Laparoscopic surgery
Information you need to understand your disease and the tests you may need.
What is Laparoscopic Cholecystectomy
A cholecystectomy is a surgical procedure to remove your gallbladder — a pear-shaped organ that sits just below your liver on the upper right side of your abdomen. Your gallbladder collects and stores bile — a digestive fluid produced in your liver.
A cholecystectomy is most commonly performed by inserting a tiny video camera and special surgical tools through four small incisions to see inside your abdomen and remove the gallbladder. This is called laparoscopic cholecystectomy.
Why is it done?
A cholecystectomy may be recommended to treat gallstones and the complications they cause.
- Gallstones in the gallbladder (cholelithiasis)
- Gallstones in the bile duct (choledocholithiasis)
- Gallbladder inflammation (cholecystitis)
- Large gallbladder polyps
- Pancreas inflammation (pancreatitis) due to gallstones
What are the risks associated with LC
A cholecystectomy carries a small risk of complications including:
- Bile leak
- Bleeding
- Infection
- Injury to nearby structures, such as the bile duct, liver and small intestine
- Risks of general anesthesia, such as blood clots and pneumonia
How is the surgery done
Minimally invasive (laparoscopic) cholecystectomy
During a laparoscopic cholecystectomy, four small incisions in your abdomen will be made. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. A video monitor in the operating room will be used to monitor while using surgical tools inserted through the other incisions in your abdomen to remove your gallbladder.
Next you may undergo an imaging test, such as an X-ray or ultrasound, if there is a concern about possible gallstones or other problems in your bile duct. Then your incisions are sutured, and you're taken to a recovery area. A laparoscopic cholecystectomy takes one or two hours.
A laparoscopic cholecystectomy isn't appropriate for everyone. In some cases your surgeon may begin with a laparoscopic approach and find it necessary to make a larger incision because of scar tissue from previous operations or complications.
What you can expect from the surgery
A cholecystectomy is performed using general anesthesia, so you won't be aware during the procedure. To prepare for a cholecystectomy, your may be asked to
- Eat nothing the night before your surgery
- Stop taking certain medications and supplements
You'll be taken to a recovery area as the anesthesia drugs wear off. Then you'll be taken to a hospital room to continue recovery. People are often able to go home the same day as their surgery, though sometimes a one-night stay in the hospital is needed. In general, you can expect to go home once you're able to eat and drink without pain and are able to walk unaided. It takes about a week to fully recover.
Should you opt for surgery?
A cholecystectomy can relieve the pain and discomfort of gallstones. Conservative treatments, such as dietary modifications, usually can't stop gallstones from recurring. In most cases, a cholecystectomy will prevent gallstones from coming back.
Most people won't experience digestive problems after a cholecystectomy. Some people may experience occasional loose stool after the procedure, which generally resolves over time. People undergoing a laparoscopic cholecystectomy may be able to go back to work in a matter of days.
What is Laparoscopic hernia repair
A hernia occurs when fatty tissue or an organ pushes through a weak place in the surrounding connective tissue or muscle wall. Hernias usually don’t get better on their own. They tend to get bigger. A surgical hernia repair involves pushing the bulge back inside the body part that should contain it using mesh, and keeping it there.
Why is it done?
The surgery is recommended if any of these things happen:
- Tissue (such as the intestine) becomes trapped in the abdominal wall. This is called incarceration. If left untreated, it may lead to strangulation. That’s when the blood supply to the tissue gets cut off.
- The hernia becomes strangulated. This can cause permanent damage and is a surgical emergency. Strangulated organs, usually your intestines, will die, and if not removed quickly, you can become seriously ill.
- The hernia causes pain or discomfort, or it’s growing larger.
What are the risks associated with LC
This type of operation is normally very safe. But like all surgeries, having your hernia removed comes with a number of possible complications. They include:
- Infection of the wound
- Blood clots
- Pain
- Recurrence
How is the surgery done
Laparoscopic hernia repair is performed with general anesthesia and requires use of a breathing tube. Three half-inch or smaller incisions are made in the lower part of the abdomen. In laparoscopic hernia repair, a camera called a laparoscope is inserted into the abdomen to visualize the hernia defect on a monitor. The image on the monitor is used to guide the movements. The hernia sac is removed from the defect in the abdominal wall, and a prosthetic mesh is then placed to cover the hernia defect. The small incisions are closed with stitches (sutures) that dissolve on their own over time.
The majority of patients undergoing elective or non emergency groin hernia repair go home the same day as the surgery once their pain is under control, they have urinated, and they are able to tolerate food or liquids without nausea or vomiting.
What you can expect from the surgery
Most patients can expect soreness over the first 1 to 2 days after surgery. Take pain medication as prescribed. Some patients may experience bruising in and around the groin area. This is normal. However, if there is significant swelling in the groin, you should contact immediately.
You should walk every day but limit strenuous activity such as running and lifting anything until evaluated at your postoperative visit 1 to 2 weeks after surgery. In general, if an activity hurts, it shouldn’t be done. Constipation and straining during bowel movements increases the pressure on the repair and should be avoided; eat a high-fiber diet and use stool softeners if needed.
What is Adhesions release
An adhesion is a band of scar tissue that binds two parts of your tissue that are not normally joined together. Adhesions may appear as thin sheets of tissue similar to plastic wrap or as thick fibrous bands. The adhesion develops when the body's repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation, resulting in inflammation. Adhesion release is the surgical method to remove them.
Why is it done?
The adhesion develops when the body's repair mechanisms respond to any tissue disturbance, such as surgery, infection, trauma, or radiation, resulting in inflammation. Most adhesions are painless and do not cause complications. However, it might lead to the development of chronic pelvic pain. As scar tissue begins to restrict motion of the small intestines, passing food through the digestive system becomes progressively more difficult. The bowel may become blocked.In extreme cases, adhesions may form fibrous bands around a segment of an intestine. This constricts blood flow and leads to tissue death. If such symptoms and complications show up, Adhesions will have to be released
What are the risks associated with AR surgery
This type of operation is normally very safe. But like all surgeries, having your hernia removed comes with a number of possible complications. They include:
- Infection of the wound
- Blood clots
- Pain
- Recurrence
How is it done
Two common surgical techniques used to treat abdominal adhesions are laparoscopy and laparotomy.
- With laparoscopy, a camera is placed into your body through a small hole in the skin to confirm that adhesions exist. The adhesions then are cut and released.
- In laparotomy, a larger incision is done to directly see adhesions and treat them. The technique varies depending on specific circumstances.
What you can expect from the surgery
Adhesions requiring surgery commonly come back because surgery itself causes adhesions. Steps are taken during surgery to try and minimize the formation of adhesions. Some of these may include: shortening surgical time, keeping the tissues moist, gentle handling of any tissues or organs, and using starch –free and latex-free gloves. Several surgical products have also been developed to try to help prevent adhesions from forming during surgery. If you have undergone surgery or have a history of medical illness, always discuss changes in your recovery or condition.
Should you opt for surgery?
In many cases, abdominal adhesions do not cause symptoms. If they do cause symptoms, chronic abdominal pain is the most common symptom.
Abdominal adhesions may cause intestinal obstruction, which can be life-threatening. If you have symptoms of intestinal obstruction, seek medical help right away.
Symptoms of intestinal obstruction may include
- abdominal pain
- bloating
- constipation
- not passing gas
- nausea
- vomiting
If intestinal obstruction cuts off the blood flow to the blocked part of the intestines or leads to peritonitis, you may develop additional symptoms such a fast heart rate or fever.
What is Diagnostic laparoscopy
A laparoscopy, also known as a diagnostic laparoscopy, is a surgical diagnostic procedure used to examine the organs inside the abdomen, as well as other closed spaces, such as the knees. It’s a low risk, minimally invasive procedure that requires only small incisions. A laparoscope is a long, thin tube with a high intensity light and a high resolution camera at the front. The instrument is inserted through an incision in the abdominal wall. As it moves along, the camera sends images to a video monitor. A laparoscopy allows to see inside your body in real time, without having to make large incisions. It can also obtain biopsy samples during this procedure, as well as also perform surgery.
Why is it done?
A laparoscopy is often used to identify and diagnose the source of pelvic or abdominal pain. It’s usually performed when noninvasive methods are unable to help with diagnosis.A laparoscopy is performed when these tests don’t provide enough information or insight for a diagnosis. The procedure may also be used to take a biopsy, or sample of tissue, from a particular organ in the abdomen. Your doctor may recommend a laparoscopy to examine the following organs:
- appendix
- gallbladder
- liver
- pancreas
- small intestine and large intestine (colon)
- spleen
- stomach
- pelvic or reproductive organs
What are the risks associated with LC
The most common risks associated with a laparoscopy are bleeding, infection, and damage to organs in your abdomen. After your procedure, it’s important to watch for any symptoms of infection.fevers or chills
- abdominal pain that becomes more intense over time
- redness or discoloration, swelling, bleeding, or drainage at the incision sites
- continuous nausea or vomiting
- persistent cough
- shortness of breath
- inability to urinate
- lightheadedness
- complications from general anesthesia
- inflammation of the abdominal wall
- a blood clot, which could travel to your pelvis, legs, or lungs
How it is it done
A laparoscopy is usually done as an outpatient procedure. This means that you can go home the same day as your surgery in many cases. You’ll likely be given general anesthesia for this type of surgery. This means that you’ll sleep through the procedure and typically won’t feel any pain.
During a laparoscopy, an incision is made below your belly button, and then a small tube called a cannula is inserted. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows to see your abdominal organs more clearly. Once your abdomen is inflated, the laparoscope is inserted through the incision. The camera attached to the laparoscope displays the images on a screen, allowing your organs to be viewed in real time.
The number and size of incisions depends upon what specific diseases are being attempted to confirm or rule out. There may be a need to use another surgical tool to perform a biopsy. During a biopsy, a small sample of tissue is taken from an organ to be evaluated. After the procedure is done, the instruments are removed. Your incisions are then closed with stitches or surgical tape. Bandages may be placed over the incisions.
What to expect from procedure
When the surgery is over, you’ll be observed for several hours before you’re released from the hospital. Your vital signs, such as your breathing and heart rates, will be monitored closely. Hospital staff will also check for any adverse reactions to the anesthesia or the procedure, as well as monitor for prolonged bleeding.
In the days following a laparoscopy, you may feel moderate pain and throbbing in the areas where incisions were made. Any pain or discomfort should improve within a few days. It’s also common to have shoulder pain after your procedure. The pain is usually a result of the carbon dioxide gas used to inflate your abdomen to create a working space for the surgical instruments. The discomfort should go away within a couple of days.
You can usually resume all normal activities within a week. You’ll need to attend a follow-up appointment with your doctor about 2 weeks after a laparoscopy.
Should you opt for surgery?
It’s usually performed when noninvasive methods are unable to help with diagnosis. By observing with a laparoscope, it can be detected if you have:
- an abdominal mass or tumor
- fluid in the abdominal cavity
- liver disease
- the effectiveness of certain treatments
- the degree to which a particular cancer has progressed
It’s a low risk, minimally invasive procedure which allows real time diagnosis for critical conditions & requires only small incisions.
What is Laparoscopic Splenectomy
A splenectomy is surgery to remove the entire spleen, a delicate, fist-sized organ that sits under the left rib cage near the stomach. The spleen is an important part of the body's defense (immune) system. It contains special white blood cells that destroy bacteria and help the body fight infections when you are sick. It also helps remove, or filter, old red blood cells from the body's circulation.
Why is it done?
Spleen is removed in case of an injury that damages the organ, causing its covering to break open, or rupture. A ruptured spleen can lead to life-threatening internal bleeding.
A splenectomy may also be recommended in case of cancer involving the spleen or certain diseases that affect blood cells. Certain conditions can cause the spleen to swell, making the organ more fragile and susceptible to rupture. In some cases, an illness, such as sickle cell disease, can cause the spleen to shrivel up and stop functioning. This is called an auto-splenectomy.
The most common disease-related reason for a spleen removal is a blood disorder called idiopathic thrombocytopenic purpura (ITP). This is an autoimmune condition in which antibodies target blood platelets. The spleen is involved in making these antibodies and removing the platelets from the blood. Other common reasons a person may need a spleen removal include:
- Blood disorders
- Blood vessel problems
- Cancer
- Cyst or abscess (collection of pus) in the spleen
What are the risks associated with LC
Splenectomy is generally a safe procedure. But as with any surgery, splenectomy carries the potential risk of complications, including:
- Bleeding
- Blood clots
- Infection
- Injury to nearby organs, including your stomach, pancreas and colon
You can live without a spleen. But because the spleen plays a crucial role in the body's ability to fight off bacteria, living without the organ makes you more likely to develop infections. You may be recommended to receive vaccines & to take preventive antibiotics, especially if you have other conditions that increase your risk of serious infections.
How it is it done
You will be given general anesthesia a few minutes before surgery so you are asleep and do not feel pain. Laparoscopic splenectomy is done using an instrument called a laparoscope. This is a slender tool with a light and camera on the end. Three or four small cuts in the abdomen are made and the laparoscope is inserted through one of them. This allows us to look into the abdominal area and locate the spleen. Different medical instruments are passed through the other openings. One of them is used to deliver carbon dioxide gas into the abdominal area, which pushes nearby organs out of the way and gives more room to work. The spleen is disconnected from surrounding structures and the body's blood supply, and then removed through the largest surgical opening. The surgical openings are closed using stitches or sutures.
What to expect from procedure
After surgery, you will stay in the hospital for a while to monitor your condition. You will receive fluids through a vein, called an intravenous (IV) line, and pain medications to ease any discomfort. Those who have a laparoscopic splenectomy are usually sent home in less than a week. It will take about four to six weeks to recover from the procedure. Activities have to be limited for the next 4-6 weeks and it will be suggested to you on the lifestyle changes required.
Should you opt for surgery?
What is Laparoscopic Fundoplication
Fundoplication is one of the most common surgeries used to treat heartburn caused by gastroesophageal reflux disorder (GERD). GERD is a chronic backup of stomach acid or contents into your esophagus. GERD can weaken the muscles that help move food down into your stomach, including the sphincter that closes the opening between the esophagus and stomach. Fundoplication helps strengthen this opening to prevent food and acid from going back up.
Why is it done?
The most common reason for surgery is heartburn that doesn't go away with medications and lifestyle changes. Surgery may also be an option when you have:
- Severe inflammation of your esophagus, the tube that runs from your mouth to your stomach
- A narrowing of your esophagus that's not caused by cancer
- Barrett's esophagus, a change in the cells because of acid reflux
What are the risks associated with it
Some reported risks of fundoplication include:
- piercing of the lining or walls in your esophagus, stomach, or tissues around your lungs, which is more likely during laparoscopic procedures
- infection of the surgical site
- stitches breaking open and exposing the surgical area
- lung infections, such as pneumonia
- having trouble swallowing
- dumping syndrome, when food travels too fast from your stomach to intestines
- nausea and gagging
- gas buildup in your stomach
- inability to throw up when needed
- reflux continuing to happen
- needing follow-up surgery
How it is it done
You will be put intravenous (IV) tubes into your veins for both fluid regulation and anesthesia during the surgery. You’ll be asleep during the entire procedure.
Each type of fundoplication has slightly different steps. But each takes about two to four hours and follows a similar overall procedure. Here’s a general overview of a fundoplication surgery:
- Several small cuts are made through the skin and peritoneum, a layer of tissue around your gut.
- A thin, lighted tube with a camera and tiny surgical tools are inserted into the cuts.
- Your fundus is wrapped around tissue from your lower esophagus.
- Dissolvable stitches are used to attach the fundus to your esophagus.
- Any gas in the abdomen is vented out and all tools are removed from the surgical site.
- The cuts are closed with dissolvable stitches
Several types of fundoplication are possible:
- Nissen 360-degree wrap. The fundus is wrapped all the way around the bottom of your esophagus to tighten the sphincter.
- Toupet 270-degree posterior wrap. The fundus is wrapped about two-thirds of the way around the back side, or posterior, of the bottom of your esophagus.
- Watson anterior 180-degree wrap. The part of the esophagus next to the diaphragm is reconstructed. Then, the fundus is wrapped halfway around the front, or anterior, of the bottom of the esophagus and attached to part of the diaphragm tissue.
- What to expect from procedure
Here’s what to expect during your recovery:
- You’ll go home about 36 to 48 hours after surgery.
- You’ll have some surgical dressings or adhesive strips over your incisions.
- You may need to receive food through a gastrostomy tube. This may be the case for some time after a fundoplication.
- Pain reliever medications will be prescribed
- Don’t bathe right away. Wait about two days or until after dressings are removed.
- Clean your incisions with warm, clean water and a gentle, unscented soap.
- Take a few days off to drive, return to work, or do regular activities. This is usually about three to seven days after you get out of the hospital.
- Go to follow-up appointments.
- You may need to make changes to your diet to prevent any long-term discomfort or complications after this procedure.
Should you opt for the procedure
What is Laparoscopic Appendectomy
An appendectomy is the surgical removal of the appendix. It’s a common emergency surgery that’s performed to treat appendicitis, an inflammatory condition of the appendix.
The appendix is a small, tube-shaped pouch attached to your large intestine. It’s located in the lower right side of your abdomen. The exact purpose of the appendix isn’t known. However, it’s believed that it may help us recover from diarrhea, inflammation, and infections of the small and large intestines. These may sound like important functions, but the body can still function properly without an appendix.
Why is it done?
An appendectomy is often done to remove the appendix when an infection has made it inflamed and swollen. This condition is known as appendicitis. The infection may occur when the opening of the appendix becomes clogged with bacteria and stool. This causes your appendix to become swollen and inflamed.
Your appendix could burst if appendicitis isn’t treated immediately and effectively. If the appendix ruptures, the bacteria and fecal particles within the organ can spread into your abdomen. This may lead to a serious infection called peritonitis. You can also develop an abscess if your appendix ruptures.
Symptoms of appendicitis include:
- stomach pain that starts suddenly near the belly button and spreads to the lower right side of the abdomen
- abdominal swelling
- rigid abdominal muscles
- constipation or diarrhea
- nausea
- vomiting
- loss of appetite
- low-grade fever
Although pain from appendicitis typically occurs in the lower right side of the abdomen, pregnant women may have pain in the upper right side of the abdomen. This is because the appendix is higher during pregnancy.
What are the risks associated with it
An appendectomy is a fairly simple and common procedure. However, there are some risks associated with the surgery, including:
- bleeding
- infection
- injury to nearby organs
- blocked bowels
It’s important to note that the risks of an appendectomy are much less severe than the risks associated with untreated appendicitis. An appendectomy needs to be done immediately to prevent abscesses and peritonitis from developing.
How it is it done
During a laparoscopic appendectomy, the appendix is accessed through a few small incisions in your abdomen. A small, narrow tube called a cannula will then be inserted. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows to see your appendix more clearly.
Once the abdomen is inflated, an instrument called a laparoscope will be inserted through the incision. The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The camera will display the images on a screen, allowing to see inside your abdomen and guide the instruments. When the appendix is found, it will be tied off with stitches and removed. The small incisions are then cleaned, closed, and dressed.
Laparoscopic surgery is usually the best option for older adults and people who are overweight. It has fewer risks than an open appendectomy procedure, and generally has a shorter recovery time.
What to expect from procedure
When the appendectomy is over, you’ll be observed for several hours before you’re released from the hospital.
The timing of your release will depend on:
- your overall physical condition
- the type of appendectomy performed
- your body’s reaction to the surgery
In some cases, you may have to remain in the hospital overnight. You may be able to go home the same day as the surgery if your appendicitis wasn’t severe. In the days following the appendectomy, you may feel moderate pain in the areas where incisions were made. Any pain or discomfort should improve within a few days. You will be prescribed medications for pain and to prevent any infection. Full recovery from an appendectomy takes about four to six weeks. During this time, you are recommended to limit your physical activity so your body can heal.
Should you opt for surgery?
What is Laparoscopic cancer surgeries
Cancer surgery — an operation to remove part of your body to diagnose or treat cancer — remains the foundation of cancer treatment. Laparoscopy is also known as minimally invasive surgery or keyhole surgery. Laparoscopy can be used to remove or take biopsy samples of lymph nodes and is a quicker method to get cancer operated.
Why is it done?
Common reasons you might undergo Laparoscopic cancer surgery include:
- Cancer prevention
- Diagnosis
- Staging
- Primary treatment
- Partial removal of the cancer tumor
- Relieving symptoms or side effects
Surgery is often combined with other cancer treatments, such as chemotherapy and radiation.
What are the risks associated with it
In general, most cancer operations carry a risk of:
- Pain
- Infection
- Loss of organ function
- Bleeding
- Blood clots
- Altered bowel and bladder function
How it is it done
Laparoscopy may be an outpatient (you don’t need to stay overnight in a hospital) or inpatient (you need to stay in the hospital overnight or a few days) procedure depending on what is being done. For this test, you will be given drugs through an intravenous (IV) line to put you in a deep sleep (general anesthesia). A tube will be put into your throat and hooked up to a breathing machine while the procedure is being done. A small cut is made through the abdominal wall near the belly button where the laparoscope is inserted. A small amount of gas is introduced into the abdomen to expand it so the organs are easy to see. Other small cuts may be made in the lower part of the belly to put in different cutting tools to remove or biopsy abnormal areas which are then checked in the lab. The laparoscope, cutting tool, and most of the gas will then be removed and the small cuts will be closed. Once the procedure is complete, you will be gently woken up and taken off the breathing machine. The procedure can take between 30-90 minutes, but possibly longer, depending on what’s being done.
What to expect from procedure
After the procedure, Your mouth and throat will probably be numb for a few hours. You won't be allowed to eat or drink until the numbness wears off. Once the numbness is gone, you may have a sore throat, cough, or hoarseness for the next day or so. You may have pain or numbness in the sites where the cuts were made. You might also have abdominal or shoulder pain from the left-over gas that may take a few hours or days to get better.
You will most likely be able to go home after a few hours. If biopsies were done as part of the procedure, the results will typically be ready within a few days, although some tests on the biopsy samples might take longer.
Should you opt for the procedure
What is VATS for esophageal cancer
Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical technique used to diagnose and treat problems in your chest.
During a VATS procedure, a tiny camera (thoracoscope) and surgical instruments are inserted into your chest through one or more small incisions in your chest wall. The thoracoscope transmits images of the inside of your chest onto a video monitor, guiding us to perform the procedure.
Why is it done?
We use the video-assisted thoracoscopic surgery technique to perform a variety of procedures, such as:
- Biopsy to diagnose lung cancer, mesothelioma and other chest cancers
- Lung surgery, such as surgery to treat lung cancer and lung volume reduction surgery
- Procedures to remove excess fluid or air from the area around the lungs
- Surgery to relieve excessive sweating (hyperhidrosis)
- Surgery to treat certain types of esophageal disorders
- Surgery to remove part or all of the esophagus (esophagectomy)
- Hiatal hernia repair
- Thymus gland removal surgery (thymectomy)
- Certain procedures involving the heart, ribs, spine and diaphragm
What are the risks associated with it
Possible complications of video-assisted thoracoscopic surgery include:
- Pneumonia, a lung infection
- Bleeding
- Temporary or permanent nerve damage
- Damage to organs near the procedure site
- Anesthesia-related effects
How it is it done
Thoracoscopy may be an outpatient (you don’t need to stay overnight in a hospital) or inpatient (you need to stay in the hospital overnight or a few days) procedure depending on what is being done. For this test, you will be given drugs through an intravenous (IV) line to put you in a deep sleep (under general anesthesia). A tube will be put into your throat and hooked up to a breathing machine while the procedure is being done. A small cut is made in the back just below the tip of the shoulder blade between two ribs where the thoracoscope is inserted. Another small cut is made just below the underarm on the same side so the instrument with the cutting tool can be put in. Often, some of the air in the lung on that side may be released so it’s easier to see any abnormal areas. Then, any abnormal areas are removed or biopsied with the cutting tool and checked in the lab.
If fluid needs to be removed, a third cut is made in the lower chest wall and a flexible catheter (called a chest tube) is put in so fluid can drain out over a few days. The thoracoscope and cutting tool will then be removed and the cuts closed. The procedure can take between 30 and 90 minutes, but possibly longer, depending on what’s being done.
What to expect from procedure
In general, you will have the following post surgery:
- You will be hooked up to several machines so the medical staff can carefully watch your heart rate and other vital signs.
- You may get oxygen through small tubes placed in your nose. It’s usually temporary.
- You will feel some soreness. But you shouldn’t feel severe pain.
- You will probably have a chest tube to help collect fluid from your lungs.
- You will use a device that encourages you to breathe deeply to prevent an infection from developing.
- You may wear special stockings to help prevent blood clots.
- You will probably have your stitches or staples removed in a follow-up appointment
- You may tire easily after the surgery. But you will gradually start to recover your strength. It may be several weeks before you fully recover.
- You need to get up and walk several times a day.
- Avoid lifting anything heavy for several weeks.
What is laparoscopic colorectal surgery
A colectomy is an operation to remove part or all of your colon. It’s also called colon resection surgery. You may need a colectomy if part or all of your colon has stopped working, or if it has an incurable condition that endangers other parts. Common reasons include colon cancer and inflammatory bowel diseases. The procedure done through minimal invasive techniques is called a laparoscopic colorectal surgery
Why is it done?
Colorectal cancer can have the following symptoms & diagnosis:
- No symptoms, is a common symptom in significant number of patients - the incidental finding.
- Symptoms related to bowel like - change in bowel habits (constipation or diarrhoea), bleeding in stools, palpable mass when passing stools, mucous in stools, easy fatiguability, loss of appetite, weight loss, difficulty in breathing on exertions, swelling in the legs and abdomen are some of the symptoms and signs
- Anaemia in men, menopausal women or severe anaemia in menstruating women with any other above symptoms should be evaluated for GI tract related blood loss with UGI scope and Colonoscopy to look for CRCa.
- Most international groups recommend screening colonoscopy starting from 45-50 years of age for all individuals, and to be repeated at recommended time intervals.
- Individuals with family history of GI tract cancer (can be anywhere in GI tract), Ovarian/ uterine cancer in women, certain brain tumors and thyroid cancers should undergo screening endoscopy and genetic testing at an early age and should be repeated at recommended intervals.Individuals with the above mentioned symptoms and in particular when associated with alarming symptoms (Loss of appetite, weight loss) should undergo evaluation irrespective of the age.
What are the risks associated with LC
As with all surgeries, it comes with certain risks or possible complications. They include:
- Infection
- Injury
- Leakage
- Hernia
- Scar tissue
How it is it done
Laparoscopic is performed through several small incisions, using the aid of a tiny video camera called a laparoscope. If you have a laparoscopic/robotic colectomy, we will begin with a single small incision, which is used to place the laparoscope. We'll pump gas through the incision to inflate your abdominal cavity for better visibility, then place the camera, which will project your organs onto a video screen. One or more additional small incisions will give us access to your colon with special tools. You may need all or only part of your colon removed.
- A total colectomy removes your entire colon.
- A subtotal or partial colectomy removes a portion of your colon. This may depend on the part of the colon being removed
- Sigmoid colectomy. A sigmoid colectomy, or sigmoidectomy, removes the last section of your colon, known as the sigmoid colon. This is the part that connects to your rectum.
- Hemicolectomy. A hemicolectomy removes one side of your colon. A left-side hemicolectomy removes your descending colon, the section that travels downward on the left. This is in the latter half of your colon. A right-side hemicolectomy removes your ascending colon, the section that travels upward on the right side. This is roughly the first half of your colon.
- Proctocolectomy. A proctocolectomy removes part or all of the colon and the rectum with it. “Procto” means rectum.
What to expect from procedure
Patients undergoing any large bowel surgery tend to pass stools multiple times in a day. Body adapts to the changes with surgery in weeks to months, and most patients tend to pass stools one to three times a day. As with any surgery, there are some complications associated with surgery on intestines too. To mention a few, infection, bleeding, leakage from suture line, pneumonia etc.. with dedicated team approach these complications can be managed successfully. A strict follow up is needed following surgery. You will be asked to meet us every 3-4 months in the first year and then every 6 months in 2nd and 3rd year following surgery. Annual visit is recommended till 5th year following surgery. We will get a few blood test, scopy and scans to identify early recurrence, so that appropriate measures can be taken.
Should you opt for surgery?
What is laparoscopic rectal prolapse surgery
Laparoscopic rectopexy is a surgery to repair a rectal prolapse, a protrusion of the rectum through the anus. Rectal prolapse surgery is a procedure to repair rectal prolapse, which occurs when the last part of the large intestine (the rectum) stretches and protrudes from the anus. Surgery puts the rectum back in place.
Why is it done?
Rectal prolapse surgery is performed in people troubled by the pain and discomfort caused by rectal prolapse as well as the chronic symptoms that can accompany it, such as leakage of stool, inability to control bowel movements (fecal incontinence) or obstructed bowel movements.
In general, rectal prolapse surgery risks include:
- Bleeding
- Bowel obstruction
- Damage to nearby structures, such as nerves and organs
- Infection
- Fistula — an abnormal connection between two body parts, such as the rectum and vagina
- Recurrence of rectal prolapse
- Sexual dysfunction
- Development of new or worsened constipation
How it is it done
Once you are under anesthesia, we will make a small cut (about 1/2 inch) near the belly button. A laparoscope will be inserted into the abdomen through this incision. Images taken by the laparoscope will be projected onto monitors.
Once the laparoscope is in place, we make several more small incisions in the abdomen. Long, thin surgical instruments will then be placed through these incisions to complete the surgery. Your surgery will begin by locating the sigmoid colon and rectum. Next, the rectum will be freed from its surrounding structures and gently lifted into its proper position inside the pelvis. Stitches will be placed around the rectum to secure it in place. Mesh may be used along with the stitches. In some cases, a portion of your sigmoid colon may be removed. Finally, the pelvis will be rinsed out and the incisions will be stitched closed. Your stitches will be dissolvable and under the skin; you will not have any stitches that need to be removed.
What to expect from procedure
After the surgery, you will be:
- Admitted to the hospital.
- Able to eat food as tolerated.
- Given pain medications as needed.
- Able to get out of bed and walk around the same night of your surgery.
- Able to go home once you are able to eat, have no signs of infection, have return of bowel function, and can care for yourself at home.
In general, you will be encouraged to increase your activity level steadily once you are home. Walking is great exercise and will help your general recovery by strengthening your muscles, keeping your blood circulating to prevent blood clots, and helping your lungs to remain clear.
What is laparoscopic pancreas cancer surgery
The pancreas is a gland that produces digestive juices and hormones. Pancreatic cancer is when abnormal cells in the pancreas start to divide and grow in an uncontrolled way and forms a growth (tumor).
The cancer cells can grow into surrounding blood vessels or organs such as the small bowel (duodenum). And may spread to other areas of the body.
Why is it done?
What are the risks associated with it
How it is it done
What to expect from procedure
Should you opt for surgery?
What is laparoscopic stomach cancer surgery
If you have stomach cancer, your doctor may suggest taking out part or all of your stomach.The surgery can also stop your cancer from spreading and prevent it from coming back. A total gastrectomy means the doctor will remove your entire stomach. Sometimes they only need to take out part of your stomach. They’ll call this subtotal, or partial, gastrectomy. We have been using the minimally invasive approach as laparoscopic gastrectomy is safe not just for early gastric cancer but for more advanced disease.
Why is it done?
You usually have a laparoscopy if your scans show that you might be able to have an operation to remove your cancer. Or you might have a laparoscopy if the results of some of your other tests are unclear.
What are the risks associated with it
You could get what’s called dumping syndrome. When your small intestine has to digest a large amount of food at once, you may throw up or have nausea, cramps, or diarrhea. Many people notice these symptoms within an hour of eating. If you feel sick a few hours later, your blood sugar may be rising and falling too fast. It’s common to sweat, have a fast heart rate, or feel tired or confused.
Changing what you eat can help you manage these symptoms. After your gastrectomy, it may take 3 to 6 months to adjust.
How it is it done
You have the operation while you're asleep (under general anaesthetic). It takes about half an hour.We usually makes 2 or 3 small cuts:
- one in or near your tummy button
- on one or both sides of your abdomen
We put gas (carbon dioxide) into your abdomen. This makes it easier for us to see your organs, including the liver, stomach and gallbladder.
We put a thin tube with a light and camera (laparoscope) through one of the cuts. We can see the pictures on a TV screen. We put surgical instruments through the other cuts. We might use an ultrasound probe during the laparoscopy to see deeper into tissues.
We look for signs of cancer in the:
- lining of your abdomen
- surface layer of organs in your abdomen
We take samples of tissue (biopsies) and fluid to send to the laboratory to check for cancer cells.
Then we remove the tube and instruments and close the small holes with stitches.
What to expect from procedure
You might have fluids through a drip in the back of your hand or arm. Once you’re awake and drinking, your nurse takes the drip out. You should be able to eat and drink normally once you feel able to.
You might have some pain in your:
- abdomen for a few days
- shoulder for a day or two due to the gas in your abdomen
You usually have paper stitches over the wounds (Steri-Strips) or dissolvable stitches. You also have a waterproof dressing over them or a type of special skin glue.
You can soak off the dressing and paper stitches 5 days after your operation if they haven’t fallen off already.