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Laparoscopy

In the past, laparoscopic surgery was commonly used for gynaecologic surgery and gall bladder surgery. Over the last 10 years, the use of this technique has expanded into intestinal surgery. In traditional “open” surgery the surgeon uses a single incision to enter the abdomen. Laparoscopic surgery uses several 0.5-1cm incisions. 

A laparoscopy is a minimally invasive procedure and takes a peek into the stomach or pelvis without making any cuts until required. Doctors can diagnose medical conditions and/or perform surgery using the laparoscope, and thus the procedure is called laparoscopic surgery.

The surgeon puts the laparoscope through a small cut (incision) in your belly (abdomen) measuring half an inch or less. Surgeons may make up to three more cuts to insert other surgical instruments so they can see all the organs in your belly and find any problems.

The laparoscope camera projects an image of the inside of your belly or pelvis onto a monitor in real time. Using these images, surgeons can watch their hand motions during the procedure.

A laparoscopic procedure is often advised when other diagnostic tests can’t identify the cause of the condition. Healthcare providers also use laparoscopy to collect tissue samples (biopsies) for testing.

What is laparoscopy done for?

Traditional surgeries best suited for laparoscopic surgeries include:

Cyst, fibroid, stone and polyp removals.
Small tumor removals.
Endometriosis surgery.
Hernia repair surgery.
Gastric Binding.
Cholecystectomy (gallbladder removal) for gallstones.
Appendectomy (appendix removal)
Colonic or intestinal repairs surgery

Is a laparoscopy a major surgery?

Laparoscopy is a minimally invasive procedure, but that doesn’t always mean it’s a minor surgery. Many abdominal procedures can be done as laparoscopic surgeries, but they’re still major surgeries. The advantages of having laparoscopic surgery include:

  • Less trauma to the insides of the stomach.
  • Less blood loss and a lower risk of hemorrhage.
  • Smaller scars.
  • Less risk of infection.
  • A shorter hospital stay, that means less time in the hospital and is also less expensive.
  • Faster recovery time and return to your usual activities.
  • Less pain during healing, so you won’t need as much pain medication.

General Indications for Laparoscopic Surgery

Laparoscopic surgery is widely utilised across multiple surgical disciplines. Common indications include:

  • Appendectomy: Standard treatment for acute appendicitis.
  • Colorectal Surgery: For benign and malignant diseases, including diverticulitis and colorectal cancer.
  • Hernia Repair: Including inguinal, umbilical, and incisional hernias.
  • Diagnostic Laparoscopy: Evaluation of unexplained abdominal or pelvic pain, trauma, or suspected malignancy.
  • Cholecystectomy: Most commonly performed laparoscopic procedure.
  • Liver Biopsy or Resection: In selected cases, including staging of hepatic malignancies.
  • Pancreatic Surgery: Limited but increasing use in distal pancreatectomy and pseudocyst drainage.
  • Ovarian Cystectomy
  • Tubal Ligation
  • Myomectomy or Hysterectomy: For uterine fibroids or malignancy.

While generally safe, complications can occur, including:

  • Nephrectomy
  • Adrenalectomy
  • Pelvic Lymph Node Dissection

While generally safe, complications can occur, including:

  • Sleeve Gastrectomy
  • Adjustable Gastric Banding

Laparoscopic Cholecystectomy (Gallbladder Removal)

Laparoscopic cholecystectomy is the gold standard for the treatment of gallbladder pathology. Common indications include:

  • Symptomatic cholelithiasis (gallstones causing biliary colic)
  • Acute or chronic cholecystitis
  • Gallbladder polyps >1 cm or growing
  • Biliary dyskinesia (confirmed by HIDA scan with low ejection fraction)
  • Gallstone pancreatitis (post-resolution)
  • Patient is put under general anesthesia in the supine position.
  • Four small incisions are made (umbilical, epigastric, and two right subcostal).
  • Carbon dioxide (CO₂) pneumoperitoneum is established.
  • The laparoscope is inserted, and the abdominal cavity is visualized.
  • Dissection to identify the cystic duct and cystic artery, which are then clipped and divided.
  • The gallbladder is separated from the liver bed and retrieved through the umbilical port.
  • Hemostasis is achieved; ports are removed, and incisions are closed.
  • Patients are generally observed for a few hours and discharged the same day (outpatient basis) in uncomplicated cases.
  • Postoperative pain is minimal; patients can resume oral intake within hours.
  • Return to normal activities is often possible within 5–7 days.
  • Pathological examination of the gallbladder is performed to rule out incidental carcinoma or other conditions.

While generally safe, complications can occur, including:

  • Bile duct injury (0.3–0.5%): most serious complication; may require reconstruction.
  • Hemorrhage
  • Infection (surgical site or intra-abdominal)
  • Bile leak (from cystic duct stump or accessory ducts)
  • Retained stones in the common bile duct
  • Conversion to open surgery

Conclusion

Laparoscopic surgery is a significant advancement in surgical practice, and offers reduced morbidity and faster recovery across a broad spectrum of procedures. Laparoscopic cholecystectomy, in particular, is a cornerstone of minimally invasive surgery and remains the treatment of choice for gallbladder disease. Continued refinement in technique and technology (e.g., 3D laparoscopy, robotic assistance, and enhanced imaging) promises even better outcomes in the future.

FAQs

How safe is laparoscopic surgery?

Laparoscopic surgery is as safe as traditional open surgery. The risk of any operation is determined in part by the nature of the specific operation. An individual’s general health and other medical conditions are also factors that affect the risk of any operation.

What kinds of operations can be performed using Laparoscopic surgery?

Most intestinal surgeries can be performed using the laparoscopic technique. Laparoscopic surgery is safe for certain ­colorectal cancers, too.

What are the advantages of laparoscopic surgery?

Compared to traditional open surgery, patients often experience less pain, a shorter recovery, and less scarring with laparoscopic surgery.