Introduction to Laparoscopic Surgery

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Laparoscopy is just one of the many new and innovative approaches in a new era of surgery encompassing minimal intervention. Simply put, many complicated problems required large incisions to gain access to a very focal area. Minimally invasive surgery gains access to that same area without a large incision. Laparoscopic surgery refers to procedures in minimally invasive surgery isolated to the abdomen.

Surgeon, with nurses, performing an abdominal laparoscopic procedure.
Laparoscopic surgery requires only small
puncture holes for insertion of various
operating instruments.

Early experience in laparoscopy was gained by gynecologists performing tubal ligation by looking through a small telescope inserted through the umbilicus (belly button). In the late 1980s, technology evolved to a point where the images could be projected onto TV screens.

Laparoscopic surgery has evolved tremendously over the last 10–20 years. A variety of complicated procedures are now able to be performed laparoscopically with less post-operative pain, faster recovery, and smaller scars than traditional open operations.

Benefits of Laparoscopic Surgery

The advent of laparoscopic procedures revolutionized surgery in many ways. Procedures that required weeks to recover from were dramatically reduced in many ways.

A few of the benefits are:

  • reduced bleeding
  • smaller incisions
  • faster healing
  • reduced pain and scarring

Laparoscopic surgery takes more time than the traditional open surgery, but the benefits are undeniable. Recovery time can be reduced from several weeks to several days.

Laparoscopy Techniques

The concept of laparoscopic surgery is relatively simple. Imagine the abdomen as a sack or balloon containing the various abdominal organs. Once the patient is asleep, a small needle is placed through the abdominal wall, and gas is inflated to give the surgeons some "working room." Three or four more small puncture holes are made for insertion of various operating instruments including retractors, graspers, scissors, and dissecting tools. One of the instruments contains a small video camera which projects images of the abdominal cavity onto large video monitors, allowing doctors to get very good magnified views of the abdominal organs. Upon completion of the desired procedure, the instruments are removed and the abdomen "deflated." The small holes are closed with minimal scarring.

Laparoscopy involves no cutting incisions, which are what hurt after standard open surgery. Laparoscopy has a number of other advantages. Because there is minimal manipulation of the abdominal contents, there is minimal formation of scar tissue. Also, minimal manipulation of the bowel results in rapid return of bowel function. In large operations, the bowel commonly becomes paralyzed for several days post-operatively. This is rarely seen after laparoscopic surgery.