Laparoscopic surgery also referred to as minimally invasive surgery helps the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions of up to half an inch are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient.
The camera transmits an image of the organs inside the abdomen onto a television monitor. The surgeon is not able to see directly into the patient without the traditional large incision. The video camera becomes a surgeon’s eye in laparoscopy surgery, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure.
Benefits of minimally invasive or laparoscopic procedures are
- less post operative discomfort since the incisions are much smaller
- quicker recovery times
- shorter hospital stays
- earlier return to full activities
- much smaller scars
- there may be less internal scarring when the procedures are performed in a minimally invasive fashion compared to standard open surgery.
Advance laparoscopic surgery with hand-access devices
The human hand performs many functions during surgery that are difficult to reproduce with laparoscopic instruments. The loss of the ability to place the hand into the abdomen during traditional laparoscopic surgery has limited the use of laparoscopy for complex abdominal surgery on the pancreas, liver and bile duct.
Hand-access devices are new laparoscopic devices that allows the surgeon to place a hand into the abdomen during laparoscopic surgery and perform many of the different functions with the hand that were previously possible only during open surgery. Indian surgeons have utilized these new devices to develop a variety of laparoscopic pancreatic, liver and biliary procedures such as the Whipple operation, distal pancreatectomy and liver resection that were not possible previously by standard laparoscopic techniques.
Laparoscopic surgery for liver, pancreas and bile duct disease have had considerable success in our hands. Patients with laparoscopic surgery have much shorter hospital stays, less pain, rapid recovery and early return to work compared to patients with open surgical procedures.
Robot assisted surgery
Da Vinci™ is a computer-assisted robotic system that expands a surgeon's capability to operate within the abdomen in a less invasive way during laparoscopic surgery. Da Vinci™ system allows greater precision and better visualization compared to standard laparoscopic surgery. The operations with the Da Vinci System are performed with no direct mechanical connection between the surgeon and the patient. The surgeon is remote from the patient, working a few feet from the operating table while seated at a computer console with a three-dimensional view of the operating field.
The physician operates two masters (similar to joysticks) that control the two mechanical arms on the robot. The mechanical arms are armed with specialized instruments with hand-like movements which carry out the surgery through tiny holes in the patient’s abdomen. Three small incisions (approximately one half inch) are made in the abdomen, through which a video camera and the robotic arms with the highly-specialized instruments are introduced. The video camera provides high resolution, high magnification and depth perception.
Robotic system for laparoscopic surgery of pancreas, bile duct and liver surgery
The world experience on the use of the Da Vinci Robotic System for surgery on the pancreas, bowel duct, and liver is limited. We have developed experience with this robotic system for the following surgical procedures:
- Bile duct reconstruction
- Hepaticojejunostomy (suturing an obstructive bile duct to the intestine to provide drainage to a bile duct blocked by tumor or other cause)
- Distal pancreatectomy
- Reconstruction of the gastrointestinal tract after a Whipple operation
- Laparoscopic cholecystectomy
- Laparoscopic adrenalectomy
- Pancreaticojejunostomy and the Peustow procedure (suturing the jejunum to the pancreatic duct to provide drainage of pancreatic juice into the intestine in patients with obstruction of the pancreatic duct)