The term ‘Laparoscopic’ derives from the Greek to mean ‘Flank’ or ‘Side’ and ‘To see’. This aptly named procedure is a modern, state of the art surgical technique which has advanced and improved invasive surgery throughout the world. However, its roots go back more than a hundred years.
It was in 1901 that Georg Kelling, from Dresden in Germany, started performing laparoscopic surgery on dogs. In 1910, Hans Christian Jacobaeus, A Swede, adapted the technique to conduct the first laparoscopic operation on a human. Indeed, the Journal of Endourology names Hans Christian Jacobaeus as the Inventor of Human Laparoscopy and Thoracoscopy.
Today, more than a hundred years later, the procedure has undergone many technological improvements. Perhaps the seminal moment of advancement was the development of micro-chipped computers, visual monitoring, and miniature cameras. Today’s technology has lowered the risks associated with laparoscopic surgery and has now become routine for many surgical procedures.
Thailand has a rightful reputation as a leader in advanced medical care. This reputation has been built on ensuring that it would, not only utilize the technology and techniques at the cutting edge of medical science but also to push those boundaries with innovative thinking and development of perceived medical modernity.
What is Laparoscopic Surgery?
Laparoscopic surgery, as its name suggests, is used to investigate, diagnose and treat problems within the lower abdominal area below the chest cavity and through the pelvic area. Today, most intestinal surgery is performed via laparoscopic procedures. Surgery to correct rectal prolapse and severe constipation, diverticulitis, ulcerative colitis, Crohn’s disease, and cancer, are now routinely conducted using the technique.
What Are Its Advantages?
There really are no downsides of laparoscopy compared to traditional open surgery. It is far less invasive than traditional open surgery, it causes much less trauma, improves recovery time, reduces the time spent in the hospital and is cosmetically less inhibiting for the recipient.
For example, to undertake a cholecystectomy, the removal of the gallbladder, an incision is made to accommodate instruments of 5–10 mm in diameter through hollow tubes, known as trocars. This will be done either with four small incisions, 5-10 millimeters or via a single incision of 15-20 millimeters, this is compared to an incision of up to 200 millimeters required for traditional open surgery.
Interestingly, in the United States, 96% of all cholecystectomies are now conducted using the laparoscopic procedure, whilst the leading hospitals in Bangkok are now pushing this figure towards 100%. This is an indicator as to why Thailand has become renowned across the world as a leader in advanced, quality medical care.
Diagnostic and Investigative Laparoscopy
Prior to any surgery, laparoscopic procedures can be used to investigate and assess and diagnose numerous medical conditions. Not so long ago, investigative and invasive open surgery would be needed to diagnose and ascertain whether surgery or alternative treatments, were appropriate for a wide variety of abdominal issues.
Investigative and diagnostic laparoscopic procedures are particularly advantageous when diagnosing female reproductive organs. Major Thai hospitals have become leaders in female fertility diagnostics and treatment, laparoscopy has been a significant factor in this. Utilizing a laparoscope, doctors are able to look directly at the outside of the uterus, ovaries and fallopian tubes, to identify fertility issues, thus helping to ensure the correct treatment can be recommended.
What are the risks?
In Thailand’s leading hospitals, laparoscopy is now a routine and very low-risk procedure. Patients facing this procedure can do so with confidence, not only in the procedure itself but also in the knowledge that the Thai medical personnel are extremely well trained and versed in the technique. However, it must be said that, just as with any surgical treatment, there will always be some level of risk.
Whenever surgical instruments enter the body through an incision there will be a small risk of the area being investigated or treated, becoming subject to infection. With laparoscopy, the instances of infection are not only rare and very minor but are easily treated with a course of antibiotics.
The use of mechanical instruments in the body will also lead to a risk that, on occasions, tissues may be subject to a tear, cut or perforation, resulting in bleeding. This is, of course, rare, but possible. Any bleeding that should result is unlikely to be extensive and would be easily stemmed via cauterization.
Abdominal discomfort can be common after a laparoscopic procedure and would not normally be of concern. Any pain or discomfort can be relieved with pain killers, and should that be the case, corrective drugs would be prescribed by the administering doctor.
Some laparoscopic procedures may require the patient to be sedated. As with more conventional surgery, there is the risk of oversedation, although extremely rare, this is not unheard of. There is also the chance that a small percentage of patients will have an adverse reaction to anesthesia. Due to this small risk, post-surgery patients are carefully monitored for signs of any complications. A small minority of patients may experience nausea or vomiting, along with light sensitivity or hypertension.
Other minor side effects may include headaches and bloating as well as localized soreness at the point of incision. This is only to be expected, but with the incisions being very small, healing is usually quick and complication-free.
Post Laparoscopic Concerns
Although very rare, there are cases where some patients have experienced post-treatment symptoms that exceed the normally perceived side effects. Shortness of breath or excessive pain should not be ignored, vomiting blood or dark-colored stools are also of particular concern. Symptoms of this type or anything of an incapacitating nature should immediately be reported to a doctor for appraisal and diagnosis, then, where necessary, further treatment can be administered.
Recovery from Laparoscopic Procedures
Post-procedure, a patient will be monitored by the medical staff to ensure their wellbeing. Some patients may be treated as outpatients, in this instance, there are a few things to be aware of. Immediately after treatment, the patient will be cared for until any anesthesia or sedation has worn off, this would usually be within no more than a couple of hours.
Under no circumstances should a patient return to any form of work, or operate any machinery, immediately after treatment. A patient should also refrain from attempting to drive any type of vehicle. As an out-patient when leaving the hospital, it is advisable to be accompanied by a friend or family member who can stay with you until you are fully recovered. The patient should rest, take any course of medication that has been prescribed and heed any advice that has been given to them by their doctor.