What is Laparoscopy?
Laparoscopy is a surgery performed under general anesthesia and based on the principle of imaging the abdominal organs by inserting a thin telescope into the abdomen through the belly button. By illuminating the inside of the abdomen, it also provides the opportunity to directly observe diseases or problems and, if necessary, simultaneously treat them with auxiliary instruments inserted through 3 - 5 mm holes opened in various parts of the abdomen. It is also known as closed, bloodless or knifeless surgery among the public.
Since when has laparoscopic surgery been performed?
Reducing the size of surgical incisions has been the dream of surgeons and patients for thousands of years. While decorating it, in fact, a primitive rectoscope (an instrument that shows the inside of the large intestine) was made for the first time 3000 years ago, and in the 11th century, the Arab scholar Abu Kasım developed a similar instrument. Today, thanks to the rapidly developing technology, the devices have been much improved, and although instruments such as light source, lens-optical system and video device have reached millimeter sizes, they have become very powerful and placed in a single pipe. Modern laparoscopy was first performed by Gynecologists, but laparoscopy was a procedure generally performed for diagnostic purposes until the mid-1980s.
In parallel with technological developments, it has recently become increasingly common for therapeutic purposes (surgical laparoscopy). has started to be implemented. The first laparoscopic gallbladder surgery was performed in the field of general surgery in the late 1980s.
How is laparoscopic surgery performed?
In laparoscopic surgery, the organs to be operated on are visible on the screen with the camera placed. and the surgery is performed with images on the screen. Thanks to the camera, an image that is 20 times larger and more detailed than what is seen with the naked eye is obtained, allowing anatomical structures to be seen in finer details. Although the number of entry holes and the width of the incision vary depending on the type of surgery, the width of the incision is generally between 0.5-1 cm.
Laparoscopy is performed in the operating room under general anesthesia with the patient asleep. The main reason for this is that the gas injection into the abdomen causes tension and pain in the awake person. � patients are absolutely put to sleep. The abdominal cavity is expanded by injecting gas into the abdomen with the help of tube-shaped cannulas of various diameters and lengths. In this way, the instruments are separated from the abdominal wall and a suitable space is gained to allow the instruments to work.
Who can undergo laparoscopy?
There is no age limit for minimally invasive surgery; It can be applied to anyone, from a newborn baby to a 100-year-old person. The main determinant in the selection is the laparoscopic surgery experience of the center where the application is performed and whether it has appropriate equipment, especially for the pediatric age group. When choosing surgery, “Open surgery? Closed surgery? When answering the question, it is necessary to carefully evaluate the specific situation of the patient and his disease. Although it can be performed from time to time, especially in patients who have previously undergone open surgery, due to intra-abdominal adhesions, this poses an obstacle to laparoscopy surgery.
In fact, first of all, it is a prerequisite for patients to have confidence in this method; Because many patients still rely more on open surgical methods and think that their surgeries will be incomplete or inadequate; However, it has superior advantages over open surgical methods in terms of medical aspects rather than aesthetic appearance.
Which diseases is it used in the treatment of?
Laparoscopic surgery; It is applied in many general surgery surgeries, especially gallbladder removal, inguinal hernia, appendicitis, reflux and hiatal hernia surgeries. In addition, minimally invasive techniques are increasingly used in gynecological, orthopedic, urological and cardiovascular surgery. In addition, thanks to advanced laparoscopy techniques, it can be easily applied in cases where the spleen or adrenal gland needs to be removed, in colon cancers, and in gastric by-pass operations. The definition of advanced laparoscopy has actually changed a lot over the years.
When we consider general surgery surgeries, 10 years ago, applications beyond gallbladder and appendicitis surgeries were called advanced laparoscopy, but today, even colon cancer surgeries are not considered advanced laparoscopy and are technically much more challenging. B.C rbid obesity, stomach cancer, liver and pancreas surgeries are considered in the advanced laparoscopy class. These surgeries require special time, the entire operating room team, especially the surgeon, must receive additional training and different equipment must be kept in the operating room. As knowledge and experience increases, these will become routine surgeries.
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