Since the arrival of laparoscopic surgery in the late 1980s, there has been no looking back. Laparoscopic surgery has revolutionized the field of surgery and has bettered the acceptance of surgery for both cases and clinicians likewise.
Dr. Nikhil Jillawar is an eminent Laparoscopic Surgeon in Pune, providing specialized treatment in the field of Gastroenterology including Piles, Fistula/fissure treatment, Pancreatic Surgery, Trauma Surgery,
Conventionally, an open abdominal operation is performed using a large cut in the abdomen ranging from 6 to 12 inches in size. This helps the surgeon in attaining a good exposure and performing the procedure on the organ of interest.
The term “ minimally invasive surgery” is inclusively used for any surgery which is performed using cuts lower than the traditional open surgery. This includes laparoscopic and robot-assisted surgeries.
Laparoscopic surgery is performed using small cuts ranging from 5-15 mm in size. The number and position of similar small cuts vary depending on the type of procedure but generally range from 1-6. Laparoscopic surgery is hence also called “ keyhole surgery”.
The original step for any laparoscopic surgery is to induce space in the abdomen for the conduct of the procedure. This is done by filling the abdomen with carbon dioxide gas. This is followed by the insertion of hollow tubes, which allow a safe entry of the instruments. The laparoscope is a long narrow instrument that transmits high-intensity light and has a high-resolution camera at its end. The camera transmits the image of the inside of the abdomen to a video monitor in real-time. The surgeon operates on the organ of interest using long slender instruments while looking at the video monitor.
The benefit of laparoscopic surgery isn’t only limited to a better cosmesis. Laparoscopic surgery decreases the overall stress of the procedure and is thus associated with a drop in pain, shorter hospital stays, before initiation of diet, early discharge, and enhance overall recovery, therefore, allowing the cases to return to their normal lives faster.
Laparoscopy can help in diagnosing conditions when a conclusion can not be reached using imaging modalities like ultrasound and CT scans. Laparoscopy done in such a situation is also called “ individual laparoscopy” and a biopsy, if needed, can also be obtained to establish the final diagnosis.
Certain malignancies of the abdomen gallbladder and stomach cancer have a high propensity for peritoneal deposits. These cancerous deposits can be very small in size and are therefore not appreciated on a CT scan or PET scan. Laparoscopy is done for the purpose of discovering these small deposits is called staging laparoscopy and avoids an unnecessary procedure for these cancers.
Laparoscopic surgery is commonly used to treat conditions like :
The scope of laparoscopic surgery has now expanded to advanced laparoscopy and multiple further procedures are now performed using this approach.
These include :
Laparoscopic surgery generally requires general anesthesia. The case needs to suffer blood tests, chest X-ray, and ECG previous to meeting the anesthetist, who also evaluates the case for fitness for anesthesia and surgery. The case is admitted one day previous to or on the day of surgery. The surgeon needs to explain all the benefits and risks associated with the case and family in detail in the form of written informed consent. The chances of conversion to an open procedure should be easily explained in all cases as such a step might be needed for the safe conduct of the operation in some cases. The awaited period of ICU and hospital stay and questions regarding postoperative recovery and follow-up must also be explained by the surgeon.
Laparoscopic surgery is likely one of the topmost advancements in our field. Still, it might not be suitable for all cases and situations. In some delicate situations, laparoscopy can be tried by an educated surgeon, but the case must be explained regarding a high chance of conversion to open surgery in similar cases. The surgeon should easily understand the limitations of laparoscopic surgery and explain the same to the case.
Laparoscopic surgery might not be suitable or chances of conversion are advanced for
In cases who have experienced multiple previous open operations-in similar cases the surgery becomes delicate because of thick adhesions from former surgery
Large tumors, especially those which require complicated procedures. These are better treated with open surgery.
Dr. Nikhil Jillawar, Senior Consultant – Department of Gastrointestinal and HPB Surgery, Gastrointestinal Oncology, Minimal Access, and Bariatric Surgery,
Surgical Gastroenterologist in Pune provides care for patients who need surgical intervention for diseases of the gastrointestinal (GI) tract. The GI tract runs from the mouth to the rectum. Gastrointestinal surgery involves the removal of cancerous or non-cancerous growth or any damaged part of the intestine. It s also used to repair structures like hernias. Smaller surgical procedures are also used in the screening and diagnosis of diseases. Surgery also helps to improve quality of life when it cannot be managed by medical or diet changes. Dr. Nikhil Jillawar is the best gastrologist in Pune for Gastrointestinal Disease that requires surgical intervention. Surgeons use minimally invasive surgical procedures that ensure a speedy recovery and quick return to normal life. The hospital also has a dedicated liver clinic that has successfully conducted complex liver surgeries for liver cancer using intraoperative ultrasound guidance, which renders safety and better outcomes. The obesity clinic is equipped to handle obesity cases that cannot be medically managed. Here, they offer surgeries like gastric bypass, gastric banding, sleeve gastrectomy, and long-term care. The colo-rectal clinic helps in the early screening and detection of colorectal malignancies, which is on the rise today. Patients are given laparoscopic colorectal surgery which gives them complete oncological clearance and faster recovery. Surgeons handle hernia cases using laparoscopic and open hernia repair surgery to the patients in the dedicated hernia clinic. Dr. Nikhil Jillawar’s could be your one-stop solution that guarantees comprehensive care when you need surgical intervention