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What Is Laparoscopic Surgery (Minimal Access Surgery)
 
We are all witness to an unprecedented revolution of the surgical sciences.  The era has seen the transformation of surgery into an entirely new patient friendly technique. It was the amalgamation of the miniaturised camera, digitalised images and fibre optics, which made laparoscopy possible.  Unlike the past, resistance to acceptance of laparoscopy was rapidly wiped out by the phenomenal success of laparoscopic cholecystectomy. 
 
The minimal access was responsible for all the benefits attributed to the technique viz.
  • Less discomfort,
  • Less pain,
  • Less hospitalisation,
  • Early mobilisation
  • And earlier return to normal activities 

It is important to understand that the surgical procedure performed, remain the same as performed by open surgery.

Laparoscopic surgery (Minimal Access Surgery) describes the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions are made and ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient. The camera transmits an image of the organs inside the abdomen onto a television monitor.

This era of laparoscopic surgery has prompted general surgeons to scrutinize nearly all operations for possible conversion to this technique. Today most of the surgical procedures except for pancreaticoduodenostomy, major hepatic resections, bypass of aorto-iliac occlusive disease, exploration in the hemodynamically unstable patient can be safely performed laparoscopically.

It is important to be aware of conditions, which increase the risk of complications during laparoscopy. These include prior abdominal surgeries, obesity, generalized peritonitis, minor bleeding disorders, uncontrolled coagulopathy, pregnancy and bowel obstruction with massively dilated bowel. Once regarded as absolute contraindications, these conditions still demand careful consideration.

 

 

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