THE LAPAROSCOPIC REVOLUTION
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The discipline of surgery is changing. Traditional concepts
and approaches to the treatment of surgical illnesses are giving
way to a new type of operative intervention variously referred
to as minimally invasive surgery, limited exposure surgery or
endoscopic surgery. Several factors have driven this change.
The most important impetus has been the hightened awareness
of patients. Advanced imaging techniques, improved optics and
new classes of instruments have paved the way for these innovative
procedures;this is just the beginning of the technology transfer
we are witnessing. New techniques to gain access to the body
cavity without the need for the external exposure present an
exciting challenge for this and the next generation of surgeons.
These are exciting times to be a surgeon.
Although not widely recognised for almost two
years, an event occured in the summer of 1987 that dramatically
changed the practice of general surgery. In that year, P.
Mouret
and his colleagues performed the first laparoscopic cholecystectomy
(removal of the gall bladder) in Lyons, France. What has happened
since is without precedent in modern surgery.
In a few years medical historians will begin
describing the most important achievements affecting surgery
during the twentieth century. It is the belief of several
leading surgeons of the world that laparoscopic surgery will
be considered a milestone as significant as the discovery
of antibiotics, the introduction of blood transfusion therapy,
and advances in anaesthesia.
WHAT IS LAPAROSCOPIC SURGERY?
In laparoscopic surgery a telescope is introduced
into the abdominmal cavity via the umblicus after the cavity
has been inflated with carbondioxide. A video camera is connected
to the telescope and so what is inside the abdominal cavity
is visualized on the television screen. Additional punctures
are made as and where required and watching the television
screen various surgeries are performed.
WHAT SORT OF SURGERIES CAN BE PERFORMED BY THIS
METHOD?
Various surgeries can be performed using the
laparoscope. Eg: Cholecystectomy (removal of the gall bladder),
hysterectomy (removal of the uterus), appendectomy ( removal
of the appendix), surgery for peptic ulcer etc. In fact, at
the centre in Melbourne, Australia, where the Dr.H.Krishna
Hande was trained, more advanced procedures like the removal
of the adrenal glands for various conditions are done routinely
laparoscopically.
WHAT IS THE ADVANTAGE OF PERFORMING A PROCEDURE
LAPAROSCOPICALLY?
The greatest advantage is for the patient. All
the morbidity and pain associated with a long scar is avoided.
In fact is most instances the patient should be up and about
performing normal day to day activities within three days
of surgery. Cosmetically also there is no disfigurement.
If conducted safely, endoscopic surgery offers
savings in total health care as a result of shorter hospital
stays and a more rapid return to work. Though the initial
investment is high laparoscopic surgery need not be more expensive
than open surgery.
CAN A SURGERY ALWAYS BE PERFORMED LAPAROSCOPICALLY?
No. There may be instances where a procedure
has been started using the laparoscope
but may have to be reverted to the traditional open method.
If for example the anatomy is unusual or the disease is such,
a surgeon may abandon the laparoscopic method and perform
the surgery by opening the abdomen. Patients should always
be told that this as
a possibility.
For more details and clarification
regarding any of the above,please contact
Dr.H.KRISHNA
HANDE,
M.S., F.R.C.S., M.Ch., F.M.M.C., at
Tel : 91-044- 26644517,26646422,26645538, 26645509,30584002,30584003
Fax: 91-044- 26641563 |
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