Laparoscopic Surgery and Single Site Laparoscopic Surgery (SILS)

Advantages and disadvantages

laparoscopiaThe main advantage of laparoscopic surgery compared to conventional open surgery is that the incisions that are made are very small, almost negligible in many cases. Besides, apart from the obvious aesthetic benefit, the patient recovery is faster, needs fewer painkillers to ease the postoperative pain and has a reduced risk of surgical wound infection. All these factors lead to an earlier discharge, reduced postoperative complications and a quicker recovery. It has been shown a decrease in the sick leaves and a faster reintegration into normal daily social and working life.

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Open surgery patient Vs. Patient operated by laparoscopy.

What can we operate by laparoscopy?

Today there are virtually no limits for laparoscopic surgery. Almost all surgical techniques have been already performed by laparoscopy. Some of them have become the “standard” treatment; others are performed depending on the surgeon experience.

Currently, these sorts of operations are performed safely and as first choice according to the surgeon experience: gallbladder, hiatal hernia and gastro-esophageal reflux, morbid obesity, hernias and eventrations, colon and rectum, spleen, suprarenal glands, stomach, pancreas and liver. Also many emergency interventions such as appendicitis, cholecystitis, acute abdomen and peritonitis are performed by laparoscopy as first choice, depending on the surgeon.

Who should operate on patients by laparoscopy?

The answer is obvious: those surgeons who have experience not only in general and digestive surgery, but also in techniques of mini-invasive surgery or laparoscopy. Nowadays, it is estimated that over 50% of surgeons have no experience in laparoscopic surgery and 80% of those who use it only perform the basic technique, which is known as cholecystectomy. It is estimated that less than 10% of surgeons are experts in advanced laparoscopic surgery. This is logical, since it is a technique that, although it has been fully proven, it is relatively new. The basic laparoscopic surgery has been integrated in the current speciality training programs, but depending on where the surgeon has trained his skills, this training will be more or less extensive.