Advanced Surgical Associates

Advanced Laparoscopy

Our team of surgeons have compiled the following list of the most frequently asked questions to help you in your decision making,

1 What is laparoscopic surgery?
2 Am I a candidate?
3 What do I need to get ready?
4 How is the surgery done?
5 What can I expect after the surgery?

What is laparoscopic surgery?

Laparoscopic surgery consists of a group of operations that allow for smaller incisions to treat damaged or diseased organs. Small tubes called trochars are inserted through the incisions. Using long thin instruments and a 5 millimeter camera many complex procedures can be completed with less pain and a shorter hospital stay.

The most common procedures include:

1 Gallbladder removal and bile duct exploration
2 Inguinal and ventral hernia repair
3 Intestinal resection for problems like diverticulitis or tumors
4 Anti-reflux operations for GERD
5 Appendectomy

Am I a candidate?

Most patients who are candidates for abdominal surgery are candidates for a laparoscopic approach. One limiting factor includes the need to avoid general anesthesia in a patient with significant medical problems such as poorly controlled heart disease. Another problem occurs in patients who have developed dense intra-abdominal scar tissue (called adhesions) from multiple prior open abdominal procedures. There is always a risk that an operation that is started laparoscopically would have to be converted to a larger incision. When this decision is made during an operation it is always for the benefit and safety of the patient.

What do I need to get ready?

Depending on the surgery, most patients only need to eat nothing after midnight until their surgery is done. Patients undergoing laparoscopic bowel surgery may be asked to undergo a bowel cleansing regimen. If other health problems exist then a consultaton with a specialist may be requested.

This may include a:

1 Cardiologist
2 Pulmonologist
3 Endocrinologist

With laparoscopic surgery many operations that once required a prolonged hospital stay are now performed as day surgery. This means that recovery is rapid and done in the privacy and comfort of your own home.

How is the surgery done?

There are a variety of different operations done using laparoscopy. The main concept is the use of plastic tubes called trochars that are passed through small incisions in the abdominal wall to access the abdominal cavity. The usual starting point is just below or above the belly button. Carbon Dioxide gas is then pumped into the abdomen to lift up the abdominal wall and create a working space. A telescope is then passed through the tube below the belly button to allow direct visualization of the inner abdomen. Various other tubes are then placed. These tubes are from 1/2 inch to 1/8th of an inch in diameter. Special long, slender instruments are passed through the tubes to perform the operation. Once the operation is complete, the gas is released, the tubes are removed and the small incisions are closed. Usually, the incisions have been numbed to further reduce pain. The cuts usually have internal absorbable sutures and are covered with tissue glue so that there is no suture removal or dressing care required.

What can I expect after surgery?

Once again, laparoscopy has made recovery from surgery much quicker and less painful. Most patients are released on the day of their surgery. For procedures that require a hospital stay, the length is usually from 1 to 3 days. Laparoscopic surgery usually reduces hospital stays by 1 to 3 days, so a 2 day hospital stay after laparoscopic surgery would have been a 4-5 day stay when a larger incision is required. The main source of discomfort after surgery is the incision around the belly button. This is usually well managed with standard oral pain medications and tends to resolve significantly after the first 48 to 72 hours.