What Is Laparoscopy Surgery?

Hello friends,

I am Dr. Dilip S Rajpal. I am a general and laparoscopic surgeon. I specialize in single incision laparoscopic surgery. Before single incision laparoscopic surgery, what is laparoscopic surgery? laparoscopic surgery is a minimally invasive surgery in which surgery is done exclusively through minimal holes in the abdomen ranging from 0.5 to 1 centimeter, typically around three to four holes are made and in any laparoscopic surgery we need minimum 3 holes and we need to put one camera which is connected to TV for visualization of what is going inside the abdominal cavity. Second will be to hold the tissue and third will be to cut the tissue. Now we specialize in something called single incision laparoscopy, so this is a new advanced minimally invasive surgery in which instead of three holes or four holes we do exclude this complete surgery in a single hole and that would typically from the patient's navel. Now who does this particular surgery? so this is the advanced surgery it has a long learning curve so because it is advanced and the surgeon who is doing it should have an expertise about the laparoscopic surgery, so that is a main indication of this thing.

Now what all surgeries can be done? In today, the most common surgery what can be offered is what we call SILS (single incision laparoscopic surgery). SILS cholecystectomy, a gallbladder stone disease that is the most commonest of the surgeries. Of course indication-wise we do SILS appendectomy, we do SILS diagnostic laparoscopy, SILS mesenteric lymph node biopsy. In best of the Centers it is done for any disease including that of bariatric surgeries also. Today the main advantage of this particular surgery is that the single hole in the navel and the size is hardly 2 centimeters because we take inverted stitches, patient gets a waterproof dressing, so patient has a feeling that he has never been operated, though psychologically patient doesn't have any pain per se and because there is a single hole obviously the chances of complication, wound infection, herniation everything is very low.

We use all normal conventional instruments, here again there are two parts, one is either using conventional instrument or using something called SILS port. SILS port is a disposable port which is slightly expensive and it costs around twenty thousand rupees per patient. Now we are doing by conventional surgery in which we use the normal conventional instruments so there is no extra cost burden to the patient and with the same common instruments we can complete the surgery so definitely the cost part also doesn't increase for the patient so in the same cost patient gets an added advantage of less scar.

Now it has its own disadvantages in the sense the instruments manipulation is very difficult, it has its own long learning curve because we were always taught that the instrument angulation has to be 90 degrees and has both angles and all those things we were always taught, but here all the principles are gone now, actually all the instruments are going parallel to each other so when we are doing this surgery all the instruments are fighting and cross fighting with all the instruments so it has its own learning curve that secretly that is the thing, but today in eight years of experience we have started with the simple cholecystectomy, simple gallbladder diseases and we reach the stage of accurate appendix and now in today we even manage puss in the gallbladder, empyema, mucosa of gallbladder, appendicular abscess, even gangrene of appendix and gallbladder that can be managed.

There is no restriction we put in a single hole for SILS surgery for all our patients. We do our own modification as I already said that we use all normal conventional instruments we don't use any special instruments, so it definitely doesn't increase any cost burden to the patient so the main nutshell is that SILS is advanced laparoscopic surgery and which causes very little pain, better cosmesis because small scar is there. We usually do subcuticular stitches so patient’s scar is hardly visible, no need for any suture removal we give waterproof dressings, so next patient is back to normal activity, We usually hospitalize for 36 hours and in 48 hours patient is back to normal activities, so for any such more videos you can connect to lybrate page.

Thank you.