During the past few years, recovery time, scarring, and pain linked with a wide array of general surgeries have decreased hugely. This is all because of the growing popularity of “laparoscopic” procedures or keyhole surgeries. Through the help of laparoscopic surgery, Dr Jain says now surgeons can treat patients in outpatient procedures itself avoiding unnecessary risks, scarring, pain, and expenses, allowing the patient to recover easily at home. In this article Dr Amita Jain who is Delhi’s top laparoscopic surgeon shares laparoscopic risks and benefits that require to be factored in while deciding to opt for the procedure.
Thought laparoscopic procedures could be traced as far back as 1805. However, it was Dr Heinz Kalk, a German gastroenterologist who made it famous by inventing a superior laparoscope. This earned him the title of “Father of Modern Laparoscopy”. During the 1930s, Laparoscopy gained big popularity in the US through the work of internist John Ruddock. While in the last few decades, laparoscopy has become the first preference of surgical treatment for both doctors and patients.
According to the National Health Service- in the United Kingdom, laparoscopic surgeries or keyhole surgeries are defined as “a form of surgical procedure that enables a surgeon to access the inside of the abdomen or pelvis without having to create large incisions in the skin”.
How laparoscopic surgery is done?
In this process, the surgeon makes a single or more small incisions. A small tube is utilized to pump gas into the body cavity through one of those incisions. This is to assist the surgeon to have a clearer view of the body. Using a laparoscope (a small tube having a light source and camera), the surgeon can either see inside the patient’s body to make a diagnosis or use it to make way for other surgical instruments. Over the years, laparoscopy has become a quite common procedure to diagnose and treat several conditions that are gynaecological, GI, minimal access, and urological conditions.
When it is done?
Laparoscopy is done to treat a wide array of GI, gynecological and urological conditions. It could be used to do tubal sterilization, hysterectomy, gallbladder removal, appendectomy, and gallbladder stone removal.
Laparoscopy is also a general way to carry out a number of diagnostic tests to diagnose and treat conditions like endometriosis, fibroids, ovarian cyst, ectopic pregnancy, disorders of the pelvic floor, and certain forms of cancer.
The most certain and basic benefit of laparoscopic surgery is that big open wounds and incisions are avoidable. This as a result significantly reduces blood loss, pain, discomfort, and scarring. Even the side effects caused due to anesthesia could be reduced or avoided. The instruments utilized in laparoscopy also makes less trauma to the tissue.
Because of the nature and size of incisions in laparoscopic procedures, the risk of forming postoperative complications linked with the wound is a lot lesser. It includes complications like dehiscence, infection, and incisional hernia amongst others.
Laparoscopic procedures also assist to avoid cooling, drying, excessive handling, and retraction of internal organs that could occur in traditional open surgeries.
These benefits together assist in minimizing recovery time and post-surgery pain hence lowering the risk of forming conditions associated with prolonged bed rest and inactivity (like bone loss, muscle atrophy, and urinary retention). The majority of the time, laparoscopic surgeries can also be done as outpatient procedures.
In a more practical manner, laparoscopic procedures minimize direct contact between the surgeon and the patient. As a result, there is a much lower risk of transmission of any sort of infection between the two, making it a preferred surgical choice for a huge range of treatment and diagnostic needs.
Risks associated with the laparoscopic procedures
The benefits of laparoscopic surgery are certainly there and widely accepted. However, like every other surgical procedure, it does not come without its own share of risks. One of the major risks is that laparoscopy takes longer time to do as compared to open surgery. This boosts the exposure of the patient to general anesthesia which could result in complications.
Other serious problems that may occur (rarely) in laparoscopic procedures are:
- Damage to an organ that could result in loss of organ function
- Damage to any major blood vessel
- Complications because of the gas (carbon dioxide) being pumped into the body cavity
- Allergic reaction to the general anesthetic used at the time of the procedure
- Forming a blood clot in a vein (deep vein thrombosis) which might result in blockage of blood flow in one of the blood vessels of the lungs (pulmonary embolism)
Just as with any traditional surgical process, the complications might not be visible right after surgery. Rather they may start forming over a period of time following the surgery. So, it is usually, advised that the patient is not left alone for the initial 24 hours post surgery. Even if they get discharged from the hospital. If you see any of the following symptoms posts a laparoscopic procedure, seek immediate medical assistance:
- High fever
- Severe or constant vomiting
- Abdominal pain with enhanced intensity
- Pain, swelling, bleeding, discharge, or redness nearby the incisions
- Unusual, vaginal discharge or bleeding
- Pain and swelling in either of the legs
- Discomfort or burning sensation while urination
In certain cases, because of the complications arising during the procedure, the surgeon may also have to switch to open surgery in place of laparoscopic surgeries. Further surgery might also be needed to treat some of the serious complications that could arise after a laparoscopic procedure.
Laparoscopic surgery – How safe it is?
Now, let us come to the point. Is laparoscopic surgery safe? Considering all of the above criteria, it is clear why laparoscopic surgeries are gaining in popularity. Contrary to traditional open surgeries, they are regarded safer as they minimize the duration spent by the patient in the hospital or on bed rest. In fact, in several cases, patients are discharged post a few hours once the procedure is done.
It is essential to remember that laparoscopic surgery is by no means a magic cure for every surgery. Not all patients are fit for this procedure. Depending on the severity of the condition and the patient’s general and overall health, the doctor will decide between open or laparoscopic procedures.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi