Laparoscopic Surgery

What is Laparoscopic Surgery?

Laparoscopy is a surgical technique in which the abdominal cavity (belly) is inflated with carbon dioxide gas (CO2) and distended. A small (3-11mm thick) telescope resembling a long, thin tube is then inserted through the belly button into the abdominal cavity. This telescope, called a laparoscope, has a light source at its end and a camera that allows the surgical team to watch on TV monitors what is inside the belly, under magnification and in great detail. The CO2 gas helps keep the walls of the abdomen and the organs separated from each other and allows excellent exposure. One to three additional 5-10mm incisions are made in the lower abdomen for inserting long, thin instruments. These instruments are essentially extensions of the surgeon’s hands, allowing him or her to use them from outside the body and perform surgery inside the abdominal cavity. Dr. Camran Nezhat was a pioneer in this technique that has revolutionized modern gynecological surgery.

Video laparoscopy, introduced in the late 1970s and early 1980s by Drs. Nezhat, is the performance of laparoscopy using special video cameras attached to the end of the laparoscope. This allows the surgeon to watch a TV monitor and perform the procedure with excellent visualization while assuming a comfortable standing posture.

Picture 1: Dr. Camran Nezhat performing video laparoscopy in the early 1980s

Picture 2: Dr. Camran Nezhat performing laparoscopic surgery (March 2003)

Picture 3: Dr. Camran Nezhat performing laparoscopic surgery (March 2003)

Most importantly, the whole operating room, including assistant surgeon(s), nurses, and observing physicians, is able to participate in the procedure. The introduction of video laparoscopy worldwide in the early 1980s brought about a surge in research and clinical applications of laparoscopy all over the world. Since the late 1980s almost all private or university-based gynecologic services and their residency training programs have used video laparoscopy, so that is now considered the standard of care for a variety of gynecologic procedures. Thanks to video laparoscopy, what used to be a single surgeon's mostly diagnostic procedure is now a surgical team's combined effort in performing multiple and complex surgical operations.

Picture 4: Dr. Camran Nezhat demonstrates how laparoscopic surgery was performed before he introduced video laparoscopy

Today laparoscopic surgery has many applications including ovarian cysts, tubal reversal, endometriosis, infertility , management of fibroids, and hysterectomy, and it also has an increasing role in gynecologic oncology.

Picture 5: An example of a modern operating room equipped with monitors and other specialized instruments such as the CO2 laser

Please your questions about Laparoscopy.