Laparoscopic Surgery

Laparoscopic surgery, also known as laparoscopy, is a type of surgical procedure that allows the surgeon access to the inside of the abdomen (tummy) and pelvis without requiring major incisions in the skin. It is also known as minimally invasive surgery or keyhole surgery.A small tube equipped with a light source and camera transmits images of the inside of the abdomen or pelvis to a television monitor.

Laparoscopy is commonly used in the following medical specialties:

• Gynaecology: Laparoscopic surgeries are performed as treatment for disorders that affect the female reproductive system, which includes the fallopian tube, uterus, and ovaries.
• Gastroenterology: Laparoscopic surgeries are performed as treatment for disorders that affect the digestive system, which includes the pancreas, liver, stomach, gallbladder, colon, and small intestine. 
• Urology: Laparoscopic surgeries are performed as treatment for disorders that affect the urinary system, which includes kidneys, bladder, ureters, and urethra.

Surgeries that can be performed laparoscopically

Laparoscopic surgery is becoming the preferred approach for most surgeries due to the improved patient outcome. For example:

• Cholecystectomy or gallbladder removal surgery
• Appendicectomy or appendix removal surgery
• Colectomy or bowel resection surgery
• Hernia repair surgery
• Nephrectomy or partial or complete removal of kidney
• Hysterectomy or uterus removal surgery
• Oophorectomy or removal of one or both ovaries
• Treatment for ectopic pregnancy 
• Removing fibroids
• Removing organs affected by cancer

Advantages of laparoscopy

There are many advantages to laparoscopic surgery over conventional ones and they include the following: 

• Smaller external scars
• Minimally invasive
• Less pain
• Minimal blood loss
• Reduced risk of infection 
• A shorter length of hospital stay
• Faster recovery

Complications of laparoscopy

Laparoscopy is a frequently performed safe procedure with a low incidence of serious complications.

Minor complications:

• Bruising or minor bleeding from the incision site
• Infection 
• Nausea and vomiting 

Serious complications: 

• Organ damage (bowel or bladder) which can cause loss of organ function
• Damage to the major artery 
• Air bubbles entering your arteries and veins due to the usage of carbon dioxide
• Allergic reaction to general anaesthesia 

Serious complications may require further surgery to address the issue. 

Procedures of a laparoscopy surgery

Laparoscopy is a minimally invasive surgical procedure usually performed under general anaesthesia. Therefore, you would be unconscious throughout the surgery. You are mostly allowed to return home on the same day of the surgery or the next day.

Before laparoscopic surgery

Most laparoscopic surgeries require you to not eat or drink anything from 6 to 12 hours prior to surgery. In order to prevent excessive bleeding during the procedure, blood thinning medications (anticoagulants) such as warfarin or aspirin may need to be stopped in the days leading to the surgery. You may also be required to refrain from smoking a few days before the surgery, as smoking can delay recovery post-surgery and increase the likelihood of complications such as infection.

During laparoscopic surgery

During laparoscopy, the surgeon makes a small cut (incision) of approximately 1 to 1.5cm, typically near your belly button (umbilicus). Through the incision, a tube is introduced, and carbon dioxide gas is pumped through the tube to expand your abdomen. By inflating the abdomen, the surgeon can view your organs more clearly and has greater room to work. By inflating the abdomen, the surgeon can view your organs more clearly and has greater room to work. This tube is then used to insert a laparoscope. In the operating room, the laparoscope relays images to a television monitor providing the surgeon a greater view of the operating site.

Further abdominal incisions will be required if the laparoscopy is utilised to perform a surgical procedure, such as appendix removal. The surgeon can insert small surgical instruments through these incisions and guide them to the right location using the image from the laparoscope. The instruments can then be used to carry out the required surgery. After the surgery, carbon dioxide is released from the abdomen, the incisions are closed with stitches or clips, and a dressing is applied.

After laparoscopic surgery

You may feel drowsy and disoriented as you recover from the effects of the anaesthesia given during laparoscopy. Some individuals experience nausea and vomiting. These are typical side effects of anaesthesia and would subside quickly. A nurse will observe you for several hours until you are fully conscious and able to eat, drink, and pass urine.

Before leaving the hospital, you will be taught methods to clean the wound. You would also be informed when to return for a follow-up visit or remove your stitches. For a few days following the procedure, you may experience pain and discomfort at the incision site, and if a breathing tube was used, you might have a sore throat. Your doctor may prescribe you analgesics (painkillers) to relieve pain.  

Since gas is used to inflate the abdomen, some of it could remain in the abdomen and cause bloating, cramps, or shoulder pain because it irritates the diaphragm (the muscle you use to breathe), which in turn irritates the nerve endings in the shoulder.

These symptoms are harmless and should subside within a day or two once the body has absorbed the remaining gas.

You will likely feel more exhausted in the days or weeks following the surgery. Remember to rest and take regular naps. The recovery period differs for everyone. Speak to your doctor to know how long it would take for you to recover following your procedure. 

Future developments in laparoscopy

Nowadays, many hospitals use robots to assist with procedures and this is known as robotic-assisted laparoscopy. In the operating theatre, the surgeon controls robotic arms equipped with a specialised camera and surgical instruments during robotic-assisted laparoscopy via a console.

This robotic system delivers enhanced 3D vision and a wider range of motion for instruments operating in the body. Surgeons may perform intricate procedures with greater precision and through smaller incisions by using robotic-assisted laparoscopy.

Compared to traditional laparoscopy or open surgery, robotic-assisted laparoscopy may have a shorter recovery time and reduced risk of complications.

Make an appointment at Gleneagles Hospitals

Our caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care. Get in touch with us at your nearest Gleneagles Hospital if you would like to know more about laparoscopic surgeries.