Laparoscopic surgery, also referred to as minimally invasive surgery (MIS) or laparoscopy, is a surgical technique in which a thin, camera-equipped surgical device is inserted into the abdomen or pelvis through one or more small incisions. The camera relays a real-time video of the internal organs on a monitor for surgical guidance, and the operation is done through the small incisions. Laparoscopy can be used for many different types of surgeries, such as hernia repair, hysterectomy, stomach ulcer surgery, and weight loss surgery.

Laparoscopic procedures are surgeries that require incisions. They are described as minimally invasive because they are done with small incisions that measure a quarter to a half-inch in length.

A laparoscope is placed into the surgical incisions to project the body’s structures on a screen. Rather than seeing the internal organs directly when operating, the surgeon performs the entire procedure using the visualization projected on the monitor by the scope.

There are several types of laparoscopic devices, and they range in length, width, and degree of flexibility or rigidity. They generally include a camera, a light source, and surgical tools.

Laparoscopic surgery is a type of minimally invasive surgery for abdominal and pelvic procedures. Minimally invasive surgeries in other areas of the body are not described as laparoscopic.

Laparoscopic surgery is used to surgically repair a problem in the pelvis or abdomen. Among the many uses for this type of surgery are:

• Removal of a cyst, polyp, or abscess
• Biopsy
• Controlling a bleeding blood vessel
• Removing a blood clot
• Tear repair
• Tumor resection
• Removal of an inflamed gallbladder
• Obstruction relief
• Elective care such as tubal ligation or vasectomy
• Exploratory surgery to observe structures for diagnostic purposes

Laparoscopic surgery is also associated with minimal risk of contamination and infection, as well as a lower overall cost of care and shorter hospitalization.

Laparoscopic surgery may take longer than open surgery. A longer duration of anesthesia may increase the risk of complications, including those that appear days to weeks after surgery. Possible problems during laparoscopic surgery include:

• Bleeding or hernia at the incision site
• Bleeding in infection
• Injury to blood vessels or other organs, such as the stomach, intestines, bladder, or ureters.

Laparoscopy Techniques

The concept of laparoscopic surgery is relatively simple. Imagine the abdomen as a sack or balloon containing the various abdominal organs. Once the patient is asleep, a small needle is placed through the abdominal wall, and gas is inflated to give the surgeons some “working room.” Three or four more small puncture holes are made for insertion of various operating instruments including retractors, graspers, scissors, and dissecting tools. One of the instruments contains a small video camera which projects images of the abdominal cavity onto large video monitors, allowing doctors to get very good magnified views of the abdominal organs. Upon completion of the desired procedure, the instruments are removed and the abdomen “deflated.” The small holes are closed with minimal scarring.

Laparoscopy involves no cutting incisions, which are what hurt after standard open surgery. Laparoscopy has a number of other advantages. Because there is minimal manipulation of the abdominal contents, there is minimal formation of scar tissue. Also, minimal manipulation of the bowel results in rapid return of bowel function. In large operations, the bowel commonly becomes paralyzed for several days post-operatively. This is rarely seen after laparoscopic surgery.