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Laparoscopic Surgery-Myths and Facts

Imagine a doctor says - " you have to undergo surgery", things which strike your mind are pain, ugly scars and the question ` When can I return to work?’ No more worries. We are in the era of Laparoscopy (minimally invasive surgery). Laparoscopic surgery has grown to such an extent that things formerly considered impossible are possible now.

Laparoscopic surgery is also known as "keyhole surgery", as no large cut is made. This is a mode of surgery, which is performed through small holes created in the abdominal wall. The telescope, which is used to visualise organs inside the body, is passed inside the tummy via the navel. The tummy is distended with a gas to make more room. Picture images of the abdominal organs can be viewed on a TV screen. It gives visualization and clarity of the internal organs better than that of conventional surgery since the image is magnified. Two or three small pencil-like instruments are passed on the sides along with it to perform the procedure.

It is virtually painless and cosmetic (skin marks 1 cms or lesser). Your hospital stay is very much reduced so that you can walk home early. Infections and complications are substantially reduced and above all, the trauma of the operation is minimal. There isn’t much restriction in games or sports after surgery.

Initially started in adults to remove gallstones, the technique is now successfully being used for surgeries of other organs in the tummy like Gullet, Stomach, Spleen, Liver, Pancreas, Small and large bowels, Uterus, Kidneys and Major Blood vessels. It is usually done under general anesthesia.

In sound hands, removal of the gall bladder is a safe operation. (Oral medication to dissolve gall stones or shattering the stones through sound waves are not as effective as surgery) So is the case with hernias as well. In the case of abdominal wall hernias, the repair is done with the help of mesh as in open surgery.

Hyper acidity could also be stemmed through Laparoscopy by tightening the esophagus-gastric junction. Rectal Prolapse is another condition where Laparoscopy has a great role.

Hysterectomy is another surgery, which can easily be done by laparoscopy. In case large uterine tumors (fibroids) it is removed through small holes after cutting up into pieces with the help of an instrument called morcellator.

In case of renal transplantation the kidney can be taken from the donor with the help of key-hole surgery, thus the motivation for donating the kidney for one’s blood relative can be improved

Lack of awareness, inadequately trained surgeons and improperly informed patients are the major problems associated with Laparoscopy, especially in our state. People stay away from the procedure thinking that it’s very expensive. But they don’t realize that though the technique is expensive, the over all cost is not when the short hospital stay and early return to work are taken into consideration

Patients often think that with Laparoscopic surgery, the treatment they are getting is sub optimal when compared to open surgery. That is not true. The surgeon can do a better job utilising the magnified image on the screen. Moreover the video images of the surgical procedure can be recorded and reviewed later if any need arises

Lot of studies are there in the world literature favoring Key-hole surgery for even cancer. Studies have shown that your surgeon can remove the abdominal cancer better by Laparoscopic surgery, than by the conventional surgery. In a case of cancer of the liver, Laparoscopic surgery can remove specified part of the liver affected by the disease with minimal blood loss.

Laparoscopic surgery for obesity is an area, which is evolving very fast. You don’t need to exercise a lot; you can reduce your overweight by taking a key-hole surgery

Though we are living in an era of robotic surgery, and though dedicated surgeons are trying to bring that technology within our reach, our patients are still reluctant to accept and utilise it because of myths and misconceptions existing in our society. Laparoscopic surgery is fast catching on.

Let us hope for a new era where with the acceptance of Laparoscopic surgery people will start taking up surgery with a smile, without any apprehension.

Dr.Baiju Senadhipan, MBBS, MS, DNB, MNAMS, FMAS, MCh (Gastro), Consultant Surgical Gastroenterologist and Laparoscopic Surgeon, Holy Cross Hospital, Kollam.

senadhipan@yahoo.com

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