Advantages of Laparoscopic Surgery
Laparoscopic or “minimal Access Surgery” is a highly specialized technique for performing surgery of abdomen. In the past, this surgical technique was commonly used only for gynaecologic surgery, for diagnostic laparoscopy in cases of infertility and for gall bladder surgery. Over the last 10 years the use of this specialized surgical technique has expanded into intestinal surgery. In traditional “open” surgery the surgeon uses a single incision to enter into the abdomen. Laparoscopic surgery uses several 0.5-1cm incisions. Each incision is called a “port.” At each port a tubular instrument known as a trochar and cannulla is inserted. Specialized instruments and a special telescope known as a laparoscope are passed through the port during the procedure. At the beginning of the procedure, the patient’s abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the laparoscopic surgeon. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors through a digitally advanced camera system in the operating room. During the operation the surgeon watches detailed images of the abdomen on the high resolution monitor. This system allows the surgeon to perform the same operations as traditional surgery but with smaller multiple incisions.However recently single incision laparoscopic surgery is also evolved.
In certain situations a minimal access surgeon may choose to use a special type of port that is large enough to insert a hand known as Hand Port. When a hand port is used the surgical technique is called “hand assisted laparoscopic surgery". The incision required for the hand port is generally 5.5 cm and hence larger than the other laparoscopic incisions, but is usually smaller than the incision required for traditional surgery.
Advantages of laparoscopic surgery?
Compared to traditional open surgery, patients often experience less pain, an earlier recovery, and less scarring with laparoscopic surgery.
Operations which can be performed using laparoscopic surgery?
Most of the abdominal advanced surgeries can be performed using the laparoscopic technique in experienced hand. These include surgery for gallbladder, duodenal perforation, appendicitis, Crohn’s disease, ulcerative colitis, diverticulitis, cancer, rectal prolapse and severe constipation.
In the past there had been concern raised about the safety of laparoscopic surgery for radical cancer operations. But recently several studies involving hundreds of patients have shown that laparoscopic surgery is safe for certain colorectal cancers.
How safe is laparoscopic surgery?
Laparoscopic surgery is as very safe as traditional open surgery. At the beginning of a laparoscopic operation the laparoscope is inserted through a small incision near the umbilicus, Either superior crease or inferior crease of umbilicus. The laparoscopic surgeon initially inspects the abdomen by doing diagnostic laparoscopy to determine whether laparoscopic surgery may be safely performed. If there is a large amount of inflammation or if the surgeon encounters other factors that is risky and prevent a clear view of the structures the surgeon may need to make a larger incision in order to complete the operation safely by converting laparoscopic surgery into open surgery.
Any intestinal or abdominal laparoscopic surgery is associated with certain risks such as complications related anaesthesia and bleeding or infectious complications. The risk of any operation is determined in part by the nature of the specific operation and hidden risk factor within the patient itself. An individual’s general health and other medical conditions are also factors that affect the risk of any operation. Patient should discuss with your surgeon your individual risk for any operation. World Laparoscopy Hospital, Gurgaon is very reach in this concern because for poor and needy patient surgery is completely free at World Laparoscopy Hospital.
Single Incision Laparoscopic Surgery (SILS)
Single incision laparoscopic surgery (SILS) or Single port access (SPA) surgery, also known as laparoscopic endoscopic single-site surgery (LESS), umbilical surgery (OPUS) or single port incision less conventional equipment-utilizing surgery (SPICES) or natural orifice transumbilical surgery (NOTUS), or Embryonic Natural Orifice transumbilical surgery (E-NOTES) is an advanced minimally invasive surgical procedure in which the surgeon operates almost exclusively through a single entry point, typically the patient’s navel. SPA surgical procedures are like many laparoscopic surgeries in that the patient is under general anaesthesia, insufflated and laparoscopic visualization is utilized.The World Laparoscopy Hospital in NCR Delhi is the first hospital in Haryana and only the third in the India to perform a single-port, natural orifice gallbladder surgery through the navel for gallbladder stone disease. During the procedure, surgeons use a single opening in the umbilicus as they manipulate a camera and two laparoscopic instruments to separate the gallbladder from its attachments in the abdomen. The gallbladder is then removed through that same opening. Only a tiny bandage is required to close the navel, and there are no scars.
Single-incision laparoscopic surgery employs the same tools and techniques as conventional laparoscopic surgery and can be used in both men and women. The only difference is a specially-designed port that accommodates the tools.
World Laparoscopy Hospital surgeons have always been leaders in minimally invasive surgery,” says Dr R K Mishra, Director of the World Laparoscopy Hospital and professor of TGO University. “This procedure signals another step forward for our nationally single incision surgery and elevates our efforts to provide the best surgical care while improving patient recovery.”
Dr. Mishra says that single incision laparoscopic surgery should not only for simple surgery like cholecystectomy but should also be used for surgery like donor nephrectomy and for donor who have already decided to give the gift of life and are willing to go through surgery to help a person in need, the possibility of coming through the surgery without scars is a secondary benefit.
Where India Stands in Laparoscopic World?
Laparoscopic Surgery in India
Over the years many hospitals of India has been treating patients from various countries like USA, UK, Canada, Pakistan, Iran, Malaysia, Oman etc. Indian Hospitals are committed to provide quality services with care, compassion & competence in order to meet all kinds of needs of our patients coming from all over the world. World Laparoscopy Hospital, Gurgaon and Laparoscopy Hospital, New Delhi is one of the most advanced surgical centers for laparoscopic treatment like: Laparoscopic Cholecystectomy, Laparoscopic Gastric Banding, Laparoscopic hernia repair, Gastric bypass, Fundoplication, Nephrectomy, Enlarged prostate disease management and many more. Laparoscopy Hospital is the first super speciality Laparoscopic institute to introduce “One roof Traetment, Training and Research” in minimal access surgery in India. It was established in the year 2001 with its foundation in Delhi and later one state of the art branch named as World Laparoscopy Hospital was launched at Gurgaon.
Laparoscopic Training in India
During the past two decades, minimally invasive surgery has become a part of almost every field of surgery in India. Results from many indian literature has documented that advanced operative laparoscopy, when performed by trained laparoscopic surgeons in centers with appropriate and specialized Minimal Access Technical amenities and with adequate laparoscopic support staff, is at least as safe and effective as, and in certain situations superior to, more traditional open surgical procedures, with the added benefit of significantly shortened postoperative recovery and decrease morbidity. These results are apparently, somewhat biased, as these study conducted in India are based on the experience of a select group of expert laparoscopc surgeon and may not reflect the data and laparoscopic surgery performed in every corner of India especially in rural setup. The Indian chapter of World Association of Laparoscopic Surgeons suggested that the single most important factor in determining the efficacy and safety of laparoscopic surgery is the skill and the laparoscopic experience of the surgeon performing the procedure.
In India there is great need for formal training in laparoscopic surgery is obvious, and it is evident that assistance is needed on the resident and postgraduate levels. In the medical colleges of India the challenges of resident education in laparoscopic surgery include time limitations as well as the lack of exposure to an adequate number of minimal access procedures. There are only few courses in India which is internationally recognized. The Laparoscopic courses at Laparoscopy Hospital meet the guidelines established in the SAGES Framework for Post-Residency Surgical Education and Training. The University Diploma in Minimal Access Surgery (D.MAS) and Fellowship in Minimal Access Surgery (F.MAS) course designed and offered by Laparoscopy Hospital is endorsed by the Society of American Gastrointestinal Endoscopic Surgeons (SAGES). The “Hands On” training which is accepted globally by the Government of more than hundred countries is scientifically designed by academic council of World Association of Laparoscopic Surgeons and it ensures that the participants are able to do all the taught surgery themselves after training. Many thousand of surgeons and gynecologists from every corner of the globe have been trained for advanced laparoscopic skill at Laparoscopy Hospital within last eight years. There is hardly any country left in the world from where surgeons and gynecologist has not come to get laparoscopic training at Laparoscopy Hospital.
In India now it is more than two decades after the introduction of minimally invasive surgery. Among the surgeons and gynecologists of India the amount of exposure and training to advanced laparoscopic procedures varies widely. To ensure development of future of Indian surgeons, an adequate volume of advanced laparoscopic procedures must be a high priority of any training program. The acquisition of skills for non-dominant hand dexterity, two-handed dissection, adequate instrument targeting, and intracorporeal as well as extracorporeal suturing is strongly recommended for resident level programs. To reach these goals, programs should include both training modalities outside the surgical suite as well as resident participation in the operating room. At Laparoscopy Hospital, New Delhi and World Laparoscopy Hospital, New Delhi both these priority to develop laparoscopic skill can be achieved.
Laparoscopic Instruments in India
Slowly India is becoming the World leader in manufacturing laparoscopic Instruments. In India now there are many laparoscopic instruments company who are producing state of the art laparoscopic instruments. One of the leading company Laparoscopy.Biz ( http://www.laparoscopy.biz ) offers 3mm and 5 mm Pediatric Laparoscopic Instruments in both 20cm and 29cm length. Made with high quality stainless steel and durable materials, these instruments are designed specifically to accommodate small anatomical structures for grasping, electrocautery and dissection capabilities. They make wide variety of insert graspers, dissectors, scissors, biopsy and needleholders round out the instrument line.
Laparoscopy.Biz laparoscopic instruments are made of high quality stainless steel and durable materials. Each instrument is superbly crafted using the latest in computer-controlled machine technology. Offered in both 5mm and 10mm sizes, this line offers a variety of handle and inserts styles for grasping, dissecting, suturing and cutting capabilities. The latest additions to this laparoscopic instrumentation line are the rotating and non-rotating slide lock graspers which offer a precise and ergonomic ratcheting mechanism.
Laparoscopy.Biz also offers 5mm Bariatric Laparoscopic Instruments in a 45cm length for perfect ergonomics. Made with high quality stainless steel and durable modern materials, these instruments are designed to accommodate bariatric procedures. The latest additions to the bariatric line are the rotating and non-rotating slide lock graspers, which offer an ergonomic and precise ratcheting mechanism for bariatric cases. These bariatric instruments also allow for the off-setting of instrumentation during single incision surgery. This durable design decreases instrument interference and creates optimal work space and maneuverability.
Features & Benefits of these Indian Instruments
- Safe and durable
Milled Radel shaft insulation ensures durability, longer instrument life, increased patient safety and reduced maintenance cost. - Modular Design
This design allows for customization of instruments for each user as well as easy disassembly for cleaning and maintenance. - Surgeon comfort and control
A special handle design allows for greater dexterity and larger finger rings help prevent finger fatigue. - Available in multiple sizes and lengths
Laparoscopic instruments of Laparoscopy.Biz are offered in the following sizes:
• 3mm pediatric instrumentation: 20cm and 29cm long
• 5mm & 10mm standard instrumentation: 33cm
• 5mm bariatric instrumentation: 45cm