In our clinic, the focus of our minimally invasive techniques is laparoscopic surgery. Laparoscopic surgery in Germany is a sub-area of surgery in which an optical instrument, the laparascope, is used for surgical procedures within the abdominal cavity, in some cases together with additional instruments.
Laparoscopic examinations are an important diagnostic process used to determine disorders of the abdominal and pelvic organs. This type of examination is particularly useful in the case of abdominal symptoms that cannot be cleared up by other methods of examination. Unfavourable changes to the stomach, intestines, liver and pancreas and also parts of the uterus and ovaries can usually be clearly recognised in this way.
During the procedure, the surgeon can also take tissue samples (biopsies). In the case of tumours in the abdomen and pelvis, laparoscopic examinations are also very useful since they enable the surgeon to determine whether or not a tumour can be removed surgically. The functioning of specific organs can be examined in the same manner. For example, in childless couples, a laparoscopic examination can be used to determine whether the fallopian tubes are obstructed.
Laparoscopy is not limited to examinations alone. It is also used in minimally invasive surgery for the treatment of various disorders.
The following procedures are examples of operations than can be performed with a laparoscope (keyhole surgery):
The surgeon performs a laparoscopy by inserting a tube-shaped optical instrument (endoscope) into the abdominal or pelvic cavity in order to examine the internal organs. Besides making a diagnosis, he can also perform laparoscopic surgery at the same time.
As opposed to open surgical procedures on the abdomen (laparotomy), procedures with the laparascope require only a few small incisions in order to provide access for the endoscope and the surgical instruments. It is therefore referred to a keyhole surgery. A laparoscopic operation is performed under general anaesthetic. The surgeon makes two or three incisions about 1cm long, in the abdominal wall. The laparoscope is inserted through the first incision in the navel. On the end of the tube-shaped instrument are a light source and a very small camera. Images are transmitted to a monitor on which the surgeon is able to assess the appearance and condition of the abdominal or pelvic organs and he can also perform the operation via the monitor.
The additional cuts are required for the insertion of the very small surgical instruments (e.g. grasping forceps, scissors, aspiration device) into the abdominal cavity. The surgeon usually also inflates the abdomen with carbon dioxide. This raises the abdominal wall from the internal organs, allowing room for the surgeon to perform the laparoscopic surgery and giving him a better view so that he can work more precisely, thereby reducing the possibility of injury occurring.
Compared to open abdominal surgery, laparoscopic surgery is gentler on the patient. With the help of the laparascope, fine details can be enlarged on the monitor, thereby making it easier for the surgeon to see what he is doing. Even narrow sections and acute angles between organs can be viewed clearly.
The small cuts usually heal more quickly and cause less pain. The patients can get up sooner and the digestive tract is restored faster, making it possible for the patient to resume his normal eating habits after a shorter period of time.
This not only shortens the period of hospitalisation - it also reduces the rate of complications.
Laparoscopic surgery is sometimes done on an out-patient basis, particularly when it only involves an examination, or the removal of small cysts or endometrial growths. Laparoscopic surgery also results in fewer complications later on, such as adhesions of the abdominal cavity and umbilical hernia, that are more common in open procedures.
Minimally invasive techniques such as laparoscopic surgery are much loved by patients because they result in very little scarring and cause less pain. This means less time in hospital and quicker recovery, and also less time away from work.
With modern laparoscopic surgery the chances of recovery from carcinoma surgery and good healing after cosmetic surgery are much better than in non- laparoscopic procedures in which the incisions are much longer.
Laparoscopic examinations have become routine for us. We have now been performing such procedures for decades and our clinic is equipped with the latest technology, enabling us to perform such procedures in an anatomically contoured, precise manner with very little blood-loss.
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