Definition : Laparoscopy is a type of surgical procedure in which a small incision is made, usually in the navel, through which a viewing tube (laparoscope) is inserted. The viewing tube has a small camera on the eyepiece. This allows the doctor to examine the abdominal and pelvic organs on a video monitor connected to the tube. Other small incisions can be made to insert instruments to perform procedures. Laparoscopy can be done to diagnose conditions or to perform certain types of operations. It is less invasive than regular open abdominal surgery (laparotomy).
It is derived from the Greek word Lapara ( meaning flank) and English word Scopy (to see)
It is part of an umbrella term : Minimal Access Surgery (MAS)
as the name implies MAS involves accessing the area of surgery / disease with minimal incisions (cuts).
The different types of Minimal Access Surgeries are :
Arthroscopy (MAS for joints )
Laparoscopy (MAS for abdomen and pelvis)
Thoracoscopy (MAS for chest )
Hysteroscopy (MAS for Uterus)
Laparoscopy can be used for both diagnosis (by visualising abdominal and pelvic organs and if needed taking biopsies from them) and treatment (by performing surgeries on abdominal organs using special instruments thru the small cuts).
The different components involved in the process of Laparoscopy are:
The Laparoscope : This is long cylindrical instrument which has at its outer rim fiberoptic fibres which throw light inside the abdomen.At its centre is a rod lens system which transmits a magnified image (approx. 20 times magnified) to an attached camera and this image then is seen on a higresolution medicalmonitor.
The Light Source:This device is the source of illumination (via Halogen or lately Xenon lamps) and is connected to the Laparoscope.
The Insufflator : This is a special device which is connected to a gas cylinder ( a CO2 gas cylinder) and transmits the gas to the abdomen to fill it up and distended it resulting in the abdominal organs being pushed down and a space being created for surgery to be performed.
Camera : This is a special high resolution camera connected to the laparoscope.
Trocar & Cannula : This is a two piece instrument with a sharp component inside a hollow cylinder.The sharp part (trocar) helps in penetrating the abdominal wall and placing the hollow cylinder ( cannula ) inside the abdomen. The laparoscopic instruments then are introduced thru the cannula into the abdomen for performing surgeries.
Laparoscopic Instruments : These special instruments (laparoscopic scissors , laparoscopic dissectors , laparoscopic cautery) are used to perform the surgical procedures. They are thin and long(approx. 33 cm in length)
The Laparoscopic Tower : The above equipment is arranged in a tower inside the Operation Theater (OT)
The picture below gives an idea of how laparoscopy helps in visualisation of intra-abdominal organs and performance of procedures on them.
The Surgeon is able to visualise the inside of the abdomen on the medical monitor which has been transmitted by the laparoscope inside the abdomen.The video image is approx. 20 times magnified allowing excellent visualisation of the internal organs.It requires a lot of skill on part of the surgeon to co-ordinate his hands and eyes to move and manipulate the special instruments inside the abdomen to perform surgeries.