Laparoscopy or laparoscopic surgery is a type of surgical procedure, which allows the surgeon to access the inside of the abdomen (tummy) and the pelvis (the lower part of the trunk between the abdomen and thighs) without having to make very large incisions on the skin. This procedure is also called as a keyhole surgery or a minimally invasive surgery.
While in an open procedure, one large abdominal incision is made for access of the tissues and structures inside for examination and surgery, but in a laparoscopic procedure, only a very small incision of up to 1.5 cm in length is made on the abdomen. A surgery with a small cut is made possible by inflating the abdomen with carbon dioxide to expand the abdominal walls to enable the surgeon to have a clear view of the structures inside, as well as provide enough space to perform the surgery. A laparoscope is then inserted through the incision to visualise the internal organs under magnification for better examination and precisely perform the surgery. Two or three more small incisions are placed to provide access to other small instruments to perform the surgery. At times, depending on the requirement, another 3-4 cm incision is placed to remove the surgical specimen. Once the operation is completed then the carbon dioxide is expelled from the abdomen and the incisions are closed using absorbable sutures.
There are a few prejudices, common one being that the laparoscopic or minimal access surgeries are not safe in cancer treatment, but this is not true. The surgical procedure, extent of removal of the tumor remains the same in both open and minimal access surgery. The only difference between the two is the external approach with respect to incision. Hence, MINIMAL ACCESS SURGERY IS SAFE IN CANCER SURGERIES, WHEN INDICATED.
The abdominal wall consists of muscles, which needs to be cut in open surgery which results in more abdominal wall pain. While the small incisions in minimal access surgery is associated with lesser pain due to minimal injury to muscles of abdominal wall.
Every surgery has certain after care to be followed. In the case of open surgeries there are many restrictions, though not so many restrictions with laparoscopy. As in any surgery, during the recovery period there are certain dos and don'ts. Same is the case with the laparoscopic surgery. Here is a list of few of them.
Follow up: The patient will need to see the doctor about 2–6 weeks after the surgery to make sure the patient is healing well. It is important to keep this appointment even if the patient feels in the best of health.
Wound care: The patient will need to keep the stitches covered for the first 48 hours after the surgery. The patient should gently pat the stitches dry with a soft towel after shower, and cover them with a small adhesive bandage. If the patient has any type of discharge, redness, swelling, or tenderness around the stitches, the patient should immediately contact the medical practitioner/the surgeon.
Hygiene practices: The patient may generally be allowed to shower after 48 hours.
Emotional Recovery: After the laparoscopy the patient may be tired and irritable. It is advisable for the patient to use for rest and quiet activities.
Once while at home recovering from the surgery, it is important to rest, eat healthy foods, and keep the incision(s) clean. It is not necessary to stay put in bed, but rest is needed for the body to recoup. As such, after 24 hours, there is no limit on the physical activity as long as the patient is not taking narcotic medication.
The patient may return to work when he/she feels ready (usually about 2 weeks after the surgery).
Car driving: The patient should not drive a car for 48 hours after the laparoscopy, because the anaesthesia causes drowsiness.
Heavy duty exercise: The patient not to participate in sports or use heavy equipment while the patient is on narcotic pain medication.
Pain medication usage: The patient to not use pain medication (narcotics) unless prescribed.
The patient should avoid getting into a hot tub or jacuzzi for 2 weeks after the laparoscopy.
The patient should avoid swim in a swimming pool/lake/pond until further advise by doctor.
It is important to drink as much fluids/liquids as possible, as the patient did before the surgery.
As most often prescription pain medications cause constipation, it is important for the patient to drink lots of water, eat foods that contain fibre such as fruits and vegetables, and stay active.
The dietary recommendations are varied and depends on the surgery the patient undergoes. Depending on the extent and kind of surgery, doctor recommended diet must be followed.
Home cooked meal is recommended
Avoid food from outside
The patient to avoid extremely spicy, deep fried foods.
Heavy bleeding from the vagina or incision sites.
Redness, swelling or pus at the incision sites.
An upset stomach or vomiting after the first day.
A fever higher than 101°F (taken by mouth).
Severe pain that does not get better with pain medicine.
If the patient is constipated, the patient can take mild laxative (over–the–counter) twice a day.
To call the primary care provider if the patient has not had a bowel movement within 3 days after surgery or if the mild laxative has failed to work.
WARNING: The recommendations may vary and the above mentioned list of dos and don'ts are general and not specific. The follow up care your treating doctor provides overrules above mentioned recommendations.
The patient needs to diligently follow the dos and don'ts prescribed by the doctor or nurse. The set guidelines of the dos and don'ts (after Laparoscopic Surgery) to be followed about the activity, nutrition, hydration, pain treatment and bandage/dressing care should enable the patient to heal fast and not have any further complications after the surgery.
Each of our body is unique, amazing, and different. When there is a damage done, there is a certain time required for the repair. After repair healing time is very crucial. The patient should clear all the doubts of after care before leaving the hospital. The nurse or the doctor will go over the discharge orders/Home Care Instructions with the patient. Every patient needs a definitive time to recover from surgery. After a successful surgery, the process of complete healing is very important. Complying with the list of guidelines of aftercare which includes the dos and don'ts after Laparoscopic Surgery appropriately ensures no further complications and a better healing.