April 19, 2007 9 Comments

Laparoscopic system

Perhaps a little bit of explanation about laparoscopy might be of interest to some readers… it seems that quite a number of you have had laparoscopic procedures before.

What is laparoscopy?

“Laparo-” means the abdominal cavity. Laparotomy means a procedure to open the abdominal cavity. Laparoscopy means insertion of a scope into the abdominal cavity.

How is it performed?

There’s are 2 major components, the camera system and the operating system. The camera system is the eye for the surgeon and the operating system is the one used to perform procedures on the tissues.

Here’s are some photos from an earlier post in publicinfo to show the set-up (”ports” are the short, hollow tubes that enter the abdomen to allow passage of the gas, camera and instruments):

Ports for laparoscopy (channels to insert the camera, instruments etc.)

1. Ports are inserted into the abdomen. CO2 is pumped in to inflate the abdomen.

OT scene

2. The surgeon looks at the image from the scope and attached camera, and operates with instruments through the ports.

Appendix

3. The appendix

Appendix stump

4. The appendix stump

Closure

5. Three port sites to close after the operation.

April 19, 2007 11 Comments

A season for everything

Kedah, being the rice bowl of Malaysia, is green again. There’s been rain since the end of March. Now is the season for planting rice. I don’t know whether you remember the old campfire song..

Planting rice is never fun
Bent from morn till set of sun
Cannot stand and cannot sit
Cannot rest for a little bit

Nowadays, planting rice is ~~automated~~ motorized.. with the help of machinery.

April 15, 2007 20 Comments

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.

April 14, 2007 8 Comments