Laparoscopic or minimally invasive surgery began to develop in the usual practice in the early 90s of last century and today is widespread in multiple processes, the most common being the removal of the gallbladder. The operation requires a few small incisions (0.5 to 1cm) through which instruments are inserted into the abdomen and connected to an optical video camera and high resolution monitor. Through such instruments in surgery and experts coloproctology observed inside the abdomen and perform the same interventions but less aggressively.
Peculiarities of laparoscopic colon and rectal
Laparoscopic colon and rectal surgery is complex because it presents the difficulties of having to work on a long body and mobile and also having to remove an area of significant size. This is done through a small incision and sometimes, relatively hidden (over the pubis, for example), or even, though less frequent, through natural orifices, such as the vagina or anus own. The surgical technique is similar to that performed in the classical open surgery, while using specific and longer instruments and special maneuvers, always with the philosophy of getting the maximum benefit with the least aggression.
Operations and affordable pathologies laparoscopically
Almost all surgery colon and rectum can be performed laparoscopically, although it is not indicated in all cases where, having contraindications (patients with multiple abdominal scars, very advanced tumors, pathology cardiovascular serious, etc.), which make, in each patient must be assessed feasibility. In addition, to difficulties or problems once the intervention started, you can always open the abdomen conventionally. Laparoscopic resections can be made right and left colon (hemicolectomies), the complete removal of the colon or total colectomy, rectal resections and even entire colon and rectum (proctocolectomías).
The conditions in which laparoscopy can be made are, in order of frequency, malignant and benign tumors, inflammatory bowel disease (ulcerative colitis and Crohn's disease), and diverticular disease. More recent forms with very definite indications are transanal endoscopic surgery (TEO, TEM, TAMIS) and transanal removal Mesorectal (TaTME). They can also be made colostomy or ileostomy as stomata, rectal prolapse repairs and other interventions that do not require the removal of any organ. Although the use of these techniques is different depending on the experience of surgeons, an average of 50% of cases of colon and rectal surgery in our country are approached laparoscopically and, in many centers, in a clearly higher percentage.
Does laparoscopy offers the same security as conventional surgery?
Since when laparoscopic surgery is performed right is to perform the same operation when performed by conventional means or laparotomy, security is identical surgery if you have an experienced surgeon. It has already been mentioned that the selection of patients is essential for good results. As with any type of intervention, it may be associated with specific risks that will be detailed by your surgeon.
Specific pre and postoperative care laparoscopy
Usually, no specific pre or postoperative care are required. However, being much lower postoperative discomfort, they depend mainly on the size of the abdominal incision, since evolution is more comfortable and the patient can recover quickly in the absence of complications. Do not forget that the surgery itself involves an assault or injury and, if lower, will result in less blood loss, less postoperative pain and analgesic requirements, minimal or invisible scars and faster recovery.
Edited by Patricia Crespo Pujante