Definition and Overview
Laparoscopic surgery refers to new and advanced surgical technique that requires only small incisions and minute, specially designed instruments. When compared to traditional open surgery, it is significantly less invasive and results in minimal bleeding and pain as well as shorter recovery and downtime.
Due to the great advancements in the field of medicine, numerous open or traditional surgical procedures now have minimally invasive counterparts. These include hand surgery, gallbladder and uterine fibroids removal and vaginal hysterectomy, among others. This type of surgery can be performed to treat a wide range of conditions including some types of cancers, gynecologic problems, heart conditions (such as mitral valve repair and atrial fibrillation) and urological conditions (such as incontinence and vaginal prolapse).
Patients who are about to undergo this procedure are scheduled for a pre-surgery consultation where all the details of the surgery will be covered. The surgeon may conduct pre-operative investigation and order tests to better understand the patient’s unique circumstances that can possibly complicate the procedure. For example, if the patient has a bleeding disorder, the surgeon may order laboratory screening. The result of this test can help him better prepare for the procedure with a special focus on how to minimise possible risks and complications.
Who Should Undergo and Expected Results
A laparoscopic surgery consultation is performed to:
Determine if the patient is eligible for the surgery – Many surgeons promote laparoscopic surgery because of its many benefits. However, some patients may not qualify for it especially those with more complex illnesses. During the consultation, the surgeon will assess the patient’s condition and consider other factors, such as the patient’s medical history and other existing health problems to decide whether minimally invasive procedure or open surgery would be more appropriate.
Provide more information about the procedure – Patients who are about to undergo laparoscopic surgery must fully understand the procedure before they commit to it. During the consultation, the surgeon will explain all the details including the technique and the type of anaesthesia to be used, how long the procedure will take and what to expect during and after the surgery. The surgery’s risks, benefits and possible complications will also be discussed. The patient will also be given an opportunity to raise all his questions and concerns.
Get a second opinion – A patient may approach another surgeon to request for a second opinion. This normally happens if the patient does not have a good relationship with the first surgeon or would want to explore other treatment options aside from surgical procedures.
Prepare the patient for the surgery – Surgery, whether traditional or laparoscopic, requires preparation. As such, the surgeon will provide the patient complete instructions on the dos and don’ts before, during and after the surgery.
How Does the Procedure Work?
Before meeting with the surgeon, it is expected that the patient has already gone through a series of tests that were previously requested by his primary physician or a general practitioner who made the referral to the laparoscopic surgeon. The results of the tests and the patient’s medical records will then be forwarded to the surgeon and will form part of the surgical plan.
During the consultation, the surgeon will review the patient’s medical profile and conduct a short interview where he may ask about the general feeling of the patient, any new or worsening symptom, medications taken and kinds of activities he is engaged in.
The surgeon will then orient the patient and details listed below are covered:
- Fasting, which is normally a requirement at least 8 hours before the surgery
- Medications to take and not to take (e.g., blood thinners are not to be taken at least a day before surgery)
- The laparoscopic technique to be used
- Expected outcomes
- Possible risks and complications of the procedure
- Recovery time
- Follow-up care
The surgeon also takes the time to answer questions and concerns of the patient as well as his immediate family members and carers.
The initial consultation may take at least an hour while the succeeding ones are usually shorter.
Possible Risks and Complications
The idea of going through surgery, especially one that uses a technique that the patient is not entirely familiar with, may be enough to increase his level of anxiety and worry. These negative emotions may limit the success of the consultation as the patient may avoid discussing symptoms and following the much-needed preparations.
Thus, it is important that the surgeon must know how to establish a good rapport or relationship with the patient, particularly during the initial consultation to encourage the patient to be more comfortable and more open about his apprehensions.
- Rao PP, Rao PP, Bhagwat S; Single-incision laparoscopic surgery - current status and controversies. J Minim Access Surg.