectomy (removal of infected appendix) formed majority of the surgeries performed by this approach.

But in recent times, laparoscopy has evolved and majority of the surgically treatable diseases in the abdomen as well as the chest can now be treated by this technique.

These diseases not only include benign diseases, but also cancers.

How is laparoscopy performed?

Laparoscopy is done by making small incisions (key-holes) in the abdomen through which ports (long tubular channels) are placed allowing for introduction of camera and special laparoscopic instruments in the abdomen. The abdomen is inflated with gas (usually CO2) to create working space. Through one of the ports, a telescope attached to a camera is introduced which is connected to a monitor (TV). The surgeon then performs the procedure looking at the monitor. This requires specialised training as the surgeon has to develop good hand-eye co-ordination.

What are the benefits of laparoscopy?

As laparoscopy is done through key-hole incision, patient has very less pain and thus recovers from the surgery early reducing the hospital stay. Laparoscopy is also associated with less wound infection rates as well as lesser chances of hernia development in the future. This is an understated benefit for a country like ours where a lot of people are on daily wages.

Another important benefit is the cosmetic advantage of these small key-hole incisions which almost become invisible after a few months. Laparoscopy is also advantageous to the surgeon as it give magnified view of the operative field, thus, improving precision of surgery.

What type of surgeries are performed laparoscopically?

Most of us know that gall bladders and appendix are removed laparoscopically. Many of us also know that some gynaecological procedures are also done through this process. However, laparoscopy has a come a long way today, with more and more complex procedures being performed laparoscopically. These procedures include advanced hernia surgery, bariatric (weight loss) surgery, upper gastrointestinal tract surgery, surgery for cancers of colon and rectum, pancreatic surgery, liver surgery and many more.

Laparoscopic hernia surgery: Hernia is the most common disease which is treated surgically. Hernia is an abnormal protrusion of contents of the abdomen (usually intestines). This condition needs to be treated as it can lead to significant problems. Traditionally, hernias were treated by open surgery but with the advent of laparoscopy, almost all types of hernias can be treated by this approach. Patients can go home on the next day of surgery with little or no pain. Newer hernia techniques are allowing even complex hernias to be treated by laparoscopy

Laparoscopic bariatric surgery: Obesity has become a global pandemic. It is associated with other diseases like diabetes, hypertension, heart disease, risk of cancers etc. Bariatric surgery is the most effective treatment for obesity. It is an advanced laparoscopic surgery, wherein, alterations are made in the stomach and/or intestines leading to sustained weight loss. Not only do the patients achieve weight loss, but they are also cured of many of the associated diseases.

Laparoscopic upper gastrointestinal surgery: There are many surgeries of the upper intestinal tract which are routinely performed by laparoscopy. These include surgery for acid reflux disease, hiatus hernia, diaphragmatic hernia, achalasia cardia, other esophageal diseases, esophageal and stomach tumors etc. Diseases of the esophagus procedures can be performed by thoracoscopy (micro-surgery in the chest). Many procedures which were performed by incision in the chest (painful incisions) can now be performed by this minimally invasive approach, thus, improving patient's acceptability for these surgeries.

Laparoscopic surgery for diseases of colon and rectum: Many diseases of the colon and rectum can be treated by laparoscopy. Patients can undergo major cancer surgery and can recover quickly and get back to their normal life. Other diseases like rectal prolapse can also be treated laparoscopically, avoiding the unnecessary pain of long incisions.

Today laparoscopy is being done for more and more complex procedures like pancreatic, biliary and liver surgeries. As the experience with these procedures is improving so is their outcome. Technology has helped us in this endeavor with newer, more sophisticated instruments making the surgery safer. To be able to give our patients a pain free experience through the surgical process brings great satisfaction to the surgical team.

Patients, also, feel much more confident when we tell them that we are going to do their procedure laparoscopically.

Dr Siddhartha Bhattacharya MS (General Surgery), DNB, FNB (Minimal Access surgery), MNAMS, FMAS, FAIS, Fellowship in Bariatric and Metabolic surgery, Consultant, Advanced Laparoscopic GI and Bariatric surgery, Peerless Hospital, Kolkata

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