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Many surgeries today are performed with a laparoscope or endoscope, utilizing cameras or scopes to perform advanced, delicate procedures through small incisions. Often applied to the neck, chest or abdomen, these procedures are considered minimally invasive because patients experience less pain, earlier discharge and resumption of normal activities. In many cases, minimally invasive surgery can be performed on an outpatient basis. Also, these surgeries help avoid complications – infections and scarring – that can occur with larger incisions. Although minimally invasive surgery is preferred, physicians still perform conventional surgery when laparoscopy or endoscopy is not feasible.
Appendicitis
A relatively common disease, appendicitis occurs when the appendix becomes inflamed and filled with pus. The standard treatment for appendicitis is removal of the appendix (appendectomy). The preferred approach (laparoscopy) results in minimal scarring. When performed on women, this technique is especially appropriate for examining the female genital tract and ruling out other diseases that may mimic appendicitis.
Gallstones / Common Bile Duct Stones
Gallstones are clusters of solid material that form in the gallbladder. Typically one large stone or several small ones, they vary in size and can be as large as a golf ball or as small as a grain of sand. As many as 42 million Americans have gallstones and do not even know it, often experiencing no symptoms. However, gallstones sometimes result in abdominal or back pain and can cause serious health problems.
Gallstones develop in the small pear-shaped organ (gallbladder) located beneath the liver on the right side of the abdomen. The gallbladder stores and releases bile to help with digestion. Obesity is a strong risk factor for gallstones, especially among women. Many women over age 40, who have been overweight or had several pregnancies, develop gallstones. In addition, people who lose a large amount of weight quickly are at greater risk than those who lose the weight more slowly. Laparoscopy is typically preferred for these procedures. In fact, gallbladder removal was one of the very first laparoscopic procedures performed. Surgeons also perform radiologic examinations of the bile ducts and remove stones that have created jaundice or pancreatitis with laparoscopy.
Gastric Tumor
Another common procedure that is performed laparoscopically is the removal or resection of gastric tumors.
Gastroparesis
A chronic medical condition of impaired stomach motility, gastroparesis results in delayed gastric emptying, which means patients can feel full after eating small amounts of food and experience some degree of abdominal discomfort or pain. Generally a consequence of abnormal activity of the stomach muscles or a defective communication between stomach nerves and gastric muscles, gastroparesis can be caused by diabetes or scleroderma, but may also result as a consequence of other surgical procedures. In some cases, gastroparesis can put a patient’s life at risk for several metabolic or nutritional deficiencies when severe weight loss or dehydration results.
Heartburn or Reflux / Hiatal Hernia/ Paraesophageal Hernia
Probably one of the most common symptoms in the USA, heartburn is often treated with drugs to decrease or stop the stomach’s acid production. However, a procedure that creates a new high-pressure zone around the stomach can typically be performed in about two hours, preventing the reflux of acid.
Hiatal hernias occur when the lower part of the esophagus and a portion of the stomach slide up through the esophageal hiatus (an opening in the diaphragm through which the esophagus passes before it reaches the stomach). In some cases, a junction of the esophagus and stomach remain in place, but a portion of the stomach rolls up and through the esophageal hiatus alongside the esophagus.
Hernias
Typically hernias, which allow organs to protrude, are congenital or acquired defects in the abdominal wall. Sometimes they occur when the abdominal muscle becomes weakened. Hernias may also occur in the groin (inguinal), navel (umbilical), or at the incision site of a previous surgery. Although there are several minimally invasive procedures to repair hernias, open surgeries may still be performed. Laparoscopy is preferred for recurrent or bilateral inguinal hernias.
Obesity
A chronic disease that affects many people and requires long-term treatment to promote and sustain weight loss, obesity is related to nearly 300,000 deaths per year in the U.S. As a result, surgical techniques have been developed to help patients maintain weight loss. Two of the most successful have been adjustable gastric banding and gastric bypass – both performed laparoscopically.
Small Bowel & Colon Surgery (for benign and malignant disease)
Surgery of the colon may be performed for a variety of reasons, including cancer (malignancy), diverticulitis, inflammatory bowel disease, polyps or fistulae. During a colectomy, part of the colon, large intestine or bowel may be removed. In addition, hemorrhoids and anal fissures might be treated with a small surgical procedure and an overnight stay.
Spleen (diseases of)
The removal of the spleen has been performed through a large abdominal incision in the past, but has become an excellent option for laparoscopy. Most typically, idiopathic thrombocytopenic purpura (ITP) or an enlarged spleen due to neoplastic disease are common causes for the spleen’s removal.
Swallowing Disorders/Achalasia
The inability to swallow due to a weak esophageal muscle and/or a too tight gastric inlet may result in the use of drugs to relax the gastric inlet, balloon dilatation or injection of botulin toxin to paralyze the muscle and decrease the pressure. Splitting the muscle surgically has shown more prolonged effects and may be used as well.
If you have any questions or concerns related to the above conditions or treatments, please contact Dr. Salimath or call 672-5975 for a professional consultation.
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