WHAT IS LAPAROSCOPIC SURGERY?
Laparoscopic or “minimally invasive” surgery is a specialized technique for performing
surgery. In the past, this technique was commonly used for gynecologic surgery and
for gall bladder surgery. Over the last 10 years the use of this technique has expanded
into intestinal surgery. In traditional “open” surgery the surgeon uses a single
incision to enter into the abdomen. Laparoscopic surgery uses several 0.5-1cm incisions.
Each incision is called a “port.” At each port a tubular instrument known as a trochar
is inserted. Specialized instruments and a special camera known as a laparoscope
are passed through the trochars during the procedure. At the beginning of the procedure,
the abdomen is inflated with carbon dioxide gas to provide a working and viewing
space for the surgeon. The laparoscope transmits images from the abdominal cavity
to high-resolution video monitors in the operating room. During the operation the
surgeon watches detailed images of the abdomen on the monitor. This system allows
the surgeon to perform the same operations as traditional surgery but with smaller
incisions. In certain situations a surgeon may choose to use a special type of port
that is large enough to insert a hand. When a hand port is used the surgical technique
is called “hand assisted” laparoscopy. The incision required for the hand port is
larger than the other laparoscopic incisions, but is usually smaller than the incision
required for traditional surgery.
WHAT ARE THE ADVANTAGES OF LAPAROSCOPIC SUrGERY?
Compared to traditional open surgery, patients often experience less pain, a shorter
recovery, and less scarring with laparoscopic surgery.
WHAT KINDS OF OPERATIONS CAN BE PERFORMED USING LAPAROSCOPIC SURGERY?
Most intestinal surgeries can be performed using the laparoscopic technique. These
include surgery for Crohn’s disease, ulcerative colitis, diverticulitis, cancer,
rectal prolapse and severe constipation. In the past there had been concern raised
about the safety of laparoscopic surgery for cancer operations. Recently, several
studies involving hundreds of patients have shown that laparoscopic surgery is safe
for certain colorectal cancers.
HOW SAFE IS LAPAROSCOPIC SURGERY?
Laparoscopic surgery is as safe as traditional open surgery. At the beginning of
a laparoscopic operation the laparoscope is inserted through a small incision near
the belly button (umbilicus). The surgeon initially inspects the abdomen to determine
whether laparoscopic surgery may be safely performed. If there is a large amount
of inflammation or if the surgeon encounters other factors that prevent a clear
view of the structures, the surgeon may need to make a larger incision in order
to complete the operation safely. Any intestinal surgery is associated with certain
risks such as complications related to anesthesia and bleeding or infectious complications.
The risk of any operation is determined in part by the nature of the specific operation.
An individual’s general heath and other medical conditions are also factors that
affect the risk of any operation. You should discuss with your surgeon your individual
risk for any operation.
WHAT IS A COLON AND RECTAL SURGEON?
Colon and rectal surgeons are experts in the surgical and non-surgical treatment
of diseases of the colon, rectum and anus. They have completed advanced surgical
training in the treatment of these diseases as well as full general surgical training.
Board-certified colon and rectal surgeons complete residencies in general surgery
and colon and rectal surgery, and pass intensive examinations conducted by the American
Board of Surgery and the American Board of Colon and Rectal Surgery. They are well-versed
in the treatment of both benign and malignant diseases of the colon, rectum and
anus and are able to perform routine screening examinations and surgically treat
conditions if indicated to do so.