Laparoscopic Exploratory Surgery

Exploratory laparoscopy has often been used for diagnostic purposes to view the abdomen after abdominal trauma and in cases of abdominal illness.

Laparoscopy is a term given to a group of operations that are performed with the aid of a camera placed in the abdomen. Originally, the laparoscope was used during surgical removal of the gallbladder (laparoscopic cholecystectomy) and appendix (laparoscopic appendectomy).

Now the laparoscope also allows physicians to perform minimally invasive surgery with just a small incision in the abdomen. This technology, known as laparoscopic assisted surgery, enables the minimally invasive removal of the colon, and the weight reducing procedure gastric bypass.

The procedure is usually done in the hospital, under general anesthesia, and after informed consent has been obtained. A catheter (a small flexible tube) is inserted through the urethra into the bladder. An additional tube may be passed through the nostril and into the stomach to remove intestinal contents (N-G tube). The skin of the abdomen is cleansed, and sterile drapes are applied.

A small incision is made above or below the navel to allow the insertion of a trocar (essentially a tube extending from inside the abdomen to the outside), which allows passage of a video camera. Prior to insertion of the trocar, a needle is inserted into the incision and carbon dioxide gas is injected to elevate the abdominal wall, and thereby create a larger space to work in. This allows for easier viewing and manipulation of the organs.

After an adequate amount of gas is instilled, the laparoscope is inserted, and the organs of the pelvis and abdomen are examined. Additional small incisions are made for instruments that allow the surgeon to move the abdominal organs, cut tissue, suture, and staple structures to safely and effectively perform the necessary procedure.

Following the examination, the laparoscope is then removed, the incisions are closed with sutures, and bandages are applied. Depending upon the operation performed, a drain may be left through one of the incisions to allow for removal of accumulated fluid.

Procedures
  A. General Surgery
    1. Laparoscopic Surgery
      a. Exploratory
      b. Appendix
      c. Hernia
      d. Gallbladder
      e. Colon
      f. Hiatal Hernia
    2. Conventional Surgeries
      a. Hernia Repair
      b. Colon
      c. Stomach
      d. Appendix
      e. Thyroid
      f. Soft Tissue Masses and Skin Lesions

  B. Vascular Surgery
    1. Repair of abdominal aortic aneurysm (AAA)
    2. Bypass surgery of extremities
    3. Carotid endarterectomy (CEA)
    4. Creation of arterio-venous fistulas
    5. Placement of central lines

  C. Varicose Vein Treatment
    1. TIPPS (Trans-Illuminated Powered Phlebectomy)
    2. SEPS (Subfascial Endoscopic Perforator Surgery)
    3. Deep venous thrombosis

  D. Breast Disease Management
    1. Evaluation of breast lumps (solid or cystic)
    2. Cyst aspirations
    3. Fine-needle aspiration of solid breast lump
    4. Stereotactic breast biopsy
    5. Sentinel lymph node biopsy
    6. Conventional biopsy
    7. Lumpectomy
    8. Mastectomy

  E. Gastric Bypass (Bariatric Surgery)

  F. Wound Management and Treatment

  G. Thoracic surgery
    1. Chest tube placement
    2. Removal and biopsy of nodules in lung and mediastinum
    3. Lobectomy

  H. Vascular Laboratory