A very pertinent question indeed! In laparoscopic of key-hole surgery the steps and the procedure performed is same as in open surgery. Since the entire operation is made through small incision it provides the following benefits to the patient:
In a specialized unit, almost all the procedures in GI Surgery are performed laparoscopically too. Initially laparoscopic surgery was mainly performed for diseases of gall bladder and appendix. However, in current day practice surgery for colon and rectal cancer, surgery for inguinal or groin hernias, surgery for incisional hernias, laparoscopic splenectomy, surgery for hiatus hernia/GERD, surgery for pancreatic cysts and tumours and surgery for live tumours are being done regularly with good results. Bariatric surgery or surgery for morbid obesity is done exclusively laparoscopically with excellent results.
Please see the sections on advanced GI laparoscopy and Bariatric surgery for more information.
My unit is a specialised centre for all GI laparoscopic procedures. The track record of the unit is over 4800 successful laparoscopic surgeries, probably the highest in Kerala. This unit has performed maximum number of colonic & rectal resection for benign lesions and for cancer in the state. Unit is equipped with High Definition 3-Chip Camera systems from Karl-Storz and Stryker, Harmonic scalpel, thermosufflator, vessel sealing system etc. Commonly performed laparoscopic surgeries are:
Colorectal surgery is usually done for colorectal cancers and for complications of diverticular disease. Blood in stools, mucus per rectum, and alteration of bowel habits, weight loss or anaemia should be investigated for any colorectal disorder. All colorectal surgeries including surgery to remove entire colon (for polyposis coli, ulcerative colitis etc) effectively done laparoscopically. Patients recover very early, require no/minimum ICU stay and are started with oral feeds very early. The following are the common procedures:
Most of these surgeries require an upper abdominal or chest incision if done by open method. All these disadvantages are taken care of if these surgeries are done laparoscopically. Removal of esophageal of gastric cancer with removal of entire lymph nodes can be performed en bloc laparoscopically with minimum postoperative discomfort to the patient. Excellent functional results are obtained after surgery for achalsia cardia or GERD with minimum postoperative pain and hospital stay.
Hernia surgeries are laparoscopically very effectively. Through 2-3 small incisions hernias of both groins can be repaired using a mesh. Similarly in laparoscopic repair of incisional hernias cut through same weak scar is avoided, instead small holes in the flaks of abdomen is used for repair using a special mesh. This procedure is more cosmetic and has very less pain compared to open repair for incisional hernias
Gall bladder surgeries and surgeries for biliary stones are very commonly done laparoscopically. Many lesions in the liver including liver tumours can be removed through laparoscopic route avoiding a huge scar in the upper abdomen.
Bariatric surgeries are done very effectively by laparoscopic route. Open surgery should be avoided as far as possible in overweight patients as postoperative complications are much more with open surgery in these patients. Apart from weight loss many co-morbid conditions due to overweight like diabetes, hypertension, hypercholesteremia, heart disease, sleep disorders; joint arthritis etc gets cured/improves after this operation. See more on the page for surgery for overweight in the same website.
This is a new evolving innovation in the field of laparoscopic surgery wherein entire surgery is carried out through a 2.5 cm incision and a port introduced through umbilicus. In single port surgery of SILS approach special angled instruments are used. The main benefit of SILS is cosmetic and to an extent less pain. Almost all procedures like surgery for gall bladder, hernias, colon cancer and even gastric sleeve resections for obese patients are done very effectively using SILS approach
Apart from laparoscopic procedures, major GI surgeries are also done regularly in my unit. The unit has performed over 12500 open GI surgery procedures successfully. Other procedures commonly undertaken in my department of GI Surgery are:
Hepatic resection : Hepatic/liver resections are done commonly for liver tumours. It requires good preoperative planning, meticulous surgery and intensive postoperative care for good results following hepatectomy. The following procedures are done regularly in my department.
Pancreatic surgery : Pancreatic surgery also requires through planning and execution of surgery and meticulous postoperative care.
Luminal GI Surgery : These procedures are done for lesions of esophagus, stomach, small intestine and colon. Most of these procedures are done laparoscopically. They include,