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Small cut, few complications and less stress. Laparoscopy has many advantages, so patients often ask about the possibility of having an operation using this method. What is worth knowing about it?
Laparoscopy is a relatively young research technique, although the first experiments in this field and clinical trials were performed over 200 years ago. Even twenty years ago, it was used only for the diagnosis of the inside of the abdominal cavity and for taking specimens for histopathological examinations. Currently, it is also used for surgical procedures.
Telescope and camera, or laparoscopy
Laparoscopy is performed using a laparoscope, which is a special tube consisting of a telescope, a small camera, and a light source. Through a telescope equipped with lenses surrounded by optical fibers, the image from the patient’s abdominal cavity reaches the camera, which transmits it to the monitor screen. It is possible to zoom in and enlarge the image even ten times.
In addition to the laparoscope, other devices are needed to perform the procedure: a trocar and an insufflator. The first is a tube-shaped tool that ends with a sharp shank. The second is used to regulate the flow and maintain a constant gas pressure in the peritoneal cavity.
What is Laparoscopy?
For abdominal surgery to be performed, there must be space for observation. A refusal needle is inserted into the abdominal cavity, with the help of which gas is pumped. Most often it is carbon dioxide – from 3 to 5 liters. The abdominal wall is then cut with the sharp part of the trocar, usually around the navel, allowing the insertion of the cannula (located outside the instrument), which, when the sharp tip is extended, opens the connection between the peritoneal cavity and the surroundings. The appropriate laparoscope is inserted through the cannula and into the peritoneum.
By looking into the abdominal cavity in this way, the liver, gallbladder, spleen, diaphragm, reproductive organs and others can be viewed and assessed macroscopically. During the procedure, it is also possible to perform a biopsy and remove certain organs (e.g. the uterus, after dividing it into pieces), breaking down deposits, and even performing complicated procedures on the stomach.
Before laparoscopy is performed, it is necessary to determine the blood group, check its coagulability and perform an ECG. You should go on an easily digestible diet the day before. Regardless of the purpose of the procedure, it is always performed under general anesthesia.
Laparoscopy is said to be a sparing procedure compared to classic surgery. The incision is much smaller (approx. 1 cm) and the wound heals faster. It puts a lot less strain on the patient: he or she lies in the hospital for a shorter time, and after its implementation, it recovers faster. There is less risk of complications.
Widespread use of laparoscopy
The indications for laparoscopy are primarily liver diseases, ascites of unclear origin, diagnostics of inflammatory conditions within the abdominal cavity, spleen diseases or adhesions in the peritoneal cavity, and gynecological procedures.
In addition, this method is superior to classic surgery when it comes to excision of the gallbladder, reflux diseases and excision of adrenal tumors, colon and rectal tumors, liver cysts, abdominal hernias, appendix, ovarian, kidney and prostate cysts.
The laparoscopic method can also be used in the case of gastric cancer. So far, only doctors from the University Hospital in Krakow have undertaken it in Poland. Using a laparoscope, they resected the stomachs of four patients along with the surrounding lymph nodes.
Contraindications to laparoscopy?
Not everyone can undergo laparoscopic surgery. Most of the contraindications are the same as in the case of traditional surgery – circulatory and respiratory failure, severe asthma, chronic bronchitis or a recent infarction disqualify. Also, pregnancy and old age exclude the possibility of undergoing this technique.
In search of flaws
It happens that the laparoscopic procedure ends with a classic surgical procedure, because the problem that was the reason for starting the treatment turns out to be more serious than expected, and access to some organs is difficult. This method is also technically more difficult to perform and requires expensive equipment.
Laparoscopy is also associated with the risk of complications, e.g. the possibility of perforation of the abdominal organs, pneumothorax, air embolism, bleeding from the incision site.
Consultation: Medard M. Lech, MD, PhD, gynecologist-obstetrician
Source: Let’s live longer