Laparoscopic Surgery Procedures & Services
The following procedures can be performed laparoscopically; reducing pain, scarring, time spent under anesthesia and recovery time. Certain abdominal surgeries, such as weight loss or colon surgery, can increase the likelihood of developing a ventral/incisional hernia. Any abdominal surgery can make your abdominal wall weak causing a hernia. You are not able to prevent a hernia from developing.
To learn additional facts about each type of laparascopic surgery, select from one of the following topics:
Inguinal Hernia
Laparoscopy offers a very effective and less invasive alternative to the traditional type of inguinal hernia repair. For a traditional repair, an incision is made in the groin, the hernia sac is removed or reduced (pushed back in), and the defect is repaired either with sutures or with mesh. Healing generally takes 2 to 6 weeks depending of the extent of the hernia and the type of repair. The laparoscopic repair also removes or reduces (pulled back in) the hernia sack and then places the mesh behind the abdominal wall muscles rather than on top of them as with the open repair. This allows the abdominal cavity to seal the mesh against the abdominal wall and allows for an almost immediate ability to perform full activities with no mandatory waiting period. The laparoscopic incisions are smaller and tend to cause less pain which also facilitates a quicker recovery. This is an excellent choice for persons who need a rapid return to work or to strenuous physical activity. It is also a good option for the repair of recurrent and bilateral (both sides) hernias. In the case of a recurrent hernia, the laparoscopic repair avoids the scar tissue from the previous operation(s) which can be problematic both in identifying the important structures and in finding good tissue to use for the hernia repair. In persons with bilateral hernias, laparoscopic repair of both sides can be performed at one setting utilizing the same three small incisions and generally adds very little additional time to the procedure. The incidence of complications following laparoscopic hernia repair is similar to that of the traditional open repair, and as experience grows, actually may be less, including a very low rate of recurrence.
Paraesophageal Hernia
This is a rare but serious condition in which the stomach (and occasionally other abdominal organs) pushes up, or herniates, through an abnormally enlarged opening in the diaphragm into the chest cavity. This is considered a type of hiatal hernia, but it is one that can cause far more serious symptoms and consequences than those of the common hiatal hernia which is generally associated only with heartburn. The symptoms of a paraesophageal hernia can range from trouble swallowing to severe chest pain following a meal. Regurgitation of food, heartburn, chronic blood loss and even strangulation of the stomach can occur. The traditional operation involves either a long incision through the chest or one through the abdomen or sometimes both. Usually, persons with this problem are elderly and have a variety of medical problems making major surgery risky. Laparoscopic repair of paraesophageal herniae is a minimally invasive procedure and offers a lower incidence of complications, a shorter hospital stay, and a quicker and less painful recovery. The repair involves pulling the stomach back down into the abdomen, removing the hernia sac, narrowing the opening in the diaphragm and usually fixing the stomach to the diaphragm.
Ventral Hernia
This type of hernia involves a defect in the abdominal wall that may be congenital or acquired following a prior operation. The latter type is called an incisional hernia. These herniae can be fixed either with an open incision or with laparoscopy. Both types of repairs utilize mesh to cover or secure the defect to prevent recurrence of the hernia. Open surgery can be very painful requiring a hospital stay, may miss “occult” hernia defects that cannot be felt or seen from the outside, and has a higher complication rate, including infection and recurrence. Occult hernia defects may develop in time into larger defects that will require additional surgery. Laparoscopy offers a minimally invasive approach to the repair of these herniae. The hernia contents are separated from the defect in the abdominal wall and a large piece of mesh is secured across the defect. Occult defects can be visualized and repaired along with the primary hernia. Generally the laparoscopic repair is performed as an outpatient procedure but may require a brief overnight stay in persons with additional medical concerns.
Gallbladder Removal
The function of the gallbladder is to store and release bile, a fluid produced by the liver. Bile breaks down fats in the foods you eat and helps digestion. Usually, bile moves smoothly from the gallbladder into the rest of your digestive system. If gallstones form in the gallbladder, the stones can block the release of bile. This can cause stomach pain, shoulder pain, back pain, pain under the breastbone, heartburn and upset stomach. Often, theses symptoms occur after eating a high-fat meal or food, oils or spicy food.
If you have persisant abdominal pain or any of the symptoms listed above, it may be indicative of gallbladder disease or formation of gallstones. Gallstones form when chemicals in the gallbladder crystallize, (become solid), and move to the ducts causing blockage and backup of bile. This is what usually will give an individual pain, nausea or infection. If you suspect you may have gallstones see your doctor immediately, who will run tests to determine if you do have gallstones.
The most common technique to remove the gallbladder is laparoscopically (through small incisions in the abdomen). Sometimes, the surgery does need to be done through a small incision, (an open procedure). Your surgeon will tell you what technique he thinks will be best for you based on your medical and past surgical history. Gallbladder removal usually requires an overnight stay in the hospital and most people can resume their normal activities within 5 days.
Appendectomy
This procedure is currently missing a description. Please provide it.
Heartburn
An surprisingly large number of people suffer from heartburn, or gastroesophageal reflux disease (GERD), many of them on a daily basis. There are many excellent medications available to treat the symptoms of heartburn and for most people this is sufficient. For some, however, medical treatment is either ineffective or incompatible with their lifestyle. For those who have persistent or recurrent symptoms despite medical therapy, or for those who don’t wish to be reliant on medications for the rest of their life, laparoscopic antireflux surgery provides an excellent option. There is also an increasing concern over the rising incidence of esophageal cancer which has been linked to chronic GERD through changes in the lining of the esophagus, called Barrett’s esophagus. A national registry has been formed to study the question of whether surgery will prevent the formation of Barrett’s esophagus, prevent the progression of Barrett’s esophagus into cancer, or cause the regression of Barrett’s esophagus back to normal.
Laparoscopic Nissen fundoplication is the standard procedure performed for GERD and, in contrast to medical therapy, it provides a cure for the reflux not just control of the symptoms. In brief, it is a minimally invasive operation which typically involves the repair of a hiatal hernia (a condition where the stomach pushes up through the diaphragm and which is often found in persons with GERD) combined with wrapping the upper part of the stomach around the lower part of the esophagus. This latter part essentially recreates the natural anatomic barrier (the lower esophageal sphincter) which helps prevent the reflux of stomach acid into the esophagus. Five small incisions are required (from 1/4 to 1/2 inch in length) to perform this procedure and the hospital stay is generally one to two days. Full recovery may be as short as two weeks, long-term sequelae are minimal and successful cure of heartburn is around 90%.
Colon Surgery
Laparoscopic colon resection is an option to conventional open surgery. It is ideal for benign disease such as colon polyps, diverticultis, inflammatory bowel disease, lower gastrointestinal bleeding as well as colon cancer. It offers a shorter hospital stay, shorter convalescence, less pain, and better cosmesis. It also results in fewer adhesions and consequently may lower the subsequent risk of intestinal obstruction. Laparoscopic surgery for colon cancer is also widelyperformed
Laparoscopic surgery for colon cancer is just as effective and is associated with the same cure rate as open surgery. Multiple research studies have confirmed this, including an exhaustive multicenter trial published in the New York Journal of Medicine.
North Shore Surgical Specialists
310 East Shore Road
Suite 203
Great Neck, NY 11023
Tel: (516) 482-8657
Fax: (516) 829-0002
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