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laparoscopy goes miniDr Foo Chek Siang, a General Surgeon practising at Mount Elizabeth Novena Hospital,talks about the benefits of laparoscopy in gallbladder surgery.Laparoscopy is a common procedure and is mostoften applied for surgical removal of gallbladder(cholecystectomy).Also called minimally invasive surgery or keyhole surgery,laparoscopy is a modern technique in which operations inthe abdomen are done through three to four small incisionsbetween 6 and 11mm, compared to a conventional opensurgery where a 8 to 15cm incision is made.The most obvious advantage of laparoscopy is smallerscars, which results in better appearance and self-esteem.Patients also benefit from lower risk of infection, less postoperativepain and faster recovery.Advancements in laparoscopy have further reduced thesize of incisions. In minilaparoscopy, gallbladder patientsrequire no more than 3.5mm incisions. The tissue traumathey experience is also halved, with the use of low friction,conical-tip instruments. The result is smaller and morenatural looking scars.Further refinements to the minilaparoscopiccholecystectomy technique have removed the use of clipsto ligate the duct or artery in the gallbladder. Instead, theartery is “burnt” using a high frequency electric currentand the duct is tied with surgical knots within the body.The cost of operation is reduced and patients reportedlittle pain and greater satisfaction with the surgery results.Apart from gallbladder surgery, minilaparoscopy is alsoused in basic operations such as hernia mesh repair andappendicectomy (surgical removal of vermiform appendix).It is also applied in advanced operations including refluxprocedures, sympathectomy (surgical destruction of nervesto reduce pain and excessive sweating), abdominal lymphnode sampling and removal of abdominal mesenteric cysts.New Science 39