Laparoscopic surgery evolves with Da Vinci
Many advances, such as the Da Vinci robotic surgical system, have been made in the field of laparoscopic surgery. Laparoscopic surgery is an advanced and specialized surgical technique that allows surgeons to perform minimally invasive, life saving procedures in the abdominal region. Until recent years, laparoscopic surgery was generally reserved for gall bladder procedures and gynaecologic conditions, but in the past decade laparoscopic procedures have also been employed for intestinal surgeries.
There is a stark contrast between conventional open surgery and laparoscopic surgical procedures. The old, conventional method involves a single, yet rather invasive, incision to access the abdominal organs, while the laparoscopic technique uses multiple incisions, called “ports,” which measure 0.5-1cm in size. During a laparoscopic procedure, the surgeon relies on specialized instruments, such as a trocar, cannula and a laparoscope, which are inserted into the ports in order to perform surgery.
To allow the laparoscopic surgeon sufficient space to conduct the procedure, the patient’s abdomen is inflated with carbon dioxide gas. The laparoscope then relays images from the abdominal cavity to high-resolution video monitors by way of an advanced digital camera system located in the operating room. Throughout the procedure, the surgeon observes detailed images of the abdominal structures on the monitors; this enables one to perform the same operations formerly achieved with conventional surgery, except in a less invasive manner. Occasionally, however, situations may require the laparoscopic surgeon to make a somewhat larger port called a “hand port” to facilitate insertion of the surgeon’s hand. These hand ports are usually around 5.5 cm, making them larger than a typical port but still smaller than the incisions made during conventional open surgery.
While laparoscopic procedures are certainly more sophisticated and desirable than conventional surgeries, they have been around for quite some time and are due for further advancements, such as the previously mentioned Da Vinci robotic system. Da Vinci is a computerized, robotic system that further reduces invasiveness, increases precision and offers improved visualization when compared to standard laparoscopic techniques.
Operations performed with the Da Vinci System involve no direct mechanical connection between the surgeon and patient. The surgeon actually works a few feet from the operating table while seated at a computer console with a 3D view of the surgical area. The surgeon operates two electronic instruments, similar to joysticks, to control the system’s two robotic arms. The robotic arms are designed with highly specialized instruments possessing hand-like movements which carry out the surgery. The steady robotic arms can help to prevent medical errors that otherwise could have resulted from any hand tremors experienced by a surgeon, while they also provide motion scaling to enable extremely precise movements within the patient’s body.
Patients who can afford and have access to laparoscopic surgery often report less pain, minimal scarring and faster recovery than those who endure conventional abdominal surgeries. Additionally, laparoscopic surgery is no longer limited to gynaecology or gall bladder surgery, and can now be used for a wider range of conditions such as appendectomy, several intestinal diseases and injuries, rectal prolapse and certain cancers.
While laparoscopic surgery is well tolerated and even preferred by many patients, it isn’t for everyone. If excessive inflammation is present, or if the surgeon identifies other risk factors that prevent a proper view of the structures and organs, then a laparoscopic procedure may have to be converted to conventional surgery.