A laparoscope is a slender medical tool featuring a tiny video camera and light on its end. Surgeons use this instrument to see inside the body on a video monitor without making large incisions. This technique is a form of minimally invasive surgery, often called keyhole surgery, because it requires only small cuts in the abdomen or pelvis. This approach allows for both diagnosis and treatment of various conditions.
The Laparoscope Instrument
The modern laparoscope consists of a long, thin tube, or cannula, which houses the optical and illumination components. At its tip is a high-resolution camera and a high-intensity light source that illuminate the surgical area and transmit clear, real-time images. These images are displayed on a video monitor in the operating room, providing a magnified view for the surgeon.
The instrument’s core contains glass rod lenses and spacers that relay the image from the tip to the camera. An outer ring of fiber optic cables carries light from an external source down the shaft to illuminate the internal organs. Laparoscopes come in diameters ranging from 3 mm to 10 mm and various lengths to suit different patients and procedures. They also feature different viewing angles, such as 0 or 30 degrees, allowing surgeons to see areas hidden from a straight-on view.
The Laparoscopic Surgical Procedure
A laparoscopic procedure begins after the patient is under general anesthesia. The surgeon makes a small incision, about 1 to 2 cm long, near the navel. Through this cut, a hollow tube called a cannula is inserted using a trocar to create a port into the abdominal cavity. This port is then used to inflate the abdomen with carbon dioxide gas.
This process, called insufflation, lifts the abdominal wall away from the organs, creating a clear space for the surgeon to work. With the abdomen expanded, the laparoscope is inserted through the cannula. The camera on its tip sends live video from inside the body to a high-resolution monitor in the operating room.
The surgeon then makes one to three additional small incisions. These entry points are for inserting other specialized surgical instruments, such as graspers, scissors, and needle drivers. While watching the monitor, the surgeon manipulates these tools to perform the operation. Once completed, the instruments are removed, the gas is released, and the incisions are closed.
Common Laparoscopic Surgeries
Laparoscopy is used for many diagnostic and therapeutic procedures. One of the most common is the cholecystectomy, or gallbladder removal, to treat painful gallstones. Another standard application is the appendectomy, the surgical removal of an inflamed appendix.
Surgeons use laparoscopic techniques for many other procedures, including:
- Hernia repair, where a weak spot in the abdominal muscle is mended.
- Gynecological procedures like hysterectomy (removal of the uterus), myomectomy (removal of uterine fibroids), and treating conditions such as endometriosis.
- Diagnosing conditions when imaging tests are inconclusive, allowing a surgeon to investigate the cause of pain or other abnormalities.
- Weight-loss surgeries, such as gastric bypass and sleeve gastrectomy.
Comparison to Open Surgery
The main distinction between laparoscopic and open surgery is the incision size. Laparoscopic surgery uses several small cuts, often no longer than half an inch. In contrast, open surgery requires a single large incision, which can be 6 to 12 inches long. This difference leads to variations in the patient’s experience and recovery.
Because laparoscopic surgery involves less cutting of skin and muscle, patients experience less postoperative pain and require shorter hospital stays. Recovery at home is also faster, with patients returning to normal activities sooner. For example, a person might recover from a laparoscopic hernia repair on average eight days sooner than with an open repair.
The smaller incisions of laparoscopy are associated with a lower risk of infection because there is less exposure of internal tissues to the outside environment. Scarring is also minimal compared to the large, more noticeable scar that results from open surgery. While laparoscopy offers many advantages, open surgery may still be necessary for very complex cases or emergencies where direct, hands-on access is required.