How does conventional surgery differ from laparoscopic surgery?
Let's use gallbladder removal surgery as an example. With laparoscopic surgery, there are typically 4 small incisions made to the abdomen. These incisions open up a space for what is called a trocar to be placed. A trocar is like a bridge from the outside of the body to the inside of the body. The first trocar placed is in the umbilicus (belly button) and is typically used to insert a camera. Before the camera goes in, the abdomen is inflated with CO2 gas this allows for a better visual field. Once the camera is in, the other 3 incisions are made - these are to hold instruments to manipulate the tissue inside of the body. One is generally to pull the gallbladder up toward the liver so the surgeon can visualize the entire gallbladder and begin to remove it from the liver with the other instruments. Once the gallbladder is safely released from the liver, a bag is placed through one of the trocars to 'catch' the gallbladder, the bag is cinched around the gallbladder and removed out of one of the ports. The surgeons check for bleeding at the surgical site and inside the abdomen, particularly where the trocars were placed. Once everything checks out, the gas is turned off, the instruments and trocars are removed and the incisions are closed. Laparoscopic surgery is considered minimally invasive and the recovery time is faster than with open surgery. With the conventional open gallbladder surgery, there is one larger incision. Once open, the stomach contents are manually moved aside, then the liver is moved out of the way so the surgeons can see the gallbladder. Instruments called retractors are used to stretch the abdomen open. The gallbladder is removed from the liver, the operative site is checked for any bleeding. The retractors are removed, and the incision is closed. Another alternative is what is referred to as an open small incision gallbladder removal, which has about the same recovery time as laparoscopic surgery. Lastly, there is an alternative to laparoscopic surgery (ex: to remove a liver mass) which includes laparoscopy mixed with hand assisted surgery.
I have done PhD in Laparoscopic Surgery from MUHS( Maharashtra University of Health Sciences) INDIA. The doctorate degree was awarded to me for my work on Volume Insuffulation, Decoding of Knots and various other researches. My guide was Dr Arun Jamkar MS;PhD(Onco) who is at present Vice Chancellor of the University. I guess I am the First PhD in Laparoscopic Surgery in India. -Dr Hemant Bhansali <email@example.com>
Persons with previous multiple Abdominal Surgery may not be suitable for Laparoscopic Bariatic Surgery or for any Laparoscopic Surgery (minimal invasive surgery), as they may have adhesions due to previous Surgery. Bowels and tissues may be stuck making access and the process difficult, tedious and even dangerous. Open surgery may be an alternative option, but again it can be a difficult, tedious with increased risk of complications.
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