Minimal Access surgery or Laparoscopic surgery
In minimally invasive or minimal access surgery, surgeons use a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows you to recover faster and heal with less pain and scarring. Minimally invasive surgery is usually requires only a short hospital stay.
One type of minimally invasive surgery is Laparoscopy - surgery done through one or more small incisions, using small tubes and tiny video cameras and surgical instruments. This was one of the first types of minimally invasive surgery. Another type of minimally invasive surgery is robotic surgery. It provides a magnified, 3-D view of the surgical site, which gives the surgeon great precision, flexibility and control.
Continual innovations in minimally invasive surgery make it useful for an ever-expanding list of procedures.
Our Minimally Invasive Surgery Division is one of the centers performing the largest number of laparoscopic surgeries in the country, performing not only basic laparoscopic surgery but also most of the advanced laparoscopic procedures like laparoscopic esophageal surgery, gastric resections, colorectal surgery, pancreatic surgery and small bowel surgery. We have a state of the art Aida Touchscreen facility, and DVD recording facility and a newer version of the Harmonic Scalpel for bloodless surgery, as well as the latest in robotic techniques and equipment's. Fully equipped laparoscopic suites, which are also equipped with advanced equipment like Argon laser, endoscopic stapling devices and endoscopic suturing devices are found in most of our hospitals.
Minimal access procedures in gastroenterology
- Lap cholecystectomy
- Lap common bile duct exploration for stone disease
- Lap appendectomy
- Laparoscopic hernia repair
- Diagnostic laparoscopy for the evaluation of obscure abdominal symptoms,
- Pain or ascites
- Lap assisted colorectal resections for cancer
- Lap liver surgeries for cystic diseases of the liver
- Lap small bowel surgeries
- Lap myotomy for Achalasia Cardia
- Lap splenectomy
- Lap cysto-gastrostomy
- Lap bariatric surgery
Minimally invasive Cholecystectomy or Laparoscopic cholecystectomy
The surgery to remove the gallbladder is called a cholecystectomy. The gallbladder is removed through a 5 to 8 inch long incision, or cut, in your abdomen. During an open cholecystectomy, the cut is made just below your ribs on the right side and goes to just below your waist.
Laparoscopic cholecystectomy is a less invasive way to remove the gall bladder. This surgery uses a laparoscope.
A laparoscope is a small, thin tube that is inserted into the body through a tiny cut made just below navel. The surgeons visualize the gallbladder on a television screen and do the surgery with tools inserted in three other small cuts made in the right upper part of your abdomen. The gallbladder is then taken out through one of the incisions.
With laparoscopic cholecystectomy, there is lesser stay in hospital, less pain after surgery, and a shorter recovery time. Surgery to remove the gallbladder with a laparoscope does not require that the muscles of your abdomen be cut, as they are in open surgery. The incision is much smaller, which makes recovery quicker.
Minimally invasive or Laparoscopic Appendectomy
The appendix is a long narrow tube (a few inches in length) that attaches to the first part of the colon. It is usually located in the lower right quadrant of the abdominal cavity.
Appendicitis is one of the most common surgical problems. One out of every 2,000 people has an appendectomy sometime during their lifetime. Treatment requires an operation to remove the infected appendix.
Traditionally, the appendix is removed through an incision in the right lower abdominal wall.
In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each ¼ to ½ 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 complete the procedure.
With laparoscopic appendectomy, there is lesser stay in hospital, less pain after surgery, and a shorter recovery time.The incision is much smaller, which makes recovery quicker and return of normal bowel function is also quicker.
Other gastrointestinal surgeries
A hernia occurs when an organ, intestine or fatty tissue squeezes through a hole or a weak spot in the surrounding muscle or connective tissue. Hernias often occur at the abdominal wall. Sometimes a hernia can be visible as an external bulge particularly when straining or bearing down.
Types of Hernias
Inguinal: occurs in the inner groin
Femoral: occurs in the upper thigh/outer groin
Incisional: occurs through an incision or scar in the abdomen
Ventral: occurs in the general abdominal/ventral wall
Umbilical: occurs at the belly button
Hiatal: occurs inside the abdomen, along the upper stomach/diaphragm (For discussion of hiatal hernias, see Gastroesophageal Reflux Disease (GERD)
Most hernias are caused by a combination of pressure and an opening or weakness of muscle or connective tissue. The pressure pushes an organ or tissue through the opening or weak spot. Sometimes the muscle weakness is present at birth but more often it occurs later in life. Anything that causes an increase in abdominal pressure can cause a hernia, including obesity, lifting heavy objects, diarrhea or constipation, or persistent coughing or sneezing. Poor nutrition, smoking, and overexertion can weaken muscles and contribute to the likelihood of a hernia.
Your surgeon will watch the hernia and make sure that it is not getting larger or causing problems.
Laparoscopic - The surgeon makes several small incisions in the abdomen that allow surgical tools into the openings to repair the hernia. Laparoscopic surgery can be performed with or without surgical mesh.
Open Repair - The surgeon makes an incision near the hernia and the weak muscle area is repaired. Open repair can be done with or without surgical mesh. Open repair that uses sutures without mesh is referred to as primary closure. Primary closure is used to repair inguinal hernias in infants, small hernias, strangulated or infected hernias.
Gastric and Oesophageal Surgery
Our surgeons perform the entire range of gastrointestinal operations related to the food pipe [esophagus] and the stomach, using open, laparscopic and robotic options as appropriate. The following diseases are treated:
- Gastric Cancer - Resections for gastric and gastro-esophageal junction cancers, for both curative and palliative goals, including gastrectomy with extended lymph node dissections.
- Esophageal Cancer - Our surgeons work closely with the Oncologists and the Transthoracic and transhiatal oesophagectomies are also performed regularly. Inoperable patients are offered palliative treatment through expandable metallic stents or endoscopic feeding gastrostomies.
- Achalasia Cardia - After the esophageal motility tests Laparoscopic myotomy is often the surgery of choice for these cases
- Gastro Esophageal Reflux Disease - After the esophageal motility tests, Minimally invasive anti-reflux surgery is performed.
- Ulcers - With modern medication, ulcers do not usually need anything other than medical management. But when they are needed, appropriate surgical therapy is provided.
Small Intestine and Colorectal Surgery
The surgeries commonly performed are:
- Colorectal Cancers - Low anterior resections and stapled pouch anastomosis are surgeries carried out for treating cancers of the colrectal region. Sphincter preservation is always given maximum attention. Laparoscopic and robotic colorectal resections are done regularly.
- Appropriate surgical interventions and management of fistulas.
- Rectal Prolapse - Rectal prolapse is managed surgically by Laparoscopic Rectopexy.
- Perianal Conditions - Stapler hemorrhoidectomy is offered to patients at their choice, avoiding the painful and prolonged convalescence after piles surgery.
- Anal Sphincter Reconstruction and Augmentation - Reconstruction of anal sphincter with muscle transfer procedures are done for patients with incontinence due to traumatic injuries to the sphincter.
- Polyposis Syndrome - Patients with polyposis syndrome are often treated with sphincter-preserving procedures like Ileal Pouch Anal Canal Anastomosis.
- Inflammatory Bowel Diseases - Inflammatory bowel disease like ulcerative colitis and Crohn's Disease are really the realm of medical gastroenterology, but complicated IBD needs surgical care in certain cases.