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Laparoscopy is the surgical technique that is often called ‘keyhole surgery.’ It involves inserting a small camera inside the abdomen on the end of a long stick. The image is then projected onto monitors in the operating room so that the surgeon can see the internal organs. A full General Anaesthetic is required.
Laparoscopic surgery has the advantage of small incisions which means that there is less pain than with open surgery.
The instruments used in laparoscopy can be slid in and out of the abdomen through ports, which are valved tubes entering the abdomen through small cuts. The initial tube is usually inserted under vision in the space just below the umbilicus (belly-button) because this is usually the safest entry point. Once the first tube is in place, carbon dioxide gas is used to distend the abdominal cavity to create a space so that the surgeon can look around. Sometimes the umbilicus is not the best spot to place the initial incision, and the surgeon may decide to use a site of the abdomen not previously operated on to avoid internal adhesions.
Depending on the surgery, the surgeon will insert other ports into the abdomen to manipulate the organs they are operating on.
This image shows the sort of picture the surgeon gets at laparoscopy. By gentle pressure with instruments on the tissues the surgeon can get a sense of whether a lump is hard or soft. Biopsies can be taken, and of course, many operations are now be performed with laparoscopy.
Adhesions are fibrous bands that develop in the abdomen after previous surgery or inflammation. They are part of the way the abdomen heals itself after injury. Occasionally the bowel can get caught up in these causing a bowel obstruction. Adhesions sometimes need to be divided to release caught up bowel or to allow for other surgery to go ahead.
The post operative course depends largely on what was done. For simple surgery, such as a diagnostic laparoscopy or some laparoscopic hernias, patients will often go home the same day. Patients having more complex surgery can expect to stay overnight at least. Usually, patients return to their normal diet within a day or so.
It is painful, but less so than open surgery. Pain pills are required for the first few days. Expect around a week off work depending on your job. Dressings stay on for 1 week and stitches are dissolvable. A follow-up appointment with Dr Crawford at 3 weeks is usual.
Heavy lifting is to be avoided for around 6 weeks.