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Laparoscopy Surgery

by

Dr. K.N. Srivastava

Laparoscopic Functioning

The key in laparoscopic surgery is the use of a laparoscope. Also attached is a fiber optic cable system connected to a \’cold\’ light source (halogen or xenon), to illuminate the operative field, inserted through a 5 mm or 10 mm tube. The abdomen is usually blown up like a balloon, with carbon dioxide gas which elevates the abdominal wall above the internal organs like a dome to create a working and viewing space.

Advantages & Risks

The Advantages of laparoscopic surgery are:

1.Reduced infection risk due to the absence of large incisions

2.Reduced hemorrhaging, which also reduces the chance of needing a blood transfusion

3.Less pain, leading to less medications

4.Reduced exposure of internal organs to external contaminants

5.Reduced patient immobilization, thus shorter hospital stay

Laparoscopy may be unsafe for patients with cardiac or lung diseases as they would not be able to breathe out carbon dioxide absorbed into the circulation during laparoscopy. Ballooning of the abdomen also creates a mechanical disadvantage in breathing in such patients. Also, children tend to absorb carbon dioxide into circulation faster and may have difficulty in respiring it out. To overcome the risk, case selection is mandatory.

Popular Applications:

Laparoscopy has gained prominence as a technique of the new millennium for most abdominal and thoracic operations and is being applied to a growing number of other surgical procedures such as:

1.Gastric Bypass Surgery

2.Lap Band

3.Removal of Gallbladder

4.Hernia Repair

5.GERD or Anti Reflux Surgery

6.Treatment of Liver and Biliary Diseases

7.Treatment of Hiatal Hernia

8.Treatment of the Spleen

9.Intestinal and Colon Disorders

10.Ulcer Surgery

11.Small Bowel Obstruction

12.Removal of Appendix

13.Removal of Adrenal Gland

14.Diagnosis & Localization

Contrary to operative cost worries, ulcer disease and gastrooesophageal reflux can be cured at low cost as compared with a lifelong drug treatment

Weight-Loss Surgery:

An exciting advancement has been the widespread use of laparoscopic bariatric surgery for treating patients who are significantly obese. For them surgery is the only option to lose weight in the long term. It also offers relief from co-morbidities like diabetes, hypertension and sleep apnoea. Particularly in obese high-risk patients, operations performed through small incisions significantly reduce the potential for complications and allow for faster recovery.

Common Bariatric surgeries performed are:

a) Gastric Lap Band

b) Laparoscopic Sleeve Gastrectomy

c) Laparoscopic Gastric Bypass

Surgical Concerns:

One of the bigger concerns is training of surgeons. At present, the exposure gained by surgical residents in India to laparoscopy surgery appears inadequate and haphazard.

In addition, the technique itself offers the following surgical disadvantages:

a) Limited range of motion at the surgical site resulting in a dexterity loss

b) Poor depth perception

c) Relative technical sophistication & maintenance problems

d) Cost of the equipment

Dr. K. N. Srivastava presently is Senior Consultant and Head, Deptt. of General & Minimal Access Surgery at the BLK Super Speciality Hospital, Pusa Road, New Delhi, India, which is among the best hospitals in Delhi. He is the best

laparoscopic surgeon Delhi

India. He regards as best Hernia surgeon,

Bariatric Surgeon

and best Gallstone surgeon in Delhi India

Article Source:

ArticleRich.com