Laparoscopic Surgery

What is laparoscopic surgery?
Laparoscopic surgery is a specialized technique for performing surgery through smaller incisions. In traditional “open” surgery, the surgeon uses a single, large incision to gain access to the abdomen and perform surgery.  This incision must be large enough to allow both clear visualization of the operative field and allow adequate working space to perform the operation.  Laparoscopic surgery allows for equivalent visualization and working space to be achieved via several small (0.5-1cm) incisions, known as “port-sites.”  The key to this lies in a specialized camera mounted on a thin, tubular handle that allows the camera to be passed into the abdomen via a port site.  The abdomen is filled with carbon dioxide, providing working space and the live image of the abdominal compartment is projected to high-definition monitors in the operating suite.  A wide array of specialized instruments can then be passed through additional port-sites to perform the operation.

A hybrid technique called “hand-assisted” laparoscopy may also be used if needed.  This allows for a special port to be placed, through which the surgeon can insert a hand into the abdomen to assist with surgery.  Although the incision required for the hand port is larger than the other laparoscopic incisions, it remains smaller than incisions employed in traditional open surgery.  It is used for an added margin of safety and to help reduce the length of surgeries.   

With proper training, most intestinal surgeries can be performed using the laparoscopic technique.  There is a learning curve for laparoscopic surgery and it is estimated that at least 50 cases are needed to gain proficiency in this technique.  All of our surgeons are highly-trained laparoscopists and this is our preferred approach.

What are the advantages to laparoscopic surgery?

  • less postoperative pain and reduction in need for pain medication
  • quicker return to tolerating a diet
  • shortened hospital stay
  • earlier return to daily activities
  • improved cosmetic results

Is laparoscopic surgery safe?
Laparoscopic surgery is as safe as traditional open surgery and has been shown to be as effective as traditional open surgery, including for resection of cancer.  The first step in deciding whether a laparoscopic approach is feasible will be made during pre-operative consultation; this will be based on the patient’s specific condition, the extent of disease and the patient’s past medical/surgical history.  The final determination is made at the onset of surgery.  Upon entering the abdomen, the surgeon will evaluate the abdominal cavity and determine if it is safe to proceed in a laparoscopic fashion.  As with any intestinal surgery, certain risks related to anesthesia, bleeding, infection and bowel leaks (anastomotic breakdown) exist.  These risks depend on each person’s pre-operative health, the condition being treated and the specific operation being performed.  An assessment and minimization of these risks is a key element of successful surgery and will be discussed prior to deciding on surgery.  Several medical studies have shown that patients undergoing abdominal surgery performed by surgeons specialized in Colon and Rectal Surgery meet with improved outcomes.