Laparoscopic Surgery: Advantages, Techniques, and Common Procedures Explained

Introduction To Laparoscopic Surgery

Write short note on laparoscopic surgery or minimal access surgery.

Answer.

Advantages of Laparoscopic Surgery

Relatively less painful compared to open surgery. Trauma of access is very less.
Shorter hospital stay and early return to work.
Faster postoperative recovery.
Better visualization of the anatomy, i.e. better approach for dissection and visualization of other parts of abdomen for any other pathology.
Instrumental access to different abdominal locations is many times better compared to open method.
Minimal scars on the abdomen.

Laparoscopic Surgery Advantages, Techniques, And Common Procedures Explained

“Advantages Of Laparoscopic Surgery”

Laparoscopic Surgery Instruments Used

Zero degree laparoscope is commonly used. Side viewing scopes are also used to have bettr visualization 30°.
Cold light source either halogen lamp or xenon lamp is used. Halogen lamp is used commonly and is cheaper.
Xenon lamp gives high visualization.
Camera: 3 chip camera is commonly used with high resolution
Video—monitor to display images.
CO2 insufflor.
Long fie dissectors like in open surgical techniques.
Hooks and spatulas are used along with cautery for dissection.
Clip applicators

“Comprehensive Overview Of Laparoscopic Surgery Techniques”

“Common Procedures In Laparoscopic Surgery”

Laparoscopic Surgery Preparation

Always general anesthesia. Other preparations are same as for open method.

Laparoscopic Surgery Technique

Pressure bandages are applied to both legs to improve the venous return and to decrease the stasis.
Head end of the table is lowered to have easier insertion of veress needle and scope.
Ryle’s tube and Foley’s catheter are essential before insertion of the trocars.
Pneumoperitoneum is created using veress needle through umbilical incision.
Access can be achieved by open method through an umbilical incision. Carbon dioxide is commonly used to create pneumoperitoneum.
Pneumoperitoneum is created up to a pressure of 15 mm Hg which distends the abdominal cavity adequately to have proper visualization of the abdominal contents.

“Understanding The Benefits Of Laparoscopic Surgery”

Laparoscope is inserted through the umbilical port(10 mm).
Abdomen is evaluated for any pathology. Liver, gallbladder, pelvic organs are visualized.
Additional ports (3–4) through trocars are placed depending on the procedure to be done.
It may be either 5 mm port or 10 mm port.
These ports are placed in such a way to have a proper triangulation of instruments for dissection.
To use clip applicator 10 mm port is required.

“Risk Factors For Complications In Laparoscopic Surgery”

Physiologic Changes due to Pneumoperitoneum

Carbon dioxide causes hypercapnia, acidosis and hypoxia.
Pneumoperitoneum exerts pressure on the IVC, decreases the venous return and so the cardiac output.
It increases arterial pressure also.
It compromises respiratory function by compressing over the diaphragm impairing pulmonary compliance.

Laparoscopic Surgery Complications

Carbon dioxide narcosis and hypoxia.
Sepsis—subphrenic abscess, pelvic abscess, septicemia.
IVC compression
Bleeding
Leak from the site, e.g. bile leak.
Organ injury during insertion of ports, e.g. major vessels,bowel, mesentery, liver.
Subcutaneous emphysema and pneumomediastinum.
Gas emboli, though is rare but fatal.
Postoperative shoulder pain due to irritation ofdiaphragm.
Cardiac dysfunction due to decreased venous return.
Injury to the abdominal wall vessels and nerves.
Cautery burn to abdominal structures.
Abdominal wall hernias.
Wound infection.
Mortality—0.5%.

“Best Practices For Managing Laparoscopic Surgery Recovery”

Relative Contraindications

“The Role Of Cameras In Laparoscopic Surgical Procedures”

Basic laparoscopic Surgeries

Laparoscopic cholecystectomy: This is indicated in gallstones, cholecystitis, biliary colic
Laparoscopic appendicectomy: This is indicated in acute appendicitis.