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Laparoscopic surgery is minimally invasive performed after inflating the abdomen with gas, usually carbon dioxide, which creates a space between the wall of the abdomen and the organs inside. Using short incisions in the skin, narrow tubes are inserted into the abdominal wall so that instruments can be passed through them to perform the maneuvers necessary for the operation. All this is viewed directly on a video monitor, which receives its picture from a video camera attached to the laparoscope. With these techniques, surgery to the gallbladder, stomach, intestines, kidneys and other organs is possible. What are the benefits of laparoscopic surgery? The advantages of laparoscopic surgery come from minimizing the trauma of access to internal organs. By avoiding a long incision through the muscles, many post-operative problems are eliminated and pain is markedly reduced. This enables you to breathe and cough better. Use of strong pain medications is drastically reduced so the drowsiness, fatigue and unsteadiness they cause are minimized. What are the risks of laparoscopic surgery? All surgery carries some risk. Those, which are the most important for you to know about, are mentioned here. Most of the complicated laparoscopic procedures which we perform require full general anesthesia to allow enough relaxation of the muscles of the abdominal wall so that the operative space to work in is large enough. Modern anesthesia is very safe and the anesthesiologists at NYU are all highly skilled, board certified physicians. Naturally they will need to be fully informed of any medical disorders that you may have or problems with anesthesia in the past. It is especially important that if you have any heart problems, your regular physician can send copies of old EKGs and information about any other tests that you may have had. Bleeding and infection can complicate any operation. If an operation has been performed through a large incision, a hernia (or muscle defect) can develop in the wound days, months or years later. Thrombosis and pulmonary embolus (clots to the lungs) are an ever present risk. It has been our experience that these complications are much less frequent after laparoscopic than conventional surgery. Even in traditional surgery, each operation has a specific complication that every surgeon strives to avoid. These potential pitfalls are still present when the operation is performed laparoscopically and will be outlined to you, depending on the type of procedure you require. Occasionally, difficulties are encountered during surgery that cannot be managed laparoscopically. This may be suspected before the operation and confirmed with the laparoscope. If so, conversion to a conventional procedure is for your safety. What are the alternatives to laparoscopic surgery? Most patients come to us for laparoscopic surgery, although we have an extensive background in traditional surgery. Much of the discussion of alternative forms of treatment will have taken place before coming to see us. If we feel that your best interests will not be served by laparoscopic surgery we will tell you so and suggest an appropriate alternative. What to expect after your surgery As early as the evening following surgery you should be able to sit in a chair or even walk around your bed. You will be expected to go to the bathroom and back to bed with minimal assistance. After many types of surgery you will be drinking clear liquids immediately and advance to a light regular diet the next day. The need for pain medication varies a lot from person to person but usually after a few doses of a strong agent like Percocet it will be possible to control discomfort with acetaminophen(Tylenol), ibuprofen (Advil, Motrin) or equivalent drugs. Prolonged use of narcotic analgesics (such as Percocet or Tylenol with codeine) should be avoided, as they cause severe constipation that may be more distressing than the discomfort being treated. Avoid driving the car if there is any abdominal soreness that may prevent you from reacting quickly in an emergency, or if you are still taking strong pain-killers. You will return home with adhesive tape on your wounds. It is quite safe to shower with these in place. Leave them be till you are seen in the office again. Dissolving stitches are usually used so there will be nothing to remove except the tape. It is normal for a painless, firm bump to develop under each scar. This just indicates sound healing and disappears in about a month. You are encouraged to return to normal activities as soon as possible. It is vital that you get as much reasonable exercise as you can tolerate in the early post-operative period to stimulate the circulation and breathing. It is very difficult to disrupt any of the surgery so do not be afraid that you will do yourself harm. Body Mass Index: Weight alone is insufficient to define obesity. Height must be added to the calculation. For more information click here. |
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