Various Laparoscopic Surgeries
Laparoscopic Cholecystectomy
What is the Gallbladder?
The gallbladder is a pear-shaped organ that rests beneath the right side of the liver. Its main purpose is to collect and concentrate a digestive liquid (bile) produced by the liver. Bile is released from the gallbladder after eating, aiding digestion. Bile travels through narrow tubular channels (bile ducts) into the small intestine. Removal of the gallbladder is not associated with any impairment of digestion in most people.
How are Gallbladder Problems Found and Treated?
Ultrasound is most commonly used to find gallstones.
What are the Advantages of Performing Laparoscopic Gallbladder Removal?
Rather than a five to seven inch incision, the operation requires only four small openings in the abdomen. Patients usually have minimal post-operative pain. Patients usually experience faster recovery than open gallbladder surgery patients. Most patients go home the same day of the surgery and enjoy a quicker return to normal activities.
Laparoscopic Inguinal Hernia Repair
Laparoscopic hernia repair is similar to other laparoscopic procedures. General anesthesia is given, and a small cut (incision) is made in or just below the navel. The abdomen is inflated with air so that the surgeon can see the abdominal (belly) organs.
Laparoscopic Umbilical Hernia Repair
Umbilical hernia repair surgery is a procedure that fixes umbilical hernias. An umbilical hernia is a bulge or pouch that forms in the abdomen. This type of bulge occurs when a section of the intestine pushes through a weak spot in the abdominal muscles, near the belly button.
Laparoscopic Fundoplication
Laparoscopic Nissen fundoplication is now considered the standard surgical approach for treatment of severe gastroesophageal reflux disease (GERD).
The pathophysiology of GERD is not due to acid overproduction but rather mechanical dysfunction centered around the lower esophageal sphincter (LES).
Furthermore, the mainstay of GERD treatment, proton pump inhibitors (PPIs), have come under scrutiny because of worrisome side effects.
Laparoscopic magnetic sphincter augmentation of the LES has been proposed as an additional surgical option. Like Nissen fundoplication, it relies on 360° buttressing of the LES, but it may cause fewer long-term adverse effects.
In appropriately selected patients, laparoscopic reflux surgery may be more cost-effective than lifelong medical treatment.
Laparoscopic Nissen fundoplication may have advantages over the traditional open approach, including improved cosmesis, reduced morbidity, shorter hospital stay, decreased respiratory complications, and faster recovery.
Laparoscopic Varicocelectomy
A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains the testicles.
Varicoceles have been associated with progressive deterioration of testicular function and testicular hypotrophy. Varicocele repair can halt or even reverse this progression.
Advantages of laparoscopic varicocelectomy include: increased magnification, facilitating more accurate identification of vessels, such as spermatic collateral veins, (i.e. veins running alongside the spermatic cord and together entering the internal ring, a possible cause of recurrence if left alone), lymphatics (the ligation of which can lead to hydrocele formation) and the internal spermatic artery. Moreover, laparoscopic varicocelectomy is safe even after prior inguinal surgery.
The characteristic supra-inguinal access allows for high ligation of fewer veins vs a more labour-intensive subinguinal approach. In cases of bilateral varicoceles, an additional incision, with its attendant effects, is avoided.
Laparoscopic Nephrectomy
A nephrectomy is a surgical procedure for the removal of a kidney or section of a kidney. Nephrectomy, or kidney removal, is performed on patients with severe kidney damage from disease, injury, or congenital conditions. These include cancer of the kidney (renal cell carcinoma); polycystic kidney disease (a disease in which cysts, or sac-like structures, displace healthy kidney tissue); and serious kidney infections.
Laparoscopic nephrectomy is a form of minimally invasive surgery that utilizes instruments on long, narrow rods to view, cut, and remove the kidney.
The surgeon views the kidney and surrounding tissue with a flexible videoscope. The videoscope and surgical instruments are maneuvered through four small incisions in the abdomen, and carbon dioxide is pumped into the abdominal cavity to inflate it and improve visualization of the kidney.
Once the kidney is isolated, it is secured in a bag and pulled through a fifth incision, approximately 3 in (7.6 cm) wide, in the front of the abdominal wall below the navel. Although this surgical technique takes slightly longer than a traditional nephrectomy, preliminary studies have shown that it promotes a faster recovery time, shorter hospital stays, and less post-operative pain.
Laparoscopic Colon Resections
Large bowel resection is surgery to remove all or part of your large bowel. This surgery is also called colectomy. The large bowel is also called the large intestine or colon. Removal of the entire colon and the rectum is called a proctocolectomy. Removal of all of the colon but not the rectum is called subtotal colectomy. Removal of part of the colon but not the rectum is called a partial colectomy.
The large bowel connects the small intestine to the anus. Normally, stool passes through the large bowel before leaving the body through the anus.
Large bowel resection is used to treat many conditions, including:
Other reasons for bowel resection are:
Laparoscopic Bowel Resections
Small bowel resection is surgery to remove part or all of your small bowel. It is done when part of your small bowel is blocked or diseased. The small bowel is also called the small intestine. Most digestion (breaking down and absorbing nutrients) of the food you eat takes place in the small intestine.
Other reasons for bowel resection are:
Laparoscopic Heller’s Myotomy
Heller myotomy is a surgical procedure in which the muscles of the cardia are cut, allowing food and liquids to pass to the stomach. It is used to treat achalasia, a disorder in which the lower esophageal sphincter fails to relax properly, making it difficult for food and liq
Laparoscopic Pelvic Procedures Like Lap Rectopexy
Laparoscopic Rectopexy With Posterior Mesh Fixation, Robotic Rectopexy & Laparoscopic Ventral Rectopexy (D’Hoore and
Laparoscopic Adrenalectomy
Adrenalectomy is primarily done for tumors of the adrenal gland. It is performed for a variety of benign and malignant conditions, ranging from pheochromocytoma and hyperaldosteronism (primary and secondary) to adrenal cancer.
The traditional method of removal has been either through incisions on the front of the abdomen or through an incision in the lower back. Both of these incisions are occasionally associated with pain and prolonged recovery periods. The laparoscopic approach can reduce the pain and disability associated with these incisions.
For many benign conditions, especially Conn’s tumors and sporadic pheochromocytoma — both of which are benign tumors that can secrete hormones that make the patient’s blood pressure extremely high — and for hormonally inactive tumors found while looking for some other condition, laparoscopic adrenalectomy is an excellent alternative.
Laparoscopic Hiatal Hernia
Laparoscopic hernia repair is the repair of a hiatal hernia using a laparoscope, which is a tiny telescope-like instrument. A hiatal hernia is the protrusion of an organ through its wall or cavity. There are several different methods that can be used when performing this procedure. Among them are the Nissen Fundoplication and the general laparoscopic hernia repair.
There are two types of hiatal hernias. The two different types of hiatal hernias that are relevant to this surgery are rolling hiatal hernias and sliding hiatal hernias. A type II, rolling hiatal hernia, is when the gastric fundus is herniated, but the cardia portion of the stomach remains still. A type 1, or sliding hiatal hernia, is when the gastroesophageal junction and the cardia portion of the stomach move through the posterior mediastinum.
There are several different methods when performing a laparoscopic hernia repair. A few of these are the fundoplication and the general laparoscopic hernia repair.
In bariatric surgery, hernias are repaired laparoscopically anteriorly, rather than posteriorly as in the fundoplication procedure. This general laparoscopic procedure was introduced by Sami Salem Ahmad from Germany. The Nissen fundoplication procedure was first performed by Rudolph Nissen in 1955.
Laparoscopic Whipple Procedure
A few patients might be qualified for a minimally invasive (laparoscopic) Whipple procedure, which is performed through several small incisions instead of a single large incision. Contrasted with the exemplary system, the laparoscopic method may bring less blood loss, a shorter clinic stay, a speedier recovery, and less complications.
The Whipple procedure isn’t a choice for the 40% of newly diagnosed patients whose tumors have spread beyond the pancreas. Rarely is it an option for the 40% of patients with locally advanced disease that has spread to neighbor areas such as the superior mesenteric vein and artery, or for those whose tumors have spread to the body or tail of the pancreas.
Laparoscopic Esophagectomy
Esophagectomy is the partial or complete surgical removal of the esophagus. It is most often performed to remove esophageal cancer or benign lesions. In cases involving cancer (adenocarcinoma, typically, and sarcoma), the procedure is recommended when the disease is thought to be contained to the esophagus and not found to have metastasized.
