Advantages of Laparoscopic Surgery

October 5, 2010 by Laparoscopic Surgeon · Comment
Filed under: Laparoscopic 
Dr R K Mishra (Director, World Laparoscopy Hospital)
Dr R K Mishra (Director, World Laparoscopy Hospital)
Laparoscopic or “minimal Access Surgery” is a highly specialized technique for performing surgery of abdomen. In the past, this surgical technique was commonly used only for gynaecologic surgery, for diagnostic laparoscopy in cases of infertility and for gall bladder surgery. Over the last 10 years the use of this specialized surgical 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 and cannulla is inserted. Specialized instruments and a special telescope known as a laparoscope are passed through the port during the procedure. At the beginning of the procedure, the patient’s abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the laparoscopic surgeon. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors through a digitally advanced camera system in the operating room. During the operation the surgeon watches detailed images of the abdomen on the high resolution monitor. This system allows the surgeon to perform the same operations as traditional surgery but with smaller multiple incisions.However recently single incision laparoscopic surgery is also evolved.
 
In certain situations a minimal access surgeon may choose to use a special type of port that is large enough to insert a hand known as Hand Port. When a hand port is used the surgical technique is called “hand assisted laparoscopic surgery”. The incision required for the hand port is generally 5.5 cm and hence larger than the other laparoscopic incisions, but is usually smaller than the incision required for traditional surgery.
 
Advantages of laparoscopic surgery?
 
Compared to traditional open surgery, patients often experience less pain, an earlier recovery, and less scarring with laparoscopic surgery.
 
Operations which can be performed using laparoscopic surgery?
 
Most of the abdominal advanced surgeries can be performed using the laparoscopic technique in experienced hand. These include surgery for gallbladder, duodenal perforation, appendicitis, 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 radical cancer operations. But 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 very safe as traditional open surgery. At the beginning of a laparoscopic operation the laparoscope is inserted through a small incision near the umbilicus, Either superior crease or inferior crease of umbilicus. The laparoscopic surgeon initially inspects the abdomen by doing diagnostic laparoscopy 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 is risky and prevent a clear view of the structures the surgeon may need to make a larger incision in order to complete the operation safely by converting laparoscopic surgery into open surgery.
 
Any intestinal or abdominal laparoscopic surgery is associated with certain risks such as complications related anaesthesia and bleeding or infectious complications. The risk of any operation is determined in part by the nature of the specific operation and hidden risk factor within the patient itself. An individual’s general health and other medical conditions are also factors that affect the risk of any operation. Patient should discuss with your surgeon your individual risk for any operation. World Laparoscopy Hospital, Gurgaon is very reach in this concern because for poor and needy patient surgery is completely free at World Laparoscopy Hospital.

Single Incision Laparoscopic Surgery (SILS)

October 5, 2010 by Laparoscopic Surgeon · Comment
Filed under: Laparoscopic 

Single incision laparoscopic surgery (SILS) or Single port access (SPA) surgery, also known as laparoscopic endoscopic single-site surgery (LESS), umbilical surgery (OPUS) or single port incision less conventional equipment-utilizing surgery (SPICES) or natural orifice transumbilical surgery (NOTUS), or Embryonic Natural Orifice transumbilical surgery (E-NOTES) is an advanced minimally invasive surgical procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient’s navel. SPA surgical procedures are like many laparoscopic surgeries in that the patient is under general anaesthesia, insufflated and laparoscopic visualization is utilized.The World Laparoscopy Hospital in NCR Delhi is the first hospital in Haryana and only the third in the India to perform a single-port, natural orifice gallbladder surgery through the navel for gallbladder stone disease. During the procedure, surgeons use a single opening in the umbilicus as they manipulate a camera and two laparoscopic instruments to separate the gallbladder from its attachments in the abdomen. The gallbladder is then removed through that same opening. Only a tiny bandage is required to close the navel, and there are no scars.

Single-incision laparoscopic surgery employs the same tools and techniques as conventional laparoscopic surgery and can be used in both men and women. The only difference is a specially-designed port that accommodates the tools.

World Laparoscopy Hospital surgeons have always been leaders in minimally invasive surgery,” says Dr R K Mishra, Director of the World Laparoscopy Hospital and professor of TGO University. “This procedure signals another step forward for our nationally single incision surgery and elevates our efforts to provide the best surgical care while improving patient recovery.”

Dr. Mishra says that single incision laparoscopic surgery should not only for simple surgery like cholecystectomy but should also be used for surgery like donor nephrectomy and for donor who have already decided to give the gift of life and are willing to go through surgery to help a person in need, the possibility of coming through the surgery without scars is a secondary benefit.

Learn about Laparoscopic Surgery

July 25, 2008 by Laparoscopic Surgeon · 4 Comments
Filed under: Laparoscopic 

What is laparoscopic surgery?
Laparoscopic surgery also referred to as minimally invasive surgery or minimal access surgery describes the performance of surgical procedures with the assistance of a laparoscope, video camera and several thin long cylindrical instruments. During the surgical procedure, CO2 gas is introduced inside the abdominal cavity and small incisions of up to 5 to 10 mm are made. The laparoscopic instruments are placed through these small incisions inside the abdomen to perform surgery.

Prof. Mishra doing Laparoscopic Surgery

Prof. Mishra doing Laparoscopic Surgery

The camera transmits an image of the organs inside the abdomen onto a medical grade monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The telescope becomes a surgeon’s eyes in laparoscopic surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.
Laparoscopic surgery is now accepted all over world as an important skill and it is no more luxury it is considered as necessity.
All the good hospital of world is now equipped with laparoscopic surgery but it is important that surgeon who is doing laparoscopy should be qualified.
Benefits of laparoscopic procedures are
  • Less post operative discomfort since the incisions are much smaller
  • Quicker recovery times
  • Shorter hospital stays
  • Earlier return to full activities
  • Much smaller scars
  • There may be less internal scarring when the procedures are performed in a minimally invasive fashion
    compared to standard open surgery.
Why perform laparoscopy?
Open traditional surgery requires making a large incision, which leaves a large ugly looking scar. Laparoscopic surgery has changed that because surgeons now operate using small incisions. Even advanced surgery can be performed by this technique nowadays.
Here are a few common examples of laparoscopy?
  • Gallbladder removal
  • Hernia repair
  • Appendix removal
  • Tubal ligation (having your “tubes tied”)
  • Uterus removal
  • Kidney donation or removal
  • Spleen removal
  • Repair of hiatus and GERD
  • Removal of Ovarian Cyst etc…
Many advanced specialized hospitals perform more complex surgeries. New tools are being invented recently and so that more operations can be done. This is an exciting area in the world of surgery and slowly becoming a Necessity not luxury.
Sometimes laparoscopic surgery is used just to look inside the body known as Diagnostic Laparoscopy. You may be having some pain or you might be suffuring from infirtility and your doctor may not be sure what’s wrong. By looking inside your body, the answer may be found and your surgeon can correct the problem. This is usually done after you’ve had some x-rays, Untrasound and other non invasive tests.
Advanced laparoscopic surgery with hand-access devices
The Human hand is the best Instrument. The human hand can performs many functions during surgery that are difficult to reproduce only with laparoscopic instruments. The loss of tactile feedback and inability to place the hand into the abdomen during laparoscopic surgery has limited the use of laparoscopy for complex abdominal surgery on the pancreas, liver and bile duct. Hand-access devices like lapdisk, omniport are new laparoscopic devices that allows the surgeon to place a hand into the abdomen during laparoscopic surgery and perform many of the different functions with the hand that were previously possible only during open surgery. At Laparoscopy Hospital, New Delhi, This technique is utilized to develop a variety of laparoscopic pancreatic, liver and biliary procedures such as the Whipple operation, distal pancreatectomy and liver resection that were not possible previously by standard laparoscopic techniques.
What is Robot assisted surgery?
The most popular Robot to perform laparoscopic surgery is Da Vinci™, a computer-assisted robotic system that expands a surgeon’s capability to perform laparoscopic surgery in a less invasive way. Da Vinci™ system allows greater precision and better visualization compared to standard laparoscopic surgery.
The operations with the Da Vinci robotic system are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is sitting remote from the patient, working a few feet from the operating table while seated at a computer console with a three-dimensional view of the operating field. The roboting surgery is possible thousands of mile away for the surgeon also through the internet. This is also known as trans atlantic Minimal Access Surgery.
The surgeon operates with two joysticks that control the two mechanical arms on the robot. The mechanical arms are armed with specialized instruments with hand-like movements which carry out the surgery through small holes in the patient’s abdomen or chest. Three small incisions are made just like tradistional laparoscopic surgery in the abdomen, through which a video camera and the robotic arms with the highly-specialized instruments are introduced. The video camera of the robotic surgery provides high resolution, high magnification three dimensional vision with depth perception.
The da Vinci system for pancreas, bile duct and liver surgery
The world experience on the use of the Da Vinci Robotic System for surgery on the pancreas, bowel duct, and liver is limited because of the cost. Radical Prostectomy, Bile duct reconstruction, Hepaticojejunostomy, Distal pancreatectomy, Reconstruction of the gastrointestinal tract after a Whipple operation, Laparoscopic adrenalectomy, are the few surgery which can be performed by the robot very nicely.
Which centre is best for Laparoscopic Surgery in India
Laparoscopic surgery need specialized surgeon and World Laparoscopy Hospital, Gurgaon is the only institute in asia which is fully dedicated for this surgery. Interested patient can learn about this institute by loging to http://www.laparoscopyhospital.com
Address of World Laparoscopy Hospital is
World Laparoscopy Hospital
Cyber City, DLF Phase II, Gurgaon, NCR Delhi, 122 002, India

Laparoscopic Surgeons of India is Digg proof thanks to caching by WP Super Cache!