A laparoscopy is simply to look inside the abdominal, or peritoneal, cavity with a specially designed camera system. It has been given that name “key-hole surgery” as the technique involves several small incisions as opposed to one large incision for open surgery.
If that same camera system and the technique that accompanies it is applied to a specific procedure, such as removal of the gallbladder (a cholecystectomy) then it is given the name laparoscopic cholecystectomy. During recent times the technique has now been applied to many operations that were traditionally done as open procedures such as hernia repair and bowel resection.
There are many advantages of the laparoscopic approach, the main one being a shorter hospital stay and a shorter time back to normal activities. However, it is important that patients understand that there are specific risks and complications associated with the technique.
Visceral Injury – this means inadvertent damage to organs such as the bowel or liver. It is an unusual occurrence. This largely relates to the fact that the dissection and in particular the handling of these structures is being done by long instruments operated by the surgeon rather than using his hands. If the injury is identified at the time it is usually a straight forward matter to correct it there and then. However if the injury is occult (hidden) the problem may not manifest itself until the patient is into the post-operative period. The usual scenario is that they do not recover as anticipated or deteriorate unexpectedly with symptoms such as abdominal pain and distension, nausea, vomiting and sweats. It is vitally important that you report these symptoms to Dr Renaut’s office without delay.
Bleeding – once again this is an unusual occurrence. It is usually apparent at operation but may manifest once again in the post-operative period when you are at home. The symptoms are similar to those for visceral injury and the action is exactly the same.
Conversion to the open procedure – I do not view this as a complication per se, more a necessity. The indications for conversion are relative and the decision is taken at operation. The usual reason is inadequate visualisation of the anatomy. Under these circumstances it is best to err on the side of caution rather than risk the above two complications. Your intended operation will still have been achieved. It’s just that, having been done as an open procedure, your recovery will be somewhat more protracted.