Minimally Invasive Surgery - Syosset Animal Hospital Minimally Invasive Surgery Call Now 516-921-0700 Minimally Invasive Surgery Options at Syosset Animal Hospital Laparoscopic surgeries are less invasive, cutting-edge alternatives to traditional pet surgeries. In a laparoscopic surgery, a camera is inserted into a small incision in the abdomen. With this camera, the veterinary surgeon can see internal organs magnified on a monitor, allowing for more precision. To conduct the actual surgery, small “ports” are created in the abdomen to insert tools, but because of the camera, large incisions are not needed. Laparoscopic Spays Laparoscopic spays—the removal of ovaries so your pet cannot have puppies or kittens—offer your pets less pain and shorter postoperative recovery times than traditional spays. The cameras utilized with laparoscopic spays allow for more precision, so surgeons can cauterize the ligaments that connect the ovaries to the abdominal wall. This greatly reduces trauma and postoperative pain, and, generally, pets heal faster after laparoscopic spays because they are much less invasive than traditional spays.

Laparoscopic-Assisted Gastropexy Gastropexy is a surgical procedure in which the surgeon tacks the stomach to the body wall to prevent gastric dilatation volvulus (GDV), more commonly known as torsion bloat. GDV occurs when the stomach fills with gas and flips over, and gastropexy prevents the stomach from turning. Laparoscopic-assisted gastropexy procedures are minimally invasive, so pets heal from them quickly. Laparoscopic Liver Biopsies A liver biopsy involves taking a small piece of tissue from the liver. Our veterinarians then examine the tissue for abnormalities, which helps diagnose various liver diseases. By conducting a liver biopsy laparoscopically, we not only can view the surface of the liver with the laparoscopic camera, but we also don’t have to make a large incision. Plus, we can pinpoint a specific area of the liver to biopsy, if needed. Endoscopies Endoscopies are used to examine the digestive tract, and they can help diagnose diseases of the esophagus, stomach and small intestine. The endoscope can look for abnormalities inside these organs and can take biopsies of tissues if needed.

Endoscopies can often also be used to remove foreign bodies pets ingested, eliminating the need for invasive surgery. Colonoscopies Colonoscopies are similar to endoscopies, but they examine inside of the rectum and colon. Colonoscopies look for abnormalities and signs of disease inside the rectum and colon and can take biopsies of tissues and/or remove polyps if needed. About Syosset Animal Hospital For the past 70 years, we have provided stellar veterinary care to the Syosset, NY community. Syosset Animal Hospital staff are dedicated to high-quality animal care, including cutting-edge disease prevention and illness healing. Laparoscopic Surgery - Cancer Treatments | CTCA Infographic Laparoscopic surgery Laparoscopic surgery is commonly called “minimally invasive” surgery because it involves smaller incisions than traditional open surgery. Incisions are typically 0.5-1 cm, compared with several inches for open surgery. Laparoscopic surgery may be a treatment option for cancer patients. Laparoscopic surgery is used for several types of operations, including: Gynecologic Spleen Intestinal Our surgeons use laparoscopic surgery to treat several cancers.

For example, we use it to remove gastrointestinal stromal tumors and other sarcomas located within the abdomen. Our surgeons may perform a laparoscopic cystectomy, a surgical procedure to treat bladder cancer by removing the entire bladder or portions of it. In addition, colorectal cancer patients may undergo a laparoscopic colectomy to remove the cancerous portion of the colon and nearby lymph nodes before the healthy ends of the colon are reattached. For the procedure, your stomach is inflated with carbon dioxide gas to create a visual field and enough room for your surgeon to work. At the outset, your surgeon makes a small incision near your belly button and inserts a special camera known as a laparoscope. The purpose is to make sure the operation can be done safely. Certain conditions, such as a large amount of inflammation, may obscure your surgeon’s view and require a larger incision to operate safely. Your surgeon then makes other small incisions, or ports, and passes instruments shaped like tubes through each port. These instruments are long and narrow, and have clamps, scissors and sutures at the end.

Your surgeon uses these instruments throughout the surgery to manipulate, cut and sew tissue while watching the video from the laparoscope on high-resolution monitors in the operating room. The advantages of laparoscopic surgery over open surgery may include: Shorter recovery time Less pain Less scarring In some situation, surgeons opt to create a port large enough to insert their hand during the operation. This technique is called hand-assisted laparoscopy. It requires a port larger than typical laparoscopic incisions, but still smaller than the incision made during open surgery. Surgical oncology Minimally invasive surgery - laparoscopic surgery Minimally invasive surgery Minimally invasive surgery – laparoscopic surgery Laparoscopy /videolaparoscopy/ surgery OVERVIEW Minimally invasive surgery (MIS), also known as videolaparoscopic or just laparoscopic surgery, is a surgical philosophy that calls for performing the most advanced operations through the least invasive incisions. Although countless attempts were made throughout history to limit the use of invasive procedures, it was only after the introduction of videolaparoscopy by Dr.

Camran Nezhat in the late 1970s and early 1980s that it became possible to perform advanced operations through tiny port holes instead of through large incisions. Videolaparoscopy (also called keyhole or Band-Aid surgery) is a surgical technique in which surgery is performed using special video cameras and light sources which are attached to the end of a long, thin (3-11mm thick) telescope-like tube called a laparoscope (also endoscope). To improve visualization and access to the organs, videolaparoscopy also requires that the abdominal cavity (belly) be inflated (distended) with carbon dioxide gas (CO2). This distention allows the laparoscope to be safely inserted through the belly button and into the abdominal cavity. One to three additional 5-10mm incisions are also made in the lower abdomen for inserting auxiliary instruments. These instruments are essentially extensions of the surgeon’s hands, allowing him or her to use them from outside of the body to perform surgery inside the abdominal cavity.

Instead of looking down at the patient, the surgeon is now able to watch the TV monitor and perform advanced laparoscopic surgeries off the monitor with excellent magnified visualization, while assuming a comfortable standing posture and with the least trauma to patients. The surgical team can also follow the entire surgery by watching the TV monitors as well. Today laparoscopic surgery has many applications, including the treatment of ovarian cysts , tubal reversal , endometriosis , infertility , management of fibroids , and hysterectomy . It also has an increasing role in gynecologic oncology . Prior to the advent of videolaparoscopy, all surgeries were performed using very large incisions. These large incisions were significantly more painful for patients, requiring several weeks of recovering, often involving several days of sedation with morphine and complete immobility in the hospital. Compared to minimally invasive surgery, large incision surgeries (laparotomy, thoracotomy, etc) are also associated with a greater risk of serious injury, infection, wound dehiscence, long-term disability, and higher incidences of mortality.

Because videolaparoscopy led to such a substantial reduction in these adverse outcomes, it has revolutionized modern-day surgery in every discipline and is now recognized as one of the most important surgical innovations of the 20th century. Dr. Camran Nezhat performing videolaparoscopy, circa 1980, and a few years later in the early 1980s. The inventor of modern-day minimally invasive (video-assisted) surgery Prior to videolaparoscopy, the old method of performing laparoscopy required that doctors bend over and peer through the laparoscope’s eyepiece, as is shown in the picture on the left from the late 1970s and a reenactment on the right. Because of this awkward positioning, laparoscopy’s utility was limited to diagnostics and a few very minor procedures. EVOLUTION OF VIDEOLAPAROSCOPY Pictured above is a side-by-side comparison, showing on the left a large abdominal incision held together by staples from traditional open surgery (laparotomy) and the tiny port holes used in minimally invasive surgery showing on the right. Reproduced with permission of Science Photo Library.

More examples of the large incisions and large scars made in traditional open surgery. LAPAROSCOPY MYTHS: There are many misconceptions among doctors and patients concerning laparoscopy, the most common of which are discussed HERE. Doctor Camran Nezhat is the inventor of videolaparoscopy and an internationally-renowned advanced laparoscopic surgeon, specializing in the minimally invasive (laparoscopic) treatment of severe endometriosis, fibroids, ovarian cysts, infertility, uterine malformations, and other uro-gynecological disorders Please email us at office@camrannezhatinstitute.com if you would like to receive additional medical articles about Minimally Invasive Surgery /Videolaparoscopic/Laparoscopic Surgery. Colon & Bowel Surgery - Center for Minimally Invasive Surgery - Dr. James Rifenbery - Tacoma, WA Colon, Stomach & Bowel Surgery Laparoscopic Colon, Stomach and Small Bowel Surgery: These structures are commonly known as the gastro-intestinal tract, or GI tract. After food is swallowed, it begins to be digested and broken down in the stomach.

Food then empties into the small intestine, where the nutritional part of the food is absorbed. The liver and pancreas add enzymes, which help with food breakdown and absorption. The remaining waste moves through the colon to the rectum and is expelled from the body . Surgery on these organs is necessary for a wide variety of problems, from tumors to obstructions, strictures, infections, and many other diseases. We have had very good results with laparoscopic surgery on the GI tract. We can often use 3 or 4 small incisions to perform most GI tract procedures. Following sucessful laparoscopic surgery, patients are often able to go home after only one or two nights in the hospital. With conventional open surgery, a 6 to 12 inch incision is often needed as well as a one week or longer hospitalization following the procedure. The latest innovation in GI tract surgery is the use of the surgical robot. We are now able to offer Robotic Surgery for a variety of GI problems. The robot can increase our precision, and new developments continue to improve the lives of our patients. The robot may be offered for selected patients and conditions. Please feel free to discuss this with your surgeon.

Stomach Surgery The stomach is a large pouch in the first portion of the intestinal tract. There are a varietly of problems that require stomach surgery. Several tumors, both benign and malignant, as well as a number of functional problems can be focused on the stomach. Fortunately, the majority of them are readily approached with laparoscopic surgery. Special diet changes are occasionally necessary following stomach surgery. Please see our recommended Post Gastrectomy Diet in the Patient Education section. Small Intestine The small intestine, is the site of a variety of problems, including blockages (obstruction), tumors, and other problems. Because of the great length of the small bowel, small lesions can often be removed without any adverse problems. Many of these problems can be repaired with laparoscopic techniques. Appendix The appendix is a small tubular structure that is attached to the end of the right colon. For such a small organ it causes an enormous amount of trouble. The appendix can easily become inflammed and infected. This results in acute appendicitis, which is a true surgical emergency. Several rare tumors can also appear in the appendix. Fortunately, the appendix serves no clear function, and removing it has minimal consequence.

The Colon The colon is the large intestine; it is the lower part of your digestive tract. The rectum is the final part of the colon. The colon and rectum absorb water and hold waste until you are ready to expel it. A variety of diseases affect the colon. Among the most common are Diverticulitis and Diverticulosis , which often affects the sigmoid colon, and colon cancer. Each year, more than 600,000 surgical procedures are performed in the United States to treat a variety of colon diseases. Although surgery is not always a cure, it is often the best way to stop the spread of disease and alleviate pain and discomfort. Colon Cancer If you’ve been diagnosed with colon cancer, the first thing you should know is that you’re not alone. It’s one of the most common types of cancer. And if it’s caught early, it’s also one of the most treatable. Colon cancer occurs when cancerous growths form in or around your colon. There can be a variety of symptoms depending on where it develops – from blood in your stool to weight loss to abdominal pain. Sometimes, there are no symptoms at all.

Treatment for Colon Cancer Your doctor will work with you to develop a treatment plan based on a number of factors, such as which part of the colon is affected and the stage the disease. Colon cancer treatment may include one or more of the following: Surgery Newer targeted therapies, such as monoclonal antibodies Colostomy and Ileostomy Occasionally an ostomy (bringing the colon or small bowel to the skin and attaching a bag) is required in colon surgery. These are called colostomies if from colon, or ileostomies if from small bowel. This is especially needed in emergency surgery, when operating on a dirty (un-prepped) or infected colon. Colostomies and ileostomies are most often temporary, and can be closed at a second surgery, usually after 3 months time. Special diets are often recommended following stoma surgery. Please see our Ileostomy Diet recommendations under Patient Education . LAPAROSCOPIC AND OPEN COLON SURGERY Patients undergoing open colon surgery can face a long recovery. Traditional open procedures are highly invasive. In most cases, surgeons are required to make a long incision. Surgery results in an average hospital stay of a week or more and usually 6 weeks of recovery.

Laparoscopic colon surgery allows surgeons to perform many common colon procedures through small incisions. Depending on the type of procedure, patients may leave the hospital in a few days and return to normal activities more quickly than patients recovering from open surgery. In most laparoscopic colon resections, surgeons operate through 3 or 4 small openings (each about a quarter inch) while watching an enlarged image of the patient's internal organs on a television monitor. In some cases, one of the small openings may be lengthened to 2 or 3 inches to complete the procedure. Laparoscopic Surgery - What Is It? - WI Colon & Rectal Clinic Laparoscopic Surgery – What Is It? Laparoscopic Surgery What is laparoscopic surgery? Laparoscopic or “minimally invasive” surgery is a specialized technique for performing surgery. In the past, this technique was commonly used for gynecologic surgery and for gall bladder surgery. Over the last 10 years the use of this technique has expanded into intestinal surgery. In traditional “open” surgery the surgeon uses a single incision to enter into the abdomen. Laparoscopic surgery uses several 0.5-1cm incisions.

Each incision is called a “port.” At each port a tubular instrument known as a trochar is inserted. Specialized instruments and a special camera known as a laparoscope are passed through the trochars during the procedure. At the beginning of the procedure, the abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the surgeon. The laparoscope transmits images from the abdominal cavity to high-resolution video monitors in the operating room. During the operation the surgeon watches detailed images of the abdomen on the monitor. This system allows the surgeon to perform the same operations as traditional surgery but with smaller incisions. In certain situations a surgeon may choose to use a special type of port that is large enough to insert a hand. When a hand port is used the surgical technique is called “hand assisted” laparoscopy. The incision required for the hand port is larger than the other laparoscopic incisions, but is usually smaller than the incision required for traditional surgery. What are the advantages of laparoscopic surgery? Compared to traditional open surgery, patients often experience less pain, a shorter recovery, and less scarring with laparoscopic surgery. What kinds of operations can be performed using laparoscopic surgery?

Most intestinal surgeries can be performed using the laparoscopic technique. These include surgery for Crohn’s disease, ulcerative colitis, diverticulitis, cancer, rectal prolapse and severe constipation. In the past there had been concern raised about the safety of laparoscopic surgery for ­cancer operations. Recently several studies involving hundreds of patients have shown that laparoscopic surgery is safe for certain ­colorectal cancers. How safe is laparoscopic surgery? Laparoscopic surgery is as safe as traditional open surgery. At the beginning of a laparoscopic operation the laparoscope is inserted through a small incision near the belly button (umbilicus). The surgeon initially inspects the abdomen to determine whether laparoscopic surgery may be safely performed. If there is a large amount of inflammation or if the surgeon encounters other factors that prevent a clear view of the structures the surgeon may need to make a larger incision in order to complete the operation safely. Any intestinal surgery is associated with ­certain risks such as complications related anesthesia and bleeding or infectious complications. The risk of any operation is determined in part by the nature of the specific operation.

An individual’s general heath and other medical conditions are also factors that affect the risk of any operation. You should discuss with your surgeon your individual risk for any operation. What is a colon and rectal surgeon? Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum and anus. They have completed advanced surgical training in the treatment of these diseases as well as full general surgical training. Board-certified colon and rectal surgeons complete residencies in general surgery and colon and rectal surgery, and pass intensive examinations conducted by the American Board of Surgery and the American Board of Colon and Rectal Surgery. They are well-versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions if indicated to do so. What is Laparoscopic Surgery? | Laparoscopic.MD Contact What is Laparoscopic Surgery? Today, laparoscopic surgery is a widely accepted surgical technique that uses small incisions and long pencil-like instruments to perform operations with a camera. As the incisions are much smaller than their open counterparts, recovery is faster and post-operative pain is typically less.

Procedures such as hernia repairs , gastric bypass , bowel resection , and organ removal are now routinely carried out laparoscopically. Minimizing Physiological Stress Laparoscopic approaches avoid large incisions on the skin and abdominal wall. These techniques avoid having the intestines exposed to the room air during surgery. While not fully understood, laparoscopic approaches cause less systemic inflammation and post-operative intestinal scar tissue. Laparoscopic surgery has successfully replaced open surgery as the preferred treatment option for issues such as bariatric surgery and gallbladder removal . In fact this surgery can now be performed as an outpatient operation. The treatment of gastroesophageal reflux disease is now carried out using minimally invasive techniques. Laparoscopic fundoplication offers the advantage of faster recovery and quicker return to oral ingestion of food. Laparoscopic surgery for weight loss has caught on in a big way. Laparoscopy has advanced sufficiently to the extent that it can be repeated for a patient who has undergone a previous laparoscopic operation. However, care needs to be taken than organs do not get injured and to this end the entry site may have to be different and an alternate entry technique may have to be used.

The risk to benefit ratio of laparoscopic surgery is improving continuously in favor of benefits. Historical Perspective for Minimally Invasive Surgery There is general consensus amongst medical historians that the first credibly recorded instances of endoscopy can be credited to the Arabian physician Albukasim (936-1013 A.D). Seven more centuries were to pass before any further developments in endoscopy. In 1805, physician Phillip Bozzini used an illuminated light chamber, a tube, and mirrors for reflection in order to explore the human urethra. He was able to view the urinary bladder and to visualize stones and neoplasms. Georg Kelling of Dresden, in present-day Germany, first used laparoscopes to view the peritoneal cavities of live dogs. Stockholm - born physician Hans Christian Jakobaeus was the first person to make use of a laparoscope on multiple human patients. He viewed different pathologies and he described conditions such as cirrhosis of the liver, metastatic cancer, and tuberculosis peritonitis. The growth of laparoscopy was dependent on developments in sources of light that did not cause burns and lenses that magnified and increased the field of view.

For example, in 1929, the introduction of a new lens system that permitted oblique (135°) viewing helped popularize laparoscopy in Europe. The advent of the dual trocar technique at around the same time gave a further fillip to diagnostic laparoscopy. The method enabled surgeons to both visualize the abdominal cavity and simultaneously to pass instruments into the cavities. Optics and Laparoscopy Advances in photography, optics, lighting, and access to the abdominal cavity have defined the development of modern laparoscopy as we know it today. The technique of "cold light" fiberglass illumination introduced by a team of French scientists in 1952 improved safety by eliminating the risk of intraperitoneal burns and electrical faults that took place when using intra-abdominal sources of light. The “cold light” came from an intense proximal light source outside of the abdominal cavity along a Light Source The importance of cold light is reinforced when an endoscope is seen transilluminating the esophagus during a myotomy. quartz rod to the distal end of an endoscope and it was intense enough to permit photographs to be taken.

The advent of flexible fiber-optic instruments can be traced to this development. The 60s and 70s saw gynecologic practitioners making wide use of laparoscopic techniques. German engineer and gynecologist Kurt Semm is credited with having contributed the maximum to developments in interventional minimally invasive surgical technique. An automatic insufflation device designed by Dr. Semm in 1977 enabled surgeons to monitor both gas flow and intra-abdominal pressure. Dr. Semm also developed techniques for knot tying and developed instruments that could execute the required maneuvers. He helped popularize procedures such as laparoscopic lysis of omental adhesions, bowel suturing, and tumor biopsy and staging. In 1981, Dr. Semm performed the first laparoscopic appendectomy. How Have Visual Tubes Evolved? Laparoscopic visual tools have evolved from endoscopy of which there is documented evidence that it was used as far back as 1806 to examine the canals and cavities of the human body.

The first attempt at laparoscopic examination of the peritoneal cavity was carried out in 1901 and the procedure was termed “Celioscopy.” The Laparoscope as an Instrument The black circular adapter shows where a video camera is hooked up to the laparoscope. Just to the right an angled tip of a 5mm scope can be seen. Laparoscopic scopes now encompass a wide variety of different technologies. In their simplest form, they can be seen as simple long tubes with a lens system that allows for a camera and a light source. Laparoscopic techniques continued to develop and by 1930s, doctors were performing diagnostic biopsies of abdominal organs under direct visualization. The seventies saw laparoscopic techniques being commonly used by gynecologists. However, its spread in general surgical practice was limited because it did not facilitate complex surgical procedures because of the limited field of view and the fact that the surgeon’s hands were occupied in holding the laparoscope. Thus, the year 1986 marks a watershed event in the evolution of laparoscopic surgery because it was in this year that the video computer chip was developed.

This development enabled surgeons to project magnified images onto television screens and it paved the way for newer and more complex applications of laparoscopy. We can consider the year 1987 to be the year which truly heralded the arrival of laparoscopic surgery. This is because it was in this year that the first laparoscopic cholecystectomy or gallbladder remova l was first performed. Surgical Dogma and Laparoscopy However in general surgeons were loath to accept laparoscopy as a genuinely useful form of surgery that needed further investigation and support. The reasons for this are not very clear but not having a clear field of vision during laparoscopy and surgical dogma that had existed for centuries are some of the reasons that slowed down the acceptance of this surgical technique. Limitation of Depth of Field and 2D View Also, one of the chief hindrances to the development of laparoscopic surgeries is that unlike open surgeries the field available to the surgeon is two dimensional. This makes it difficult to acquire a perception of the depth and the surgeon has to proceed with extreme caution. The issue can be further compounded if there is a lack of illumination and vision is restricted.

Visualization The Triangle of Calot is demonstrated during Laparoscopic Cholecystectomy. The gallbladder is being adequately retracted allowing the common bile duct to be definitively visualized Internal bleeding due to errors in depth perception can also be hard to control. In the late eighties and early 1990s, gynecology was performing laparoscopy on a basis more common than general surgery. However, in 1987 a laparoscopically performed cholecystectomy (gall bladder removal) gained much approval and by 1992 more than half of the over one-half million cholecystectomies done in the United States were being performed laparoscopically. These were the early surgical experiences with laparoscopy that helped surgeons understand and appreciate the potential benefits of laparoscopy such as a reduction in hemorrhaging so that the need for blood transfusion is reduced; incisions are smaller so that recovery time is short and there is less post-operative scarring; less pain so that less pain medication is required; less chance of internal organs being exposed to contaminants. Laparoscopic Suturing Laparoscopic approaches are now available for most abdominal operations in the proper context.

Intestine connections can even be hand-sewn using laparoscopic surgery. Laparoscopic Surgery in India: Benefits of Laparoscopy vs. Open Surgery | Columbia Asia India Laparoscopic Surgery: Benefits of Laparoscopy vs. Open Surgery Laparoscopic Surgery: Benefits of Laparoscopy vs. Open Surgery Laparoscopic surgery is commonly known as minimally invasive surgery (MIS). Small incisions are made in the abdomen and pelvic cavities to perform laparoscopy. As opposed to the traditional forms of surgery, minimally invasive surgery uses very small incisions to carry out the procedure. Similar procedures known as keyhole surgery are used for surgical procedures in the throat or chest cavity using TV monitors. Laparoscopy has been successfully used for diagnosis and treatment of a number of ailments such as Crohn's disease, endometriosis and ectopic pregnancy to name a few. The key to laparoscopic surgery is the use of an instrument called a laparoscope. It is a type of endoscope equipped with a light source, which enables visualization of organs in the abdomen. Laparoscopic surgery has provided relief to patients across the globe. This procedure has lesser recovery time than traditional open surgery.

Keyhole surgery results in reduced pain due to smaller incisions and quicker ambulation and return to normalcy. Continue reading to know more about laparoscopy. Laparoscopic Surgery Benefits Today, surgery has become a lot safer than what it used to be due to technological advances. Given below are a few benefits that laparoscopic surgery/minimally invasive surgery/ keyhole surgery offer: Laparoscopy results in reduced pain and shorter recovery period. This makes the surgery more acceptable to patients. Laparoscopic surgery is used as a diagnostic tool and treatment options for several diseases and other conditions such as ectopic pregnancy, endometriosis, Crohn's disease etc. It has become the method of choice for procedures such as laparoscopic cholecystectomy for gall stones, bariatric surgery, nephrectomy (removal of kidney), benign prostatic hyperplasia, other urological procedures for stones, strictures etc Laparoscopic surgery procedure offers reduced handling of internal organs. This automatically reduces infections as Columbia Asia Hospitals follows the strictest protocols of Infection control. Columbia Asia Hospital provides you with the latest facilities for laparoscopic surgery in India.

Apart from contemporary infrastructure we have surgeons who have trained in laparoscopic surgery in some of the best institutes in India and abroad. We have branches across India and you can call our helpdesk at any given hour for medical assistance. Fear of surgery and long term recovery can be alleviated by undergoing the procedures you need by undergoing them laparoscopically in the best of hands at Columbia Asia. Tags: Laparoscopic Surgery , Keyhole Surgery , Laparoscopy , Laparoscope , Open Surgery , Endometriosis , Throat , Chest Cavity , Incisions , Crohn's Disease , Minimally Invasive Surgery Laparoscopic Spine Surgery - A SAGES Wiki Article Laparoscopic Spine Surgery (see History tab for revisions) Category Discussion Your spine surgeon has determined that you need an operation for your back problem and feels that there would be a benefit to approach your spine from the front, through the abdomen. Most people are aware of back operations that are performed from the posterior approach, through the skin of the back, but are surprised when they are told they are going to have a back operation “from the front.” The spine (or back bone) can be reached from the front.

Although back operations from an anterior or front approach have been around for decades, they have usually be used for the more difficult and complex spine problems due to the need for a large abdominal incision. With the introduction of minimal invasive surgery (also known as laparoscopy), you surgeons can now perform a spine operation from the front without having to make a big incision. Your spine surgeon has recommended one of these minimally invasive techniques for you. This minimal invasive technique is called “Laparoscopic Anterior Spine Surgery.” The laparoscopic approach uses small puncture holes instead of long incisions. A special lighted telescope is inserted through one of these puncture holes projecting a picture on a television screen allowing your surgeon to see the spine. Additional puncture holes are used to allow other specialize surgical instruments into your abdomen to perform the operation. This brochure has been designed to help you better understand your laparoscopic spine operation. Why Go Through My Front (Anterior Approach) To Get To My Back? Your doctor has selected an anterior (front) approach to your spine rather than the posterior (back) approach.

A part of your operation requires the removal of a badly degenerated disc as well as attempting to get a fusion or bond between two vertebral bodies. The disc is a cushion or pad between the bones (vertebral bodies) of the spine. An “interbody fusion” is a bony bridge that “welds” the two vertebral bodies together to stop unstable motion. It is this unstable motion that is felt to be partially responsible for your back pain. The disc is actually located on the front part of the spine. Approaching the disc from the front avoids the need to move the spinal nerves and spinal cord out of the way to get to the disc from the posterior or back side. Surgery on the disc space from a posterior approach may cause long term pain due to: Manipulation and retraction of the nerve roots which can injure or damage the nerves. Bleeding around the nerve roots which can produce scar tissue that can lead to pressure on the nerve. Are There Other Advantages To The Anterior Approach? Inter-vertebral disc height (the space between the two vertebral bodies is left after the disc is removed) may be better restored with the anterior approach.

Restoring this space opens up the neural foramen (the openings in the spine that allow the nerves to leave the spinal cord) taking pressure off of the nerve roots. Removal of bone from the spine (which is necessary from the posterior approach and can be destabilizing) is not necessary. The normal anatomy the spine is preserved since the frontal approach takes advantage of normal tissue planes and does not require removal of any bone. What Are The Advantages Of The Laparoscopic (Minimally Invasive) Approach? The advantages of the minimally invasive or laparoscopic technique are: Small incisions and little blood loss Less post-operative pain and need for pain medication Earlier discharge from the hospital Shorter post-operative disability at home Why Do I Need Another Surgeon Who Is Not A Spine Surgeon? Whereas your spine surgeon has the expertise to diagnose and treat your spine problem, the laparoscopic surgeon has the expertise to approach the spine using minimal invasive techniques. By combining the expertise of both surgeons, your surgical team can afford to offer you the best chance at a safe and efficient laparoscopic operation.

The co-surgeon is a general surgeon known also as a laparoscopic surgeon who: Is accustomed to working with non-bony structures such as major blood vessels and intestines that are in front of the spine. Can assist the spine surgeon with some parts of the operation, such as obtaining bone for the bone grafts. Is present during your operation to both assist the spine surgeon and protect the vital structures in the vicinity where the spine surgeon is working. What Other Treatment Options Are Available? Treatments for back pain include: Rest Microsurgery What Preparation Is Required? Preoperative preparation includes blood work, medical evaluation, chest x-ray and an EKG depending on your age and medical condition. After your surgeon reviews with you the potential risks and benefits of the operation, you will need to provide written consent for surgery. Blood transfusion and/or blood products may be needed depending on your condition. It is recommended that you shower the night before or morning of the operation. Your surgeon my request that you completely empty your colon and cleanse your intestines before surgery. Usually, you must drink a special cleansing solution. You may be requested to drink clear liquids, only, for one or several days prior to the operation.

After midnight the night before the operation, you should not eat or drink anything except medications that your surgeon has told you are permissible to take with a sip of water the morning of surgery. Drugs such as aspirin, blood thinners, anti-inflammatory medications (arthritis medications) and Vitamin E will need to be stopped temporarily for several days to a week prior to surgery. Diet medication or St. John’s Wort should not be used for the two weeks prior to surgery. Quit smoking and arrange for any help you may need at home. How Is The Operation Performed? Minimally invasive operations are done by using small tubes, known as cannula ports, that are placed through the skin and into the abdomen. These cannulas have inlet valves that allow the surgeon to inflate the abdominal cavity with carbon dioxide gas. This gas creates a bubble that allows room for the surgeon to see and perform surgery. The surgeon looks through a special lighted telescope that is connected to a video-TV camera which is put through one of the cannulas. Other cannulas are needed to allow various instruments to be inserted into the abdominal cavity. The number of cannula ports needed is dependent on the number of instruments required to perform the operation.

The cannulas are only 1/4 to 1/2 inch in size. Sometimes a longer incision measuring 2-3 inches is needed for other special instrumentation. Your surgeons will decide on the number and size of the incisions. Are There Different Types Of Laparoscopic Spine Operations? More than one type of minimally invasive technique has been developed for access to the anterior lumbar spine. The techniques differ not only in the approach, but in the spine instrumentation that is used to stabilize the spine. The technique chosen is based on many factors including individual surgeon preference and site (level) of the lumbar spine surgery. Some surgeons select a direct access into the abdominal cavity, known as a transperitoneal approach, and move the internal organs away from the spine. Another technique, the retroperitoneal approach, is when the operation is done from behind the muscles so the spine is actually reached by going around the internal organs. The placement, number and size of the incisions and cannula portals all depend on factors individualized for each patient. What Happens If The Operation Cannot Be Performed Or Completed By The Laparoscopic Method? In a small number of patients the laparoscopic method does not work effectively.

Factors that may increase the possibility of choosing or converting to the “open” procedure may include: Obesity Bleeding during the operation More than one lumbar disc level and which lumbar disc level The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. The decision to convert to an open (conventional) procedure is based on patient safety. What Should I Expect After Surgery? After the operation it is important to follow your doctor’s instructions. Remember, your body needs time to heal. You should check with your spine surgeon and co-surgeon about scheduling a follow up appointment, diet and what type of activity you should engage in. What Complications Can Occur? Since minimal invasive surgery is still “major” surgery, all the usual complications such as heart attack, stroke and even death are rare but possible. Most of those risks are related to the general anesthesia and being put to sleep. Complications specific to the spine surgery are related to blood vessels, small nerves and other structures that lie in front of the spine and are at risk of being injured. Injuries to the intestine and urinary bladder may occur. Infection of the incisions or to the spine is rare, but can occur.

With any operation, blood clots can form in the legs and may even spread to the lungs causing lung problems. Working near large blood vessel in front of the spine and needing to move these blood vessels aside makes these complications more likely. The occurrence of any of these complications may require additional surgical or non-surgical treatment. Retrograde ejaculation is reported to occur in 2-4% of men who undergo the anterior approach to the spine. This rare complication is due to disturbing the small sympathetic nerves that control normal ejaculation. With retrograde ejaculation, erection and ejaculation do occur, but the sperm and semen is discharged into the urinary bladder rather than going out the penis. In women, these same nerves control vaginal lubrication. Men who are considering anterior spine surgery but have not finished building a family may wish to consider donating sperm for storage in a sperm bank prior to their operation. Your surgeons will take those measures to minimize the occurrence of any of these complications. When To Call Your Doctor Be sure to call your doctor if you develop any of the following: Persistent fever (over 100 degrees Fahrenheit or 39 degrees Celsius) Bleeding Laparoscopic Surgery | Dr.

Anthony Brignoni Cosmetic Surgeon Gynecologist Obstetrician Pelvic reconstruction Surgeries for urine incontinence Most women will spend considerably less time in the hospital and will be back on their feet much more quickly than in the past because laparoscopic surgery is less invasive than most traditional gynecological operations which are known as open surgery. The majority of patients will go home the day of surgery. In an open surgery, a surgeon uses a single incision to enter the abdomen. Laparoscopic surgery uses several 0.5-1 centimeter incisions. Each incision is called a port. In each port a tubular instrument known as a trocar is inserted. The Laparoscope, a specialized camera, is passed through the trocars during the procedure. At the beginning of the procedure, the abdomen is inflated with carbon dioxide gas to provide a working and viewing space for the surgeon. The laparoscope is passed through the trocars, via ports into incisions in the abdomen. The laparoscope then transmits images from the abdominal cavity to high-resolution video monitors in the operating room. During the operation, Dr. Brignoni watches detailed images from and of the abdomen over a large screen monitor. This system allows Dr.

Brignoni to perform the same operations as in a traditional surgery but through the use of smaller incisions. Occasionally a surgeon may choose to use a larger, specialized type of port which is large enough to insert a hand. When this hand port is used the surgical technique is called “hand-assisted” laparoscopy. The incision required for the hand port is larger than for the other laparoscopic incisions, but is usually smaller than the incision required for traditional surgery. This occurs only in very rare cases. The Advantages of Laparoscopic Surgery Compared to traditional open surgery, patients often experience less pain, a shorter recovery, aesthetic incisions, and less scarring with laparoscopic surgery. The Safety of Laparoscopic Surgery Laparoscopic surgery is as safe as a traditional open surgery. The surgeon initially inspects the abdomen to determine whether laparoscopic surgery may be safely performed. If there is a large amount of inflammation or if the surgeon encounters other factors that prevent a clear view of the structures the surgeon may need to make a larger incision in order to complete the operation safely.

At the beginning of a laparoscopic operation the laparoscope is inserted through a small incision in or near the belly button (umbilicus). You will discuss with Dr. Brignoni your individual risk for an operation. He will explain that your general heath and other medical conditions factor into the risk of any operation. Any surgery carries certain risks including complications related to bleeding, anesthesia or infectious complications. Hysterectomy A hysterectomy is one of the most common gynecological and laparoscopic surgeries. So how do you know and what will determine whether you are a candidate for a Laparoscopic Hysterectomy or a Traditional Hysterectomy? There is a comparison of the surgical time frame and recovery periods for a traditional hysterectomy vs. a laparoscopic hysterectomy: Pelvic inflammatory disease Cancers of the ovaries, uterus, cervix or fallopian tubes Heavy periods lead to a loss of a large amount of blood every month, leading to an adverse impact on the physical and social life of a woman. When all other treatments have proven ineffective, removing the uterus is one of the possible solutions available to women.

Abnormal bleeding and long-term pelvic pain may be symptoms of uterine fibroids, which are benign tumors of the uterine wall, often found in women who are in their mid- to late 40s and beyond. Fibroids may remain asymptomatic for years or cause painful and heavy menstruation, urinary frequency, urinary urgency and pain during sexual intercourse. A hysterectomy may bring relief from all of these symptoms and can improve the quality of life for a woman suffering these symptoms or conditions. Endometriosis is a condition where the inner lining of the uterus (called endometrium) shows abnormal growth outside the uterus. This condition is most common in their child-bearing years. The symptoms of Endometriosis depend on the area of proliferation, but the major symptom is chronic pelvic pain. Other symptoms include urinary frequency and urgency, painful sex, constipation and chronic fatigue. Endometriosis may also cause infertility. In women who do not wish to bear more children, a hysterectomy, with or without removal of the ovaries, may bring long-term relief from symptoms. Uterine Prolapse is a condition where the uterus, and sometimes the vaginal wall, loosens from its normal position and projects into the vagina.

It is also called pelvic organ relaxation, as the ligaments that hold the uterus in position become weak and relaxed, thus causing it to drop down into the vagina. It is commonly caused by childbirth, particularly during a difficult birth. It is seen most often in women past the child-bearing years. In Uterine Prolapse when the uterus is out of position, it can put pressure on other pelvic organs, like bowel or bladder, giving rise to a number of symptoms such as abdominal or back pain, protrusion of tissue from the vagina, excessive vaginal discharge, frequent bladder infections, urinary frequency, urgency and incontinence, constipation and painful sexual intercourse. In such a condition, removal of the uterus through a hysterectomy relieves the associated symptoms and it is the often a treatment of choice made by women who are no longer within child-bearing years. Pelvic Inflammatory Disease (PID) refers to acute or chronic inflammation of various pelvic structures in women including the fallopian tubes and the ovaries. Infections may occur during sex, childbirth or abdominal surgery. If untreated, it can spread further into the reproductive system and cause infertility.

Symptoms of PID include lower abdominal pain, backache, low grade fever, heavy periods, painful sex and discomfort during urination. In case there is severe damage and other associated conditions like fibroids, a hysterectomy may be performed to remove all infected areas. Cancer of the female reproductive organs remains a leading reason for performing a Hysterectomy. In many cases there are few if any alternative procedures and a Hysterectomy becomes a life saving procedure that may also often include the removal of fallopian tubes and ovaries also known as an oophorectomy. A Hysterectomy is sometimes chosen as an elective treatment by women who have a strong family history of cancers of the reproductive system and who want to partake in a preventative measure. A Hysterectomy can correct serious chronic problems which impede normal functioning and can markedly improve the quality of life and in some preventative cases be used to save a woman’s life. How Laparoscopy Is Performed A laparoscopic surgery most commonly is an outpatient procedure that is completed while the patient is under a general anesthesia.

A small incision is made usually below or inside the umbilicus (belly-button) and carbon dioxide gas is then put into the abdomen after inserting a special needle through the umbilicus. After an adequate volume of gas is insufflated into the abdominal cavity, the surgeon removes the needle and inserts a trocar. A trocar is a specially designed tube that is 5 or 10 mm in diameter with a valve through which a surgeon can insert special instruments—in this case the laparoscope. The laparoscope is then placed through the trocar sleeve in the umbilicus. The volume of gas in the abdomen allows the pelvic organs to be seen more clearly via the laparoscope. At this point, a patient’s body will be tilted slightly on the operating table with the feet raised higher than the head. This shifts some of the abdominal organs into the upper abdomen and out of the way. Additional incisions are made just at the pubic hairline and in the left and right lower abdomen. The procedure is completed through these small incisions using special surgical instruments. A device called a uterine manipulator may be placed in the uterus through the vagina to move the uterus during the procedure.

Following the procedure, the instruments are removed and the gas is released. The incisions are then closed with sugical glue and/or steri-strips or with stitches that dissolve. Types of Hysterectomy Total Hysterectomy As the name suggests, a traditional abdominal hysterectomy involves complete removal of the uterus. In an open surgery procedure, a five-inch incision is made into the abdominal wall. Through this opening, the surgeon removes the uterus, including the cervix. This procedure requires a three- to five-day hospital stay. There is a noticeable scar and recovery time is generally six weeks. Partial Hysterectomy A partial or supracervical hysterectomy involves removal of the body of the uterus, while the cervix is left intact. Dr. Brignoni may determine you as a candidate for a minimally invasive laparoscopic hysterectomy (using small incisions), which means you will experience a shorter hospital stay, a faster recovery, and less pain and scarring than you would if you have a total abdominal hysterectomy. Minimally Invasive Hysterectomy Procedures 1. Vaginal Hysterectomy The first type of minimally invasive hysterectomy method involves what is known as a vaginal hysterectomy.

An incision is made at the top of the vagina, through which the uterus, including the cervix, is separated from surrounding tissue and then taken out through the vagina. This small vaginal incision heals quickly, and usually won’t leave an external scar. There is little discomfort since the abdominal muscles are not stretched during the procedure. This surgery takes one to two hours and requires a hospital stay of about one to three days with a recovery time of approximately six weeks. 2. Total LaparoscopicHysterectomy Dr. Brignoni performs this minimally invasive procedure with three small 5 mm incisions in the abdomen. The surgery is accomplished totally with laparoscopic approach. Dr. Brignoni uses specialized instruments inserted through small 5mm incisions, to detach the uterus, which is then removed through the vagina. Vaginal cuff is also sutured laparoscopically. Patient usually leaves the same day of surgery and may return to work in 1-4 weeks depending on work requirements. 3.

Laparoscopically-Assisted Vaginal Hysterectomy A laparoscopically-assisted vaginal hysterectomy procedure differs from the Total Laparoscopic Hysterectomy in the the last 50% of the procedure is accomplished vaginally. It can be performed using advanced minimally invasive techniques. 4. Laparoscopic Supracervical Hysterectomy Here, Dr. Brignoni uses laparoscopic tools, inserted through small 5mm incisions, to separate the uterus from the cervix. The uterus is then removed (morcilated into small pieces) through one of the small abdominal incisions. In this surgery, the cervix remains, which means there is no vaginal incisions and recovery is much faster, 3-4 weeks. The procedure usually takes one to two hours and patients usually go home the same day of the procedure. Whether you take the cervix out or it remains, annual Pap smears should still be done, especially with a history of previously abnormal Pap smears. Radical Hysterectomy A Radical Hysterectomy is usually performed when cervical cancer is involved. There is a removal of the cervix, the uterus, the upper part of the vagina, and supporting tissues, including the lymph nodes.

This procedure is usually done by a gynecologist who specializes in cancer (a Gyn Oncologist). Bilateral Salpingo-Oophorectomy This procedure involves the removal of the ovaries and fallopian tubes. This procedure can be done at the time of the hysterectomy. As a result, the patient will go through what is known as surgical menopause. A patient may or may not choose to use estrogen replacement therapy. Copyright © 2013 ~ Dr. Brignoni MD. All Rights Reserved. Minimally Invasive Benign Hysterectomy - Full Text View - ClinicalTrials.gov Study Record Detail Minimally Invasive Benign Hysterectomy The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years. Verified May 2013 by Region Skane.

Recruitment status was: Recruiting Information provided by (Responsible Party): Celine Lönnerfors, Region Skane First received: April 8, 2013 Last updated: May 30, 2013 Last verified: May 2013 How to Read a Study Record Purpose A randomised controlled trial comparing hysterectomy by minimally invasive surgical methods; robotic hysterectomy versus vaginal hysterectomy or traditional laparoscopic hysterectomy; outcome and cost analyses. Procedure: Vaginal or laparoscopic hysterectomy Study Type: Primary Purpose: Treatment Official Title: Benign Hysterectomy; a Randomized Controlled Trial Comparing Robotic Hysterectomy With Vaginal Hysterectomy and Traditional Laparoscopic Hysterectomy Resource links provided by NLM: Further study details as provided by Region Skane: Primary Outcome Measures: Cost of surgery [ Time Frame: 4 months ] The cost of surgery includes the actual surgery (anaesthesia, OR-nurse, circulating nurse, doctors and use of the OR) as well as the length of the inpatient stay.

The cost for conversions to open surgery, reoperations, readmissions, and any additional cost associated with additional procedures or medical interventions such as radiological examinations and blood transfusions. Based on the estimated cost of surgical material, use of the operating room and cost of anaesthesia each benign hysterectomy performed with robotic surgery would need to be 50 minutes shorter than other minimal invasive procedures to compensate for the additional cost. Secondary Outcome Measures: Patient outcome [ Time Frame: 4 months ] The number of patients in whom an intraoperative or postoperative complication occurs as well as the seriousness of the complication which occurs and what this entails for the patient in question. This includes conversions to open surgery as well as the need for reoperation and readmission. Other Outcome Measures: Social cost [ Time Frame: 4 months ] The length of postoperative sick leave and reasons for extending sick leave and cost thereof. Estimated Enrollment:

Question: Laparoscopic, or minimally invasive surgery, is more commonly known by what name?
Answer: Keyhole surgery