Laparoscopy workshop

Laparoscopy is the use of a laparoscope to perform an operation in the abdominal cavity via small incisions. It is part of a group of operations called minimal access surgery. It is the same operation as an open operation but done via small access points.

Among the benefits are less pain, smaller and more cosmetic scars, early discharge from hospital and early return to work or school, and less wound infection compared to open surgery. It has a longer learning curve (meaning takes longer to learn) than open surgery, though.

Laparoscopy is commonly performed nowadays for cholecystectomy and appendicectomy. There are a number of laparoscopic “guru”s who employ laparoscopy for many other operations. Some are not yet considered “mainline”, standard procedures, but if the surgeon knows his own capability, and the patient knows the limitations and is willing, then it is probably worth trying the laparoscopic approach.

Dr. John Thanakumar, from Vellore, India, is one such “guru”. He was in Penang on 12th to 13th April to demonstrate his method of doing some laparoscopic procedures at the Adventist Hospital. It was organised by Dr. Ansari, the paediatric surgeon, and I was glad to be one of those picking up pointers and gaining inspiration on how to improve our laparoscopy service to patients.

Want to see what a surgical live demonstration looks like?

The operation was transmitted to the seminar room via CCTV. On the left is the normal, external video image and on the right is the laparoscopic image.

20 comments so far

  1. Jean-Luc Picard April 15, 2007 7:59 pm

    Quite a difference from a cinema!

  2. George April 15, 2007 8:07 pm

    wow it must have been good. What cases were put up?

  3. nyonyapenang April 16, 2007 12:35 am

    looks interesting. :)

  4. C. Doodle April 16, 2007 1:07 am

    Is this what they called ‘keyhole’ procedure to the layman?

  5. Bernard April 16, 2007 9:13 am

    Capt Picard, yup.. i wonder when a holodeck might be the media for demonstrations…

    … or a 3-D holographic reproduction might be the method of imaging for performing laparoscopic surgery instead of a 2-D video on a monitor image.

    … a fertile imagination. Hehe.

    George, interesting for sure…

    … TEP hernia, TAPP hernia, varicocoele, impalpable testes, Nissen fundoplication, Heller cardiomyotomy with anterior fundoplication, hemithyroidectomy and a hysterectomy.

    … and a memorable dinner. ;-)

    nyonya, sure is. I’m in love with my laparoscope. Hahaha.

    Doodle, yup.. medics also call it “keyhole” surgery.

  6. yenjai.net April 16, 2007 11:00 am

    Wow. The projector is so good. Image is bright and sharp

  7. just me April 16, 2007 2:02 pm

    Read that surgeons who play playstation games are more adept in this skill?

  8. pelf April 16, 2007 5:11 pm

    We did laparascopy work on the terrapins! But of course the “turtle expert” from Western Australia did it, and we just watched, but well, I pretty much got the idea behind it :)

  9. eastcoastlife April 16, 2007 5:50 pm

    How many hours did you all have to watch the operations? And the guru operated non-stop?

    Man, how could any ordinary person eat dinner after seeing all this blood and gore! *pengsan*

  10. Bernard April 17, 2007 1:06 am

    yenjai, yup.. the AV team were professionals, apparently.

    just me, true.. see this. So, encourage your kids to play… :-)

    Pelf, that’s great! Kind to the terrapins :-)

    … What size ports do you use? What do they do in the terrapins?

    eastcoastlife, there were 3 operations on the first day.. the “action” took about 3 hours, not counting the time in between cases. There were another 5 slotted on the 2nd day.. these took the whole day with a break for lunch.

    The series of patients is just like a usual day in OT :-)

  11. eve April 17, 2007 10:02 am

    ohhhhh…that’s where you disappeared to la…ingat ke dah MIA…ehhe…

  12. Chelsea April 17, 2007 4:52 pm

    Wootttt…..still got appetite for lunch after surgery???….*tabik*

  13. Sweetpea April 18, 2007 12:31 am

    hhmm…. now can post something lighter? like… a tag fro me? heehehe. http://sweetpeamy.blogspot.com/2007/04/tagged.html

  14. SiwwyPig April 18, 2007 9:39 am

    Hi Dr. Bernard! Not sure you have done this tag but… you got tagged anyway..

    http://siwwypig.wordpress.com/2007/04/18/layer-by-layer-tag

    ps: I love your blog and the cool medical information you write… keep up the good work.. *thumbs up*

  15. ahhong April 18, 2007 10:42 am

    Laparoscopy….
    Seem like the all operation is done through the image projected in stead of direct look at the “keyhole”
    How they do that?

  16. Cocka Doodle April 18, 2007 3:00 pm

    What happens if the doctor has the shits on the day of the operation? Does he makes frequent unscheduled runs to the shit house?

  17. Sweetpea April 18, 2007 11:26 pm

    geeee… at least now I know how I looked like in the hands of you surgeons. my whole body was sore for days and I was told that I was literally filled up with gas! true??!

  18. Bernard April 19, 2007 9:34 am

    eve, ya lo ..

    Chelsea, even better appetite after surgery la :-)

    Sweetpea, uahh.. i’m behind on my tag instalments already.. ok.. putting it on my to-do-list :-)..

    .. i enjoy your finetunes selection too!

    .. gas is true.. we use carbon dioxide to fill up the abdominal cavity. It’s to provide a space to operate in.

    It’s inert, doesn’t support burning, and dissolves easily in water.. ideal. But it can be sore after op, sometimes at the shoulder-tip.

    Siwwypig, uahh… thankfully it’s the same one as sweetpea tagged me with. :-)

    Ahhong, very observant!

    There’s a camera attached to the scope. The video image is on a monitor in front of the surgeon. So the surgeon can stand up and operate. That’s why being good at playstation makes laparoscopic operating easy…. it’s all in the hand-eye co-ordination.

    Cocka Doodle, having the shits means having the shits already… surgeon or any other mortal.. haha.

    … the operations that I do are not that long, but some surgeons perform really long procedures. Sometimes, if nature calls really urgently, they’d have to take a break, and come back in after. Happens. Of course, they’d have to find a safe point of the surgery to take the break.

  19. pelf April 19, 2007 5:19 pm

    I don’t know what “size ports” is ;) And we used the technique to determine the sex of the terrapins. Because when they’re immature, we can’t tell their gender physically :)

  20. Bernard April 20, 2007 9:04 am

    pelf, OIC… good use for laparoscopes. We’ll find more uses for them by and by :-)

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