Frequently Asked Questions about laparoscopy

Dr. B. Premkumar. M.S. FCIP. M.MAS. F.MAS. D.MAS,

Senior Consultant and Laparoscopic Surgeon Apollo Hospital, Chennai.

What is laparoscopy?

Laparoscopy is direct visualization of the peritoneal cavity, and organ inside peritoneal cavity. The laparoscope is an instrument somewhat like a miniature telescope with a fiber optic system which brings light into the abdomen. It is about as big around as a fountain pen and twice as long.

An instrument to move the uterus during surgery will be placed in the vagina. Carbon dioxide (CO2) is put into the abdomen through a special needle that is inserted just below the navel. This gas helps to separate the organs inside the abdominal cavity, making it easier for the physician to see the reproductive organs during laparoscopy. The gas is removed at the end of the procedure.

Micro Laparoscopy is new minimally invasive diagnostic surgical procedure uses telescopes and instruments that are much smaller than normal. If this procedure is appropriate for your condition, smaller incisions will be made and postoperative abdominal tenderness may be reduced.

Laparoscopy (lap-a-ros-copee) is an examination of the interior of the abdomen by means of an instrument called a laparoscope (lap-a- ros-cope). A laparoscope is a small telescope-like instrument with a light on one end which is passed through a small incision below the navel. This allows the physician to view and examine the organs in the abdominal cavity.

What is diagnostic laparoscopy?

A diagnostic laparoscopy is a procedure in which the laparoscopic surgeon  uses a laparoscope, to look at the organs and tissues inside abdominal cavity.

What is laparoscopic surgery ?

The laparoscopic surgery  is a method by which surgery is done by making small incisions on the abdominal wall and inserting the instruments through specially designed ports. The procedure will be visualized with the help of a camera, which will also be introduced through one of these ports.

What are the advantages of this method ?

In conventional surgery a long incision is made to gain entry into the abdominal cavity and operate. This result in increased post- operative pain, longer stay in hospital, delayed recovery, long and ugly scars, respiratory problems, higher chance of wound infection, higher chance of incisional hernia, delayed feeding after surgery. The incidence of all these is dramatically reduced by laparoscopic surgery.

What procedure can be done by laparoscopic surgery... ?

Almost all surgeries being done in open surgery are nowadays being performed. The most common however are cholecystectomy (removal of the gall bladder), appendicectomy (removal of the appendix), tubal ligation (sterilisation), diagnostic laparoscopy, hernia repair.

Will I need anaesthesia ?

Diagnostic laparoscopy and hernia repairs can be done under local anaesthesia but the other procedures will require general anaesthesia.

How long do I have to stay in hospital ?

A healthy person without any other medical ailments and complications can be investigated on an out- patient basis. They can come in on the day of surgery or the previous day. Following a laparoscopic procedure for the gall bladder or appendix they can be discharged on the next day but for more advanced procedures three to four days in hospital would be the norm.

How soon can I start eating after surgery?

If the surgery is uneventful, feeding can be started on the same day once the patient has recovered completely from the effects of anaesthesia, provided no procedure has been performed on the bowel.

When can I get back to work?

Usually a weeks rest from the day of surgery should suffice. But it would be advisable for the surgeon to advice based on your progress.

Do I have to take absolute bed rest?

No. The advantage of this method as has been previously mentioned is that the incisions are very small, thereby reducing pain and danger of hernia. You can become ambulant as early as pain and anaesthetic factors permit.

Is it more expensive than open surgery?

The equipment, maintenance and procedure are more expensive but as the hospital stay and the intake of drugs is reduced it is actually the same if not less than open surgery.

Where can I get it done?

It has become very common and is being done in almost every reputed hospital with minimal complication rates.

What are the risks of laparoscopic surgery?

  1. There are some risks when you have general anaesthesia.

  2. There is chance of infection or bleeding.

  3. The abdominal organs, glands, intestines, or blood vessels may be damaged if surgeon is not experienced

  4. The lining of the abdominal wall may become inflamed known as peritonitis

  5. A blood clot may enter the bloodstream, and clog an artery in the lung, pelvis, or legs.  Clot may break off and clog an artery in the heart or brain, causing a heart attack or stroke. But these risks are very rare.

Is laparoscopy useful in children?

Several procedures can be done by laparoscopy in children.

Laparoscopy is most commonly done to find and treat the cause of abdominal pain in children when other investigations have not been helpful.  Appendicitis can be diagnosed and appendicectomy done laparoscopically.  It may be equally easy and safe to do an open appendicectomy.

Other common indications are for treatment of benign ovarian cysts and when lower intestinal bleeding is suspected to be from a Meckel's diverticulum.

In advanced centres many major operations are done by minimal access techniques (as laparoscopy or key hole surgery is called). Of these, the most useful has been laparoscopic fundoplication  for gastro-oesophageal reflux

Is some operation like hydrocele, fistula etc is possible?

There is a common confusion about the procedures possible through laparoscopic method. We are getting letters from many patients asking about laparoscopic procedure for hydrocoele, Fistula ano, abscesses, and even for procedure like circumcision, mastectomy, cysts and abortion. It should be understand clearly that minimal access surgery is possible inside hollow closed cavities of the body, like abdomen and chest. Most of the procedure of the diseased organ inside the chest and abdomen can be performed by minimally invasive techniques but operations on solid organ outside the abdomen and chest does not require and also not possible through this technique.

Dr. Prem Kumar Balachandran.