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Laparoscopic Innovations

With the advent of laparoscopic surgery, it is possible to perform major surgeries with the help of several small stab wounds rather than one long incision.

Surgery is the invasive removal of correction of diseased parts within the body. Traditionally, major surgery was performcd via long incisions to facilitate the act of surgery. Long incisions, however, come at a cost. They result in more pain, require a longer recovery period, and are also associated with increased risk of complications including wound infections and adhesions.

Laparoscopic surgery, on the other hand, involves the use of laparoscopes and thin, sleek instruments to perform surgery with the surgeon’s hands outside the abdomen rather than inside it. Surgeons only need to make a small incision to deal with the problem.

Besides decreasing the pain and complications of traditional long-incision surgery, laparoscopic surgery also has the happy advantage of a better cosmetic outcome as the scar that remains is small.

Having said that, most abdominal surgeons using laparoscopic surgery use about five to six such incisions; each ranging from 5 mm to 12 mm in length. As I continue to perform and teach laparoscopic surgery around the world, I am increasingly of the view that most laparoscopic surgeries can be performed with fewer and smaller incisions. There are specific ways to do this, as follows:

Three-port laparoscopic surgery

To use this technique, I require only a camera assistant. Thcre is no need for the usual assistant to help retract the surrounding tissues and organs. Three-port surgery is just as efficient and safe, and patients have an improved cosmetic outcome since only three incisions are needed.

Through the umbilicus

There are two procedures which can be carried out by this method.

Firstly, many surgeons remove a resectioned colon or rectum through a separate incision. I feel there is no need to make a separate incision on the abdominal wall just for this, as there is already an incision over the umbilicus. Using the umbilicus to remove the resectioned intestine enables me to keep the number of incisions to three of four, at the most, in rare cases.

Most patients who underwent three-port surgery saw a fast and good recovery with much less pain and many were able to return to normal activities sooner.

Secondly, where the entire rectum needs to be removed, saving only the anus and the colon joined to the anus, most Singapore colorectal surgeons perform a defunctioning stoma to safeguard the low ano- rectal joint. The site of this stoma would often be the ugliest scar. I use the umbilicus as the site of the defunctioning stoma. Patients are relieved that they do not need a separate incision, and when the stoma has closed about a month after the surgery, all that remains ate the seats of two small wounds and a small umbilical scar.

These methods help patients to recover more quickly, with better cosmetic results that do not compromise safety. In fact, minimally-invasive techniques are considered safer than conventional surgery.

Currently, any sort of abdominal of intestinal surgery can be performed via the laparoscope, from the most complex to the most straightforward. What used to require long incisions and hours-long surgery now takes take much less time and leaves only three of four small scars. Many patients comment that loved ones who meet them a week or two after surgery do not even realise that they have had any surgery done, let major surgery!