LAPROSCOPIC SURGERY

Laparoscopic General Surgery

Commonly performed laparoscopic general surgery procedures:

Cholecystectomy

Removal of gall bladder or cholecystectomy is one of the most frequently performed laparoscopic procedure .Lap. Cholecystectomy is the gold standard treatment for gall bladder stones .Lap. Cholecystectomy has established itself as a very cost effective and safe procedure.

Appendectomy

Removal of Appendix is called Appendectomy or Appendectomy. Lap. Appendectomy is a common safe and cost effective method of removing the diseased appendix.

CBD Exploration

Removal of stones from the common bile duct is an advanced laparoscopic procedure .It is done with the help of a flexible fiber optic choledochoscope which is passed into the CBD under laparoscopic guidance to directly visualize and remove the stones.

Liver Abscess

Laparoscopic drainage of Liver Abscess is an established treatment option for Abscesses which cannot be aspirated under ultrasound guidance because of their size and site.

Colonic Resection

Laparoscopic removal of part or complete colon as required in cancer of large intestine is being done successfully all over the world. It has a great advantage of early recovery without compromising the principles of cancer surgery.

Rectopexy

The Rectum is anchored to the sacral promontory laparoscopically to prevent it’s sliding down and prolapse. This can be done by using a prosthetic mesh or simple stitches. It is a very successful procedure for treatment of Rectal prolapse.

Fundoplication

Nissen’s Fundoplication is the most accepted procedure for GERD and Hiatus Hernia. Laparoscopic Fundoplication is a routine procedure is most advanced laparoscopic surgery programmes.

Achalasia

Removal of gall bladder or cholecystectomy is one of the most frequently performed laparoscopic procedure .Lap. Cholecystectomy is the gold standard treatment for gall bladder stones .Lap. Cholecystectomy has established itself as a very cost effective and safe procedure.

Laparoscopic Hernia Surgery

Commonly performed laparoscopic hernia surgery procedures:

Inguinal Hernia

Laparoscopic Inguinal Hernia Surgery is a better alternative to the open technique as is this surgery the defect is treated from where it has started. In addition to Inguinal, Obturator & Femoral sites for Hernia are also covered by the mesh in this surgery which is not possible in open surgery.

Umbilical Hernia

Simple Procedure done laparoscopically which obviates the need for a lot of dissection which is required in open surgery thus reducing the operative time, the recovery time and the pain associated with surgery.

Diaphragmatic Hernia

Laparoscopic surgery is a boon for patients having Diaphragmatic hernia or defects. As laparoscopic assess to this area is much easier and better then open surgery for which a very large incision is required.

Epigastric Hernia

Simple procedure done laparoscopically where a prosthetic mesh is applied from within to cover the hernia defect. Less dissection is required, early recovery and less peri-operative pain

Incisional Hernia

Any incisional or ventral hernia irrespective of it’s size and location can be repaired laparoscopically with rewarding results .A prosthetic mesh is applied from within to cover the hernia defect and fixed in place with the help of tacker and stitches.

Hiatus Hernia

Hernia through the esophageal hiatus in the diaphragm is called Hiatus Hernia , where a part of stomach slides up into the chest cavity. It can be easily brought down laparoscopically and the defect is closed and a fundal wrap is fashioned around the lower esophagus.

Single Incision Laparoscopic Surgery

Single Incision Laparoscopic surgery (SILS) is a further advancement in laparoscopic surgery .It is now possible to do almost all laparoscopic procedures through single Incision in place of the multiple incision used in conventional multi port laparoscopy .Special Instruments are required for these procedures .The most commonly performed SILS procedures are :

  • Cholecystectomy
  • Hysterectomy
  • Ovarian Cystectomy
  • Appendectomy

Laparoscopic Urology

Commonly performed laparoscopic urology procedures:

Pyelolithotomy

Laparoscopic Pyelolithotomy is done through the retro peritoneal approach without entering the abdominal cavity .It has a role in solitary renal pelvic stones where it scores over the per-cutaneous approach by not going through the kidney tissue.

Nephrectomy

Non-functioning kidneys are often removed due to the risk of infections, tumors, or hypertension from vascular issues. Laparoscopy is a preferred method for kidney removal, including in radical nephrectomy for tumors. Some centers also perform laparoscopic donor nephrectomy for transplants.

Ureterolithotomy

Transperitoneal and retroperitoneal Ureterolithotomy has its role in large stones of the ureter which are difficult to remove by ureterorenoscopy (URS).

Pyeloplasty

Laparoscopic trans-abdominal pyeloplasty (Classical Anderson Hynes or Y-V Plasty) is a routine laparoscopic procedure with comparable results as with open surgery.

Paediatric Laparoscopic

Commonly performed paediatric laparoscopic procedures:

Congenital Hernia

Laparoscopy offers a very good approach for Herniotomy in Paediatric age group .The contra-lateral side can also be assessed simultaneously and dealt with if impending herniation is detected.

Orchipexy

The Mobilization of intra Abdominal testes is much easier and better under direct laparoscopic guidance and most of the times the testes can be brought down in a single stage by this technique whereas it may require a two stage procedure in open surgery.

Pyeloplasty

Laparoscopic trans abdominal pyeloplasty (Classical Anderson Hynes or Y-V Plasty) is a routine laparoscopic procedure with comparable results as with open surgery. It has the special advantage in paediatric age group of early recovery as it is very difficult to make children take rest for a long time.

Appendectomy

Removal of Appendix is called Appendectomy or Appendicectomy. Lap. Appendectomy is a common safe and cost effective method of removing the diseased appendix.

Colectomy for Mega Colon

The Colon can be mobilized laparoscopically and a perineal anastomosis can be performed with a circular stapling device. A proximal colostomy can be done under laparoscopic guidance for additional safety without opening the abdomen.

Abdominal Lymph Node Biopsy

A simple procedure which avoids a laparotomy and gives us the liberty to choose the best lymph node which can be taken and subjected to histo-pathological examination to reach a diagnosis of the disease process.

Laparoscopy in Trauma

Haematoma / Haemoperitonium Drainage

Laparoscopic surgery is emerging as an alternative in patients with abdominal injuries .It helps to quantify the injury correctly in haemodynamically stable patients with abdominal trauma .Blood in abdominal cavity can be drained and bleeding controlled .In addition to this damaged spleen can also be removed.

Laparascopic Solid Organ Surgery

Commonly performed laparoscopic solid organ surgery procedures:

Splenectomy

Elective laparoscopic splenectomy is a very feasible alternative to open splenectomy .It is usually done in patients of splenic enlargement caused by medical disorders.

Adrenalectomy

Laparoscopic removal of adrenal tumours is a safe and better procedure than open surgery where a large incision is necessary.

Nephrectomy

Non-functioning kidneys need to be removed because they stand a great chance of developing complications due to infections and tumour formations .Non-functional kidney can also be a cause of hypertension because of vascular compromise .Laparoscopy is a well accepted and better option for the removal of such diseased kidney .Radical Nephrectomy in cases of tumours of kidney origin is also a fairly routine procedure.
Some centers are also doing laparoscopic donor Nephrectomy in kidney transplant cases.

Laparoscopy For Morbid Obesity

The patients with morbid obesity or obesity with metabolic disorders like diabetes have a surgical option to help them overcome their problems. The diabetes goes into remission immediately after surgery.

The procedures available are :-

  • Sleeve Gastrectomy
  • Gastric Bypass
  • Gastric Banding

Surgery is reserved for patients who have exhausted all other options for weight loss. Proper counseling is done by the bariatric team to decide the best procedure for each patient.

Thoracoscopy & VATS

Video Assisted Thoracic Surgery or thoracoscopic surgery is the method to do surgery inside the chest with the help of instruments inserted through small holes in the chest wall, without opening the chest. Procedures which are done thoracoscopilly commonly are-

Mediastinal Lymphnode Biopsy

Lymphnodes from within the chest are removed for the purpose of arriving at an accurate diagnosis after histopathological examination.

Thoracoscopic Decortication

Removal of thickened covering layer of lung to facilitate it’s expansion is called Decortication. Thoracoscopic decortications is a fairly commonly performed procedure and is a good alternative to open thoracotomy and decortications.

Thymus removal

VATS is now the method of choice for removal of thymus tumours.