11/26/07

Q. Dr. Diggiss,

I am scheduled for surgery and was told I could have it done laparoscopically. What is laparoscopic surgery and how is that different from general surgery?

A. Laparoscopic surgery refers to operations involving entry into the abdominal wall or into the abdominal cavity where the mode of entry is different from the traditional Laparotomy — incision (usually single and long).

In Laparoscopy, a telescope with an attached camera is placed into the abdomen through a tubular port. This port is itself placed through or into the abdominal wall and, usually a gas (carbon dioxide) is introduced under pressure via this port or via a special needle device just prior to placing this port.

With the space created by the gas lift of the abdominal wall and the positioning of the patient it becomes possible with the placing of additional ports for operations to be performed using long instruments intro7space. With the guidance of the magnified camera-projected image on a monitor or TV screen most of the same operations which would have required a long cut could now be done through small holes.

The advantages of this method of entry into the abdomen include: less pain pain; quicker recovery; shorter stay in hospital; and less scarring.

Laparotomy surgery is the traditional open knife entry into the abdomen. In most instances with Laparotomy or Laparoscopy, the actual operation performed is done in the same or similar manner using standard principles, however the other advantages of the laparoscopic method for patients explain its current "explosion" in surgery.

Laparoscopic surgery was developed significantly in the practice of Gynecology since the '60s however; it was not until the late 80s and into the 90's that this method of entry into, and operating within the abdomen became common and standard in general surgery.

Procedures like removal of the gallbladder and the appendix have become standard to perform laparoscopically unless as happens in a few circumstances, it is considered unsafe to use or persist with this approach and, a conversion to Laparotomy is done.

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