The term laparoscopy or videolaparoscopy literally means: "observation of the abdomen " (from the Greek laparos = abdomen and scopeo=look).
The technique, used from1970 for obstetric-gynaecological operations, has been subsequently used in abdominal surgery.
The first gall bladder laparoscopy dates back to 1987: from then, in a succession of innovative techniques associated with ever greater experience of abdominal surgery, laparascopy has extended to operations on organs and for illnesses which were unthinkable until a few years ago.
Today, especially in western countries, many surgical operations on the digestive and respiratory system are carried out with the laparoscopic technique.
In the last few years two sectors have been identified:
- Laparoscopic surgery properly called, used by a wide number of abdominal surgeons for the treatment of the most frequent benign pathologies and of average technical complexity,
- Advanced laparoscopic surgery used only in specialised centres and by expert surgical techniques to cure particular pathologies for which a multi-disciplinary approach is necessary (surgeon, anethetist, oncologist, medical dietician, etc.) and which require techniques and technologies which are more expensive and sophisticated.
The main illnesses which are currently cured in laparoscopy are as follows:
- lithiasis of the cholecystitis
- hiatal hernia and gastroesophagus
- Appendicitis
- Pathologies of the ovaries
- Abdominal urgencies *
- Peritoneal appendages
- Illnesses of the spleen
- Removal of intestinal tracts or colon for benign pathologies *
- Hernias and laparo-coeliac*
- Fevourous or painful states of the abdomen
- Oncological staging of abdominal tumours *
- Abdominal lyphoadenectomies *
- Varicocele
- Prolapse of the womb and/or rectal vagina *
- Obesity pathology *
- Resection of tumours of the colon and of the rectum *
- Resection of tumours of the liver and pancreas *
- Resection of tumours of the stomach and of the esophagus*
(*) Only on the specific identification and by the highly specialised surgical team forming part of the national-international study protocol.
Laparascopic surgical operations require general anesthetic .
The patient's abdomen is filled with carbon dioxide in such a way that the abdominal wall inflates and it is easier to see the internal organs.
Through small incisions in the abdominal wall in which are attached "trocar" (special canals) the surgeon inserts the telecamera and the various laparoscopic instruments.
The telecamera allows one to see the whole of the abdomen: the picture is shown on a monitor, where it can be enlarged 20-fold.
The instruments used (scissors, pliers, scalpels, stitching instruments etc) are miniaturised precision instruments.
With the laparoscopic technique, therefore, surgery can perform the operation with maximum accuracy.
Where it is necessary to remove a part of the organ, an appropriate incision is made, (2- 8 centimetres ) in the abdominal wall, at the most appropriate point for the extraction of the operated piece.
Laparoscopic operations are the same as the traditional ones, and are therefore well written-up. .
Operating times are the same, with the difference of time of opening and closing of extended injuries in the case of open surgery..
From the patient's point of view, laparoscopic treatment of abdominal pathologies offers several advantages:
- reduced post-operatory pain, due to the absence of large wounds, and therefore a reduced intake of painkillers,
- a rapid healing of the surgical wound of small dimensions,
- a rapid recovery of mobility, with a rest- in- bed period of a few hours after the operation, from which a small incidence of respiratory, heart and circulatory complications derives,
- a rapid recovery of daily activity, and therefore discharge from hospital in shorter periods,
- aesthetically, the absence of long scars.
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