LAPROSCOPIC SURGERY

Laparoscopic surgery is a minimally invasive procedure also known as a keyhole surgery. Having the advantage of avoiding larger incisions, being less painful, having shorter recovery time, lower risk of complications and minimal visible scarring, laparoscopic surgery has become a preferred option of surgery compared to conventional open surgery.

Laparoscopy has been successfully used in the diagnosis and treatment of a wide range of conditions. The key to laparoscopic surgery is the use of an instrument that consists of a tiny video camera with a light on the end to visualize detailed images of the abdomen. The laparoscope is inserted into 3 – 4 tiny buttonhole incisions that are made near the belly button, each incision being 0.5 – 1cm. These tiny incisions allow other surgical tools to be inserted, if necessary.

In order to keep the patient comfortable and pain-free during the surgery, anesthesia is administered to the patient. Laparoscopic surgeries are normally performed as an outpatient procedure. Hence, patients are often discharged on the day of the surgery. After a laparoscopic surgery, patients can resume their usual daily activities and return to work within 1 – 2 weeks.

Surgeons performing laparoscopic surgeries are expected to acquire a high degree of technical skills, precision and experience. Having performed laparoscopic surgeries on benign and malignant conditions of the colon, rectum and anus for more than a decade, Dr Shankar’s expertise and experience is incomparable.

DR SHANKAR’S EXPERIENCE IN LAPAROSCOPIC SURGERY

Dr. Shankar’s vast experience and skills include the diagnosis and treatment of the following:- 

  • Benign conditions like appendicitis and cholecystitis
  • Complex laparoscopy surgery on all colorectal tumors, i.e., laparoscopic hemicolectomy, laparoscopic sigmoid colectomy, laparoscopic high and low anterior resection for rectal tumors and laparoscopic abdomino-perineal resection (APR) for low rectal tumors
  • TAMIS (Transanal Minimally Invasive Surgery) for early rectal tumors and precancerous polyp at the rectum
  • Laparoscopic Transabdominal Preperitoneal (TAPP) for inguinal hernias and Laparoscopic IPOM (Intraperitoneal Onlay Mesh) for paraumbilical and incisional hernias

Laparoscopic Surgery for Colorectal Cancer

Colorectal cancer is one of the most commonly occurring types of cancer. In recent years, laparoscopic surgery has gained increasing interest in the treatment of colorectal cancer due to its proven short-term benefits on the recovery of patients. 

The surgery involves inserting laparoscopic instruments through a number of ports in the abdominal wall to dissect tissues around the tumour. The tumour is usually removed through an abdominal incision.

Post-operative results have shown faster recovery, earlier return of bowel function, less pain, lower complication rate, lower mortality rate and a reduced hospital stay. 

Although, laparoscopic surgery is an effective and safe alternative for the treatment of colorectal cancer, it may not be a suitable option for some patients.

For a better understanding of the treatment options available for colorectal cancer, kindly make an appointment with Dr Shankar. Being an experienced laparoscopic colorectal surgeon, Dr Shankar provides treatment tailored to meet the specific needs of each patient and ensuring the performance of a safe and effective surgery.  

Laparoscopic Surgery for Hernia

Hernia is a protrusion of the abdominal contents through a defect in the abdominal wall. The most common areas where hernia occurs are in the groin (inguinal hernia), belly button (umbilical or periumbilical hernia and the site of previous operation (incisional hernia). 

Surgery is the only treatment that can permanently fix a hernia. Whether or not a surgery is required depends on the size of the hernia and the severity of the symptoms. Untreated hernia can lead to life-threating complications.

There are two main types of surgical intervention for hernia; open surgery and laparoscopic surgery. Dr Shankar offers both of these options to his patients. In the laparoscopic option he performs Laparoscopic Transabdominal Preperitoneal (TAPP) for inguinal hernias and Laparoscopic IPOM (Intraperitoneal Onlay Mesh) for paraumbilical and incisional hernias. All these surgeries are carried out under general anesthesia.

i) Laparoscopic Inguinal Hernia Repair

Inguinal hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles, creating a bulge called a hernia. Surgical repair is recommended for inguinal hernias that are painful, enlarging, incarcerated, strangulated or for inguinal hernias in children.

It is carried out to push the bulge into place and strengthen the abdominal wall. A mesh is inserted in the weak area to prevent the hernia from recurring.

From its first description in 1990, laparoscopic inguinal hernia repair has been regarded as an alternative to the traditional open mesh repair for most new generation’s surgeons. Laparoscopic transabdominal preperitoneal (TAPP) is one of the most commonly used laparoscopic technique for inguinal hernia repair as it comes with the advantages of a minimally invasive approach.

Compared with the traditional surgery, laparoscopic inguinal hernia repair may result in less scarring and discomfort, reduced risk of complications, shorter recovery time, allowing a patient to go home the same day and return to their usual activities within 1-2 weeks.

ii) Laparoscopic Abdominal Surgery for Paraumbilical and Incisional Hernia

Paraumbilical and incisional hernia occurs when the wall of the abdomen at the umbilicus is naturally weak and the contents of the abdomen can more easily push through it, producing a lump called a hernia.  

In cases where the lump does not push back spontaneously or manually, strangulation could have happened and this requires surgical intervention. Paraumblical hernia could be a natural occurrence in infants or prevalent among women after the age of 50 as a result of abdominal muscles becoming weak due to multiple deliveries. However, incisional hernia is a common complication of invasive abdominal surgery. Both types of hernias are associated with social embarrassment, poor cosmesis and a reduced quality of life.

Laparoscopic technique places an intraperitoneal mesh to cover the hernia defect. Intra-Peritoneal Onlay Mesh (IPOM) was first reported in 1993. Laparoscopic abdominal surgery is an optimal treatment solution to repair cases of paraumblical and incisional hernia. The procedure involves insufflations of carbon dioxide gas into the peritoneal cavity to increase the intra-abdominal pressure. Thus there is reduced risk of complications, especially among the elderly or those with associated complications.

Similar to other laparoscopic procedures, it is mostly done on an outpatient basis and hence comes with several advantages.

Dr. Shankar who is an expert surgeon regularly performs laparoscopic abdominal hernia surgeries will advise you of the best course of treatment for you or your child’s hernia.