Laparoscopy - The Present Scenario

By Author: Sadhana Mishra
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Access inside body for surgical procedures by means other than making a large cut is called laparoscopic surgery. A form of minimally invasive surgery, laparoscopy has gained prominence all over world as a technique of the new millennium for most abdominal and thoracic operations and is being applied to a growing number of other surgical specialities. Most of the educated patients are attracted by minimal access surgery and patients are attracted by the reduced pain and faster recovery associated with the laparoscopic procedures and surgeons are finding that laparoscopy matches traditional open procedures in effectiveness.

Because there is less pain with laparoscopy, more patients sought minimal access treatment. They challenged physicians to apply the concept of minimal access therapy to other diseases," states Dr R K Mishra, Senior Consultant and Professor of Minimal Access Surgery, Laparoscopy Hospital, New Delhi. Today, with the development of the high end video technique and increasing application in various fields of surgery, laparoscopy is rapidly evolving. More surgeons and gynaecologists are getting trained in ...
... laparoscopic surgery with the training courses available at Laparoscopy Hospital training centre in India. New procedures are added everyday to the list of possible laparoscopies done by expert laparoscopic surgeon.

One concern is training of surgeons, gynaecologists, paediatric surgeon and urologists. According to Dr Mishra, at present, the exposure gained by surgical residents in India to laparoscopy surgery appears inadequate and haphazard. For the development of the various specialities and its safe practice the formal incorporation of theoretical as well as practical aspects of laparoscopic surgery in postgraduate surgical training is important.

There has recently been much media attention on the complications of minimal access surgery, and this has raised public concerns over training and accreditation. According to Dr Mishra, the question of accreditation in minimally invasive surgery needs to be addressed urgently. Criteria for accreditation would have to be laid down, and clearly a mechanism of appeal for those who fail accreditation would also need to be organised.

The success of a laparoscopic surgery can be measured in terms of patient's outcome and complications encountered. If the patient is adequately assessed prior to surgery and the surgeon is well trained to perform it, the laparoscopic surgery can be completed without complications. In many cases laparoscopy can be done instead of laparotomy surgery that uses a larger incision in the belly. Laparoscopy can be less stressful and may have less problems and lower costs than laparotomy for minor surgeries.

It can often be done without needing to stay overnight in the hospital if performed by well trained laparoscopic surgeon.
There are a number of advantages to the patient with laparoscopic surgery. These include:

1.Reduced blood loss
2.Smaller incision, which reduces pain and shortens recovery time.
3.Less pain, leading to less pain medication needed.
4.Although procedure times are usually slightly longer, hospital stay is less, and often with a same day discharge which leads to a faster return to everyday living.
5.Reduced external contaminants thereby reduced risk of acquiring infections.

Despite best efforts on part of the surgical team, complications may occur after laparoscopic surgery as with any form of surgery. Patients are given a fair idea of what the complications are likely to be, but their likelihood is put in proper perspective.