Laparoscopic Surgery

What is a laparoscopic procedure?

Laparoscopic surgery is a surgical procedure which uses the assistance of several small instruments guided by a video camera. During a laparoscopic procedure, small incisions are made to allow the camera and the surgical instruments to be introduced. With this, the surgeon can more easily obtain access to the needed area with smaller incisions. The video camera will put an image onto a television monitor that the surgeon will use to see and perform the procedure.

Benefits of laparoscopic procedures

Less post-operative discomfort, incisions are smaller
Quicker recovery time
Shorter hospital stays
Earlier return to activity
Smaller scars

GALLBLADDER SURGERY (CHOLECYSTECTOMY)

How safe is a laparoscopic Gallbladder surgery?

This is a very safe operation. There is an overall complication rate of less than 2%, which is similar to the traditional open gallbladder surgeries.

What is a laparoscopic Gallbladder surgery?

Also called a cholecystectomy, this is a procedure which removes the gallbladder in a minimally invasive technique. Specially designed instruments allow an easier access and surgical technique, allowing for smaller scarring and quicker recovery time.

What actually happens?

Patients are monitored under general anesthesia, so the patient is asleep
An incision around half of an inch is made at the belly button, three other small incisions are made
Four narrow tubes, or ports, are placed in the incisions to hold the camera and surgical instruments
A laparoscopic camera is placed through the incision at the belly button and connected to a monitor to allow the surgeon to visualize the other instruments inside the abdomen
The abdomen is inflated with carbon dioxide to open the area and allow visualization
Special surgical instruments are inserted through the other ports to allow the surgeon to easily separate the gallbladder from the liver and bile duct
The gallbladder is then carefully removed from through a port
The incisions are then closed with sutures and dressed by the surgeon
Rarely, the surgeon is unable to perform the surgery with the laparoscopic technique, if this happens, the traditional open surgery will be completed for patient safety.

Risks of laparoscopic Gallbladder surgery

Although these are infrequent, some complications which occur include bleeding, infection, leakage of bile into the abdomen, pneumonia, blood clots. Other rare complications include injury to the common bile duct, duodenum, or small intestine. These would require additional procedures to repair the injury.

The hospital stay

Most patients go home the same day of the operation, some will require a one night stay.

Recovery time

Typically, patients recover and return to regular activity in one week. This is dependent on the patient, and how they feel. Patients are encouraged to be actively walking. Work is usually resumed seven to ten days following surgery, however, those with manual labor (heavy lifting) may require 3-4 weeks to return to activity.

Concerns for the patient

Fever, yellow skin or eyes, persistent nausea or vomiting, excessive drainage or pain from an incision, or unrelenting fever may indicate complications a and it would be important to contact your surgeon if you had these symptoms.

APPENDECTOMY

Are you a candidate for a laparoscopic appendectomy?

Although laparoscopic appendectomy has benefits, it may not be appropriate for some patients. Patients who have early, non-ruptured appendicitis usually can be removed laparoscopically. Laparoscopic appendectomy is more difficult to perform if there is a ruptured appendix. When there is a ruptured appendix, an open procedure allows for a larger incision and is safer to the patient.

How is a laparoscopic appendectomy performed?

Patients are monitored under general anesthesia, so the patient is asleep
An incision around half of an inch is made at the belly button, three other small incisions are made
Narrow tubes, or ports, are placed in the incisions to hold the camera and surgical instruments
A laparoscopic camera is placed through the incision at the belly button and connected to a monitor to allow the surgeon to visualize the other instruments inside the abdomen
The abdomen is inflated with carbon dioxide to open the area and allow visualization
Special surgical instruments are inserted through the other ports to allow the surgeon to easily work to remove the appendix
The appendix is then carefully removed from a port
The incisions are then closed with sutures and dressed by the surgeon
At times, the surgeon is unable to perform the surgery with the laparoscopic technique, if this happens, the traditional open surgery will be completed for patient safety.

What happens if the operation cannot be performed or completed by the laparoscopic method?

Sometimes, the surgeon does not feel that laparoscopic surgery is the best way to remove the appendix. This may be before the surgery and planned, or during a laparoscopic procedure. The surgeon may feel that it is safest to the patient to convert to an open, based on the surgeon's best judgment. Factors that may increase the likelihood of open procedures include:

Infection or abscess
A ruptured appendix
Obesity
History of prior abdominal surgery
Inability to visualize the appendix
Bleeding during the operation

What should I expect after surgery?

After the operation, it's important to follow the surgeon's instructions. You are encouraged to:

Be out of bed the day of surgery and walking around
You will be able to get back to normal activities in one to two weeks. This includes walking, showering, driving, working, amongst other activities.
If you have prolonged soreness or are getting no relief from the prescribed pain medication, you should notify the office.

What complications can occur?

As with any operation, there are risks associated, it is important to recognize early signs of possible complications. You should notify the office if you experience, severe abdominal pain, fever, chills, or rectal bleeding. Common complications include:

Bleeding
Infection
Removal of a normal appendix
A leak at the edge of the colon where the appendix was removed
Injury to organs near the appendix, the small intestine, ureter, or bladder
Blood clot
Pulmonary emboli

HERNIA SURGERY

What is a hernia?

A hernia occurs when the inside layers of the abdominal wall become weak and bulge or tear. The inner lining of the abdomen pushes through the weakened area. When this occurs, a loop of intestine or abdominal tissue is able to slip into the space. Some of these may have no symptoms, but if the loop of intestine is squeezed by the abdominal wall, it may lose its supply of oxygen and is dangerous, requiring surgery. Both men and women of all ages may develop hernias. They are a result of a natural weakness in the abdominal wall or from excessive strain on the wall with heavy lifting, pregnancy, persistent coughing, or straining. There are several types of hernias, which differ in their locations. Most hernias are located at the groin area. They are also found below the groin, through the navel, and along a previous incision from a surgery.

What are common symptoms of a hernia?

A noticeable bulge
Pain with lifting, movement, or straining
A dull ache in the area
Nausea and constipation

How is a laparoscopic hernia repair completed?

Patients are monitored under general anesthesia, so the patient is asleep
A laparoscope with a camera hooked to a television monitor is placed into a port through an incision to allow the surgeon visualize the abdomen while completing the surgery
The abdomen is inflated with carbon dioxide to better visualize the procedure
The peritoneum is cut to expose the weakness, and a mesh patch is attached to secure the weak area.

The hospital stay

Most patients go home the same day of the operation, some will require a one night stay.

Recovery time

What are the benefits of doing laparoscopic hernia repairs?

Less post-operative discomfort, incisions are smaller
Quicker recovery time
Shorter hospital stays
Earlier return to activity
Smaller scars