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Laparoscopy

Written by dr- zhila abedi asl. Posted in Uncategorised

Laparoscopy λαπάρα (lapara), meaning "flank, side", and σκοπέω (skopeo), meaning "to see") is an operation performed in the abdomen or pelvis through small incisions (usually 0.5–1.5 cm) with the aid of a camera. It can either be used to inspect and diagnose a condition or to perform surgery

Types

There are two types of laparoscope: (1) a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or (2) a digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system. The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes replacing traditional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. The rigidness is required in clinical practice. The rod lens based laparoscopes are highly dominant in practice, due to their fine optical resolution (50um typically, dependant on the aperture size used in the objective lens), and the image quality can be better than the digital cameras if necessary. The second type is very rare in the laparoscope market and hospitals

Surgery

Main article: Laparoscopic surgery

The laparoscope allows doctors to perform both minor and complex surgeries with a few small cuts in the abdomen

There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time

Gynecological diagnosis

In gynecology, diagnostic laparoscopy may be used to inspect the outside of the uterus, ovaries and fallopian tubes, for example in the diagnosis of female infertility. Usually, there is one incision near the navel and a second near to the pubic hairline. For gynecological diagnosis a special type of laparoscope can be used, called a fertiloscope. A fertiloscope is modified to make it suitable for trans-vaginal application

A dye test may be performed to detect any blockage in the reproductive tract, wherein a dark blue dye is passed up through the cervix and is followed with the laparoscope through its passage out into the fallopian tubes to the ovaries

Laparoscopic surgery, also called minimally invasive surgery (MIS), bandaid surgery, or keyhole surgery, is a modern surgical technique in which operations are performed far from their location through small incisions (usually 0.5–1.5 cm) elsewhere in the body

There are a number of advantages to the patient with laparoscopic surgery versus the more common, open procedure. Pain and hemorrhaging are reduced due to smaller incisions and recovery times are shorter. The key element in laparoscopic surgery is the use of a laparoscope, a long fiber optic cable system which allows viewing of the affected area by snaking the cable from a more distant, but more easily accessible location

There are two types of laparoscope: (1) a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or (2) a digital laparoscope where the charge-coupled device is placed at the end of the laparoscope

 Also attached is a fiber optic cable system connected to a 'cold' light source (halogen or xenon), to illuminate the operative field, which is inserted through a 5 mm or 10 mm cannula or trocar. The abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures