General and Digestive System
JUAN ANTONIO LUJÁN MOMPEAN
General surgery, digestive system and morbid obesity.
EXPERIENCE
LAPAROSCOPY
What is it?
This is a minimally invasive technique that enables almost all the operations formely carried out only via open surgery. This surgery allows to operate without opening up the patient.
Advantages
Laparoscopical surgery is not as aggressive and does not make the postoperatory as painful. Moreover, patients recover earlier. The risk of infection is reduced since the wounds are very small. As the abdomen is not cut open, respiratory infections are very rare. Therefore, patients can be discharged between 24 and 48 hours after surgery.
How is the operation carried out?
In laparoscopical surgery, we make small orifices 5-10 mm deep in the skin and we introduce a mini videocamera into the cavity we want to operate on. This would be the most basic way to be able to see inside the organism but we have to introduce the optics. To this aim we have the trocars. These are some tubes from 5 to 12 mm thick that contain a valve and enable us to introduce surgical instruments into the organism.
Gaz (CO2) is insufflated into the peritoneum cavity. This way we get more space into abdomen and we can move around into it, visualise its structures and work on them. The work instruments are similar to open surgery but they are adapted in order to work from distance. Hands are out and the instrument’s tip is inside the abdomen. When the operation is over, we get gas escaped from the cavity, the latter disappears and everything returns to normality. At the end, there are just from 4 to 6 orifices into the abdominal skin.
Do all surgeons make it?
The technique is difficult the for surgeons trained only in open surgery because they have to learn from scratch the laparoscopical technique and they have to be motivated to make this effort. It means hard and constant training for many years. For example, in 1990, only 1% of surgeons used the laparoscopical technique while in 2000, 30% of them used the basic technique (bladder). Only a few of us practise the most complicated surgery (morbid obesity, colon and rectum…).
What can be operated via laparoscopia?
The first operation via laparoscopy was the removal of the gall bladder. This operation has expanded all over the regions and is very common and practised by most surgeons. Presently, only teams specially trained like us can operate on
everything via laparoscopy – such as: gastro-oesophageal reflux, hiatus hernia, colon and rectum cancer surgery, suprarenal glands, liver, morbid obesity…- that used to be operated on only by open surgery. Diseases or illnesses that are treated via laparoscopy depend on the surgical team’s experience and years of training and dedication.
