Introduction:
Minimally invasive surgeries involve small incisions and quick recovery time. Fiber optics and high-definition cameras are used to display the surgical field on a screen. These techniques are much better than traditional techniques involving long incisions from the sternum to the navel. The procedure which is performed as a minimally invasive gastrointestinal surgery is laparoscopy. It involves very small incisions and leads to faster recovery. This method of surgery is preferred to treat benign colorectal disease or cancer and bariatric weight-loss surgeries.
What Is Laparoscopy?
It is a surgical procedure that allows a surgeon to have access inside the abdomen and pelvis region without any large incision in the skin. The technique is also known as keyhole surgery or minimally invasive surgery. A small tube, known as a laparoscope, is used with a light source and camera which captures the images inside the abdomen or pelvis on the screen.
What Are the Advantages of Laparoscopy Over Traditional Open Surgeries?
Being the least invasive technique of surgery, laparoscopy has many advantages over traditional open surgery techniques.
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Time-saving procedure as it does not involve long incisions or complex techniques.
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Less bleeding and pain are experienced during and after the procedure.
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Healing time is reduced compared to open surgeries which may require weeks to heal.
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Fewer possibilities of post-operative complications due to less tissue destruction and simpler techniques.
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Scarring is reduced after minimally invasive surgery.
When Are Minimally Invasive Gastrointestinal Surgeries Used?
Laparoscopy is used for the treatment and diagnosis of many gastrointestinal conditions. It can be used to remove an infected organ such as gallbladder or gallstones or can be used to collect tissue samples for histopathological evaluations.
Conditions Diagnosed by Laparoscopy-
1. Pelvic Inflammatory Disease- It is a bacterial infection that affects the female upper genital tract region, including the ovaries, fallopian tubes, and the womb.
2. Ovarian Cyst- When sacs filled with infectious fluids develop in the ovary is called an ovarian cyst.They are very common in occurrence and do not cause any specific symptoms.
3. Ectopic Pregnancy- The development of pregnancy outside the womb is known as ectopic pregnancy. The fertilized egg is implanted generally in the fallopian tube.
4. Endometriosis- Growth of endometrium outside the uterus. The endometrium is the tissue lining of the uterus, which grows outside the womb in endometriosis.
5. Fibroids- Non-cancerous fibrous growth around the uterus. They are often called leiomyomas or uterine myomas. Generally, the condition is asymptomatic; however in some cases, it may show symptoms such as abdominal pain, heavy or painful periods, lower back pain, and constipation.
6. Undescended Testicles- Common congenital condition in which a boy might have been born without both or with only one testicle in their scrotum.
7. Cancers- Some cancers or tumor growths are also diagnosed by laparoscopic technique. Some of the examples are cancer of the bile duct, pancreatic cancer, ovarian cancer, or cancer of the gallbladder.
Conditions Treated by Laparoscopy-
1. Removal of Gallbladder- This procedure is generally carried out in cases of gallstone formation in the gallbladder which can not be cleared completely. This method can also be performed in cases of severe gallstone formation. Removal of a part of the intestine, often in cases such as Crohn’s disease or diverticulitis, which do not respond to medical treatments.
2. In Cases of Appendicitis- Where there is a high chance of appendix bursting, removal of the appendix is carried out by laparoscopic techniques.
3. Repair of Hernias- Hernias is a phenomenon of pushing out of the internal part of the body through a weak point in the affected muscle and surrounding tissue. Repair of bleeding stomach ulcers that can not be cured by medicines and preventive measures.
4. Bariatric or Metabolic Surgery- This procedure is used to reduce obesity surgically. It is performed as a preventive method to control type 2 diabetes or high blood pressure.
5. Removal of some organs which are affected by cancers such as ovaries, prostate, colon, kidneys, liver, and bladder.
6. Removal of fibroids which are an extra grown mass of muscles and fibrous tissues.
What Instructions Are Followed Before Performing Laparoscopy?
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Depending on the type of laparoscopic procedure, the patient is asked not to drink or eat anything before 6 hours or 12 hours of surgery.
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If the patient is under anticoagulants like Warfarin or Aspirin, then their administration is stopped a few days before the surgery. This helps to prevent excess bleeding during surgeries.
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If the patient is a smoker, then he/she is asked to stop a few days before the surgery, as smoking delays the healing procedure.
How Is Minimally Invasive Gastrointestinal Surgery Performed?
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A small cut (incision) is made of 1 cm to 5 cm around the belly button.
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A tube is inserted through the incision, and carbon dioxide gas is pumped to inflate the abdomen. This helps the surgeon to look at the organs clearly.
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A laparoscope is inserted through this tube. It has a camera and a light attached to it which helps to see the image on the screen.
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Depending upon the organ to be treated, small incisions are made and few small surgical instruments are inserted which helps to treat.
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After the surgery, the carbon dioxide is pumped out of the abdomen, and incisions are closed with stitches and clips.
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The process of diagnosis by laparoscopy takes a maximum 30 to 60 minutes, however treating a condition may take more time.
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After the treatment, the patient is observed until totally awake and able to drink, eat and pass urine.
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Before leaving the hospital, the patient is instructed to keep the wound clean, and come for follow-ups and stitch removal (if non-absorbable).
What Are the Complications of Minimally Invasive Gastrointestinal Surgeries?
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After the treatment, some gasses inflate the abdomen and cause cramps, bloating or shoulder pain.
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If the patient develops a fever, chills, or severe continuous vomiting after the surgery, the doctor should be consulted immediately.
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Redness, swelling, bleeding, or pain around the wound areas.
What Is Robotic-Assisted Laparoscopy?
This is a new recent development in the field of laparoscopic treatment. Robots are used to assist the procedure. Surgeons use a console located in the operating theater to carry out the procedure by controlling it with robotic arms. The robotic system provides magnified 3-dimensional vision and increases the range of movement for the instruments to carry out the surgery.
Conclusion:
Minimally invasive gastrointestinal surgeries are surgical procedures with the least tissue damage and quick recovery of the patient. The treatment involves the use of fiber optic with high definition cameras which help to locate the site of an infection more easily than traditional ways in which there was incision involved, generally from the sternum to the navel. It helps in the diagnosis of many inflammatory diseases and the removal of organs such as the appendix or gallbladder. This is the modern technique in treatment procedures and is widely used in several countries over traditional surgical methods.
