FAQs
What is keyhole surgery and what are the advantages?
Keyhole surgery, also known as laparoscopic surgery, is a technique in which fibreoptic telescopes and long, fine instruments are passed through very small incisions (5 to 10mm) into the abdominal cavity.
This approach means there is not a large incision and subsequently a large scar. There is less post-operative pain and the patient is able to move around much more quickly that they would following open surgery. This also translates into a reduced rate of complications that can be associated with longer periods of immobilisation.
The hospital stay is shorter – some procedures can be performed on a day stay basis and some require one to two nights in hospital. The length of time required off work is generally considerably reduced compared to the open operations.
Is keyhole surgery riskier than open operations?
The risk of problems and incidence of complications is about the same for the operation itself. On occasion, it may be necessary to convert the procedure from keyhole to open, for reasons such as difficulties with access to the operative field or unexpected findings at the time of operation. Most experienced laparoscopic surgeons have a low conversion rate.
In the post-operative phase, the risks are generally reduced for keyhole procedures due to the early mobility that can be achieved.
What types of operations can be performed by keyhole surgery?
Initially only gynaecological procedures were performed using this method, principally tubal ligations. In the early 1990’s general surgeons adapted the technique for removing gall bladders. With advances in surgical techniques and the development of new instruments, it is now possible to remove appendixes, perform hernia repairs and operate on various parts of the digestive system for conditions such as reflux (heartburn), obesity, ulcers and bowel disorders.
Some orthopedic procedures can be performed in this way where the technique is known as arthroscopy. Some neurosurgery is now possible using this approach.
What is obesity surgery?
Obesity surgery is also known as bariatric surgery. Its aim is to assist with weight reduction and control. There are two methods for achieving this – by gastric banding which reduces the capacity of the stomach and thereby limits the food intake, or by bowel diversion surgery which speeds up the passage of food through the gut, limiting the amount of food that can be absorbed by the body.
Gastric banding has very similar results to the bypass surgeries in terms of long term weight loss and appears to be the operation of choice initially in overweight and obese individuals who would benefit from surgical assistance with weight loss.
Can you have a gastric band and a pregnancy?
If you have a gastric band in place this should not affect your pregnancy. Patients will require individual monitoring but it is important to eat a balanced nutritious diet while controlling weight and weight gain during pregnancy. If required, the band can be fully deflated for the duration of the pregnancy and adjusted as required at a suitable time after the birth of the baby.
What is the treatment for heartburn?
Many people take medication for reflux or “heartburn” as it is commonly known. Mylanta, nexium and somac are some of the most common medications used.
The problem arises from a laxity in the area of the diaphragm where the gullet (oesophagus) passes through from the chest cavity to the abdominal cavity. When the abdominal pressure increases, for example, after meals, while coughing or by changes in posture (bending over or lying down), the stomach contents and occasionally the stomach as well, can be forced upwards into the lower chest, causing a burning sensation.
A laparoscopic repair to tighten the gap in the diaphragm and stabilise the stomach position provides symptomatic relief for the vast majority of patients.
Please note that the pain of reflux and the pain resulting from heart problems can feel the same, so all chest pains should be investigated by your doctor.
How are hernias repaired?
A laparoscopic technique for repairing hernias has been developed in recent years.
The laparoscopic instruments are inserted between the abdominal muscles and the lining of the abdominal cavity. The abdominal contents which have herniated through the gap in the muscles are pushed back into the abdominal cavity and the weakened musculature is then reinforced by the application of a specialised fabric-like mesh. A tissue adhesive may also be used.
Scar tissue forms at the site of the repair, taking over from the mesh which is absorbed by the body.