Laprascopy

Instead of traditional opening of abdomen during surgery, laprascopic surgery is a condition where the surgeon uses small keyholes in abdomen ,introduces a slim camera to watch his surgery on a monitor(like arjuna shooting the birds eye looking at its reflection in water) and along with it introduces slim instruments to operate on the desired organ like the Chinese eating noodles with chopsticks. Space required to operate is created by insufflating carbon dioxide gas into abdomen.

What are advantages of laprascopic surgery?

Because of holes through the body wall is minimal and magnification of surgical site manifold , the surgeon needs to have more self-demanding surgical skills & precision in laparoscopy – the patient gets a bloodless, almost scarless and relatively very painless post surgery period and hence a shorter stay with getting back to work early( a week mostly).

What are the complications of lap surgery?

With a well experienced laprascopic surgeon and state of art equipment and a good anaesthetist—complications are nil.

How costly is laprascopic surgery compared to open surgery?

It is equal or even less costly than open surgery if you account for the lesser days of stay at hospital and faster return to work.

Can it be perfomed on all types of individuals?

Yes, every type of human is capable of undergoing laprascopic surgery. Anyone who is not fit for lap surgery is unfit for even open surgery.

How are large tumours taken out with very small incisions?

We bring them out through natural orifices like vagina or microchop them using an inhouse morcellator device(makes the tumours very semisoilid to be sucked out).

Can caeseraean surgery for child birth be done with laprascopy?

No.we cant afford to take the live baby piecemeal.

Is laprascopic surgery indicated for any surgically removable disease including cancer?

Yes today open surgery has been replaced by laprascopy completely for any disease including cancer from any part of the body(cancer of skin and superficial tissue-don’t require laprascopy anyway).

What are the common surgeries performed & specialties that use these minimum access techniques?

Hernia repair, appendix, gallstones, ovarian cysts, uterine fibroids ,ovarian cysts and uterus removals. Cancers of stomach,intestines,kidneys ,food pipe or rectum. In Urology for stone retrieval and prostate removal..

Is it true that the chances of post-operative long term abdominal pain due to bowel adhesions are almost nil in laparoscopy compared to open surgery?

Yes. After open surgery many patients complain of abdominal pain for a long time-this is due to abdominal adhesions of intestines and secondary pulling pain. But after laparoscopy this is almost nil since we make only key holes to which the intestines cant stick easily. Infact we operate on patients with long-term abdominal pain caused by open surgery (especially caesarean) technique and release the adhesions by laparoscopy.

Can poor patients afford to get laparoscopy done at Noble?

Yes, our initial laparoscopic training started in Madras medical college operating on the poorest of poor. As a payback measure, we believe in cutting costs for them. We conduct camps, seminars and anniversary weeks where we do it free for them. At other times we do it at 50% of the normal fee.

Why should I get it done at Noble?

We have started early in the field of laparoscopy (since 1997) and done atleast 2000 lap procedures so far successfully without any complications. After seeing its benefits we have left open surgery very far behind though we are good at it too and do it for a selected patients.

Economically it makes us attractive because we are not a corporate trying to repay its investors but a family setting where the primary surgeon who is in direct and personal touch with the patient. Generating Goodwill & not only profit is our pride.

Our laprascopic surgeon Dr Balaji Ravilla has been exclusively trained for lap in European institute for telesurgery where laprascopy was born 20 years ago. He is doing advanced lap surgeries and even single port laprascopy (yes single hole surgery) and anti obesity(bariatric) lap surgeries.

What type of anaesthesia is preferred in Noble for laprascopic surgery?

Only general anaesthesia is preferred as this gives greater quality of painlessness and unconsiousness while avoiding pain in spine secondry to spinal anaesthesia.