It all started with an incarnation of God Vishnu passing his legacy to ancient ayurvedic surgeon Sushruta , who gave the first account of surgery as a form of treatment in ‘Sushruta Samhita’,  some 3000 years ago in India.

From that time, surgery has come a long way form the Jails where prisoners were operated with king’s permission, to the barber’s saloon, to the modern high tech state of art operation theatres.

With constant developments in technology & its application in medical science surgery changed its attire from its ghastly looks owing to big scars to smaller ones & then to key holes. Presently the possibility of normal orifices or scar less surgery is being explored & some centres are performing abdominal surgeries through vulva, & mouth.

There were innovations which could not stand the test of time & became obsolete, but LAPAROSCOPY or Key-hole surgery has come to stay, with its array of advantages & wide range of applications. Laparoscopy started as a diagnostic tool in a surgeon’s armamentarium & then proved its mettle in therapeutic arena to establish itself as the Gold Standard in treating some conditions like Cholelithiasis (Gall bladder stone disease).
The Laparoscopy is a procedure to look inside the abdomen with the help of a scope which is very thin & is attached to a light source. The magnified image is seen on a monitor which enables the surgeon to diagnose & treat various intra abdominal & pelvic conditions.

Advantages:

• Less pain following the procedure.
• Less risk of complications.
• A shorter hospital stay.
• A quicker recovery.
• A much smaller scar.
• Cosmetically better.

Common conditions amenable to laparoscopic treatment :

• Cholelithiasis (Gall Bladder stone)
• Appendicitis
• Hernia – inguinal, incisonal, paraumbilical etc.
• endometriosis
• pelvic inflammatory disease
• ectopic pregnancy
• ovarian cysts

Procedure:

Laparoscopy and laparoscopic surgery are usually done under general anaesthesia. The surgeon takes a small incision about 1 cm long close to the navel (belly button). Gas is injected through a small needle to inflate the abdomen in order to lift the wall. This makes it easier to see the internal organs with the laparoscope which is gently pushed through the incision into the abdominal cavity. The surgeon then looks at pictures on a TV monitor connected to the laparoscope & operates using hand eye coordination.

If a surgical procedure is to be undertaken, one or more separate small incisions are made in the abdominal skin. These allow thin instruments to be pushed into the abdominal cavity through specially designed trocars. The surgeon can see the ends of these instruments with the laparoscope and so can perform the required procedure. The dissected organs are removed through the normal ports using various types of bags. At the end of the procedure the gas is removed & then the operating ports are withdrawn taking care not to damage any organ.

The wounds are sutured in layers, the skin is closed with either glue or steri-strips to give it a neater scar, Small dressings are applied.

After surgery the patient may feel little pain at the shoulder due to gas under the diaphragm which responds to pain killers & subside after some time. The recovery is faster than it is in the open surgery, early ambulation is recommended, and oral liquids are allowed after 6 hours in most of the cases.

Complications:

Like most of the things in life laparoscopy is also associated with some complications like

Anaesthetic compilations.

Open conversion may be required in case of damage to some vital organ or unclear anatomy in badly infected cases.

Wound related complications are very rare as compared to open surgery.

To conclude I would like to emphasise the importance of laparoscopy on its merits. With newer developments more & more types of surgeries are being done laparoscopically & the benefits clearly outweigh the traditional open surgery. Always ask the possibility of Laparoscopy if you or your loved one has to undergo any surgery.