Patient Information
Surgeries: Laparoscopic: Introduction
Laparoscopic surgery is a relatively new approach to common surgical problems. It is just one of the many new and innovative approaches in a new era of surgery encompassing minimal intervention. Simply put, many complicated problems required large incisions to gain access to a very focal area. Minimally invasive surgery gains access to that same area without a large incision. Laparoscopic surgery refers to procedures in minimally invasive surgery isolated to the abdomen.
Early experience in laparoscopic surgery was gained by gynecologists performing tubal ligation by looking through a small telescope inserted through the umbilicus (belly button). In the late 1980's , technology evolved to a point where the images could be projected onto TV screens. The early reports of laparoscopic cholecystectomy (gallbladder removal) were in the late 1980's. This was originally referred to as "laser surgery" since lasers were used for parts of the dissection.
Laparoscopic surgery has evolved tremendously over the last decade. We are now able to perform a variety of complicated procedures laparoscopically with less post-operative pain, faster recovery, and smaller scars than traditional open operations.
The Techniques of Laparoscopy
The concept of laparoscopic surgery is relatively simple. Imagine the abdomen as a sack or balloon containing the various abdominal organs. Once the patient is asleep, a small needle is placed through the abdominal wall, and gas is inflated to give the surgeons some "working room." 
Three or four more small puncture holes are made for insertion of various operating instruments including retractors, graspers, scissors, and dissecting tools. One of the instruments contains a small video camera which projects images of the abdominal cavity onto large video monitors, allowing doctors to get very good magnified views of the abdominal organs. Using these views and sophisticated instruments, the surgeon can retract, dissect, and resect areas of pathology such as a diseased gallbladder. Upon completion of the desired procedure, the instruments are removed and the abdomen "deflated." The small holes are closed with minimal scarring.
Laparoscopy involves no cutting incisions, which are what hurt after standard open surgery. Laparoscopy has a number of other advantages. Because there is minimal manipulation of the abdominal contents, there is minimal formation of scar tissue. Also, minimal manipulation of the bowel results in rapid return of bowel function. In large operations the bowel commonly become paralyzed (known as ileus) for several days post-operatively. Ileus is rarely seen after laparoscopic surgery.
Numerous studies have documented the rapid return to work and decreased pain following laparoscopic procedures. With improvements in technology, we have been able to perform a number of advanced complicated procedures which previously required large painful incisions and long recoveries in hospital.