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Illustration of Laparoscopy
Laparoscopy (from Ancient Greek λαπάρα (lapara), meaning "flank, side", and σκοπέω (skopeo), meaning "to see") is an operation performed in the abdomen or pelvis through small incisions (usually 0.5–1.5 cm) with the aid of a camera. It can either be used to inspect and diagnose a condition or to perform surgery.
There are two types of laparoscope: (1) a telescopic rod lens system, that is usually connected to a video camera (single chip or three chip), or (2) a digital laparoscope where a miniature digital video camera is placed at the end of the laparoscope, eliminating the rod lens system. The mechanism mentioned in the second type is mainly used to improve the image quality of flexible endoscopes replacing traditional fiberscopes. Nevertheless, laparoscopes are rigid endoscopes. The rigidness is required in clinical practice. The rod lens based laparoscopes are highly dominant in practice, due to their fine optical resolution (50 µm typically, dependant on the aperture size used in the objective lens), and the image quality can be better than the digital cameras if necessary. The second type is very rare in the laparoscope market and hospitals.
The laparoscope allows doctors to perform both minor and complex surgeries with a few small cuts in the abdomen.
There are a number of advantages to the patient with laparoscopic surgery versus an open procedure. These include reduced pain due to smaller incisions and hemorrhaging, and shorter recovery time.
In gynecology, diagnostic laparoscopy may be used to inspect the outside of the uterus, ovaries and fallopian tubes, for example in the diagnosis of female infertility. Usually, there is one incision near the navel and a second near to the pubic hairline.
For gynecological diagnosis, a special type of laparoscope can be used, called a fertiloscope. A fertiloscope is modified to make it suitable for trans-vaginal application.
A dye test may be performed to detect any blockage in the reproductive tract, wherein a dark blue dye is passed up through the cervix and is followed with the laparoscope through its passage out into the fallopian tubes to the ovaries.
Although laparoscopy in adult age group is widely accepted, its use in the pediatric age group is questionable. The efficacy of laparoscopy is inferior to open surgery in situations such as pyloromyotomy for infantile hypertrophic pyloric stenosis. Although laparoscopic appendectomy results in fewer wounds than open surgery, the former is also associated with more intra-abdominal abscesses.
During a laparoscopic surgery the video camera becomes a surgeon’s eyes, since the surgeon uses the image from the video camera positioned inside the patient’s body to perform the procedure. Visual feedback is either similar or often superior to open procedures. The greatest limitation to these minimally invasive approaches is the impairment (in the case of traditional laparoscopy) or complete lack of tactile sensation (in the case of robotic laparoscopy) normally used to assist in surgical dissection and decision making. Despite of multiple attempts, no tactile imaging device or probe is currently commercially available for laparoscopic surgery. Figure on the right presents one of the advanced solutions, which is in the development phase.
- MedlinePlus > Laparoscopy Update Date: 8/21/2009. Updated by: James Lee, MD
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