SIVA HOSPITAL

SIVA HOSPITAL





SIVA HOSPITAL

RECEPTION

LAB

PHYSIOTHARAPY ROOM

I.C.U

OPERATION THEATRE

PHARMACY

Minimal Access Surgery

SIVAHOSPITAL 

The term minimal access surgery partially overlaps with several others, including.

1. endoscopic surgery
2. minimally invasive surgery
3. Laparoscopic surgery.

Lay people refer to it as keyhole surgery, these words often used interchangeably but that individual surgeons and surgeons and surgical teams may have their own preferred definition

Types of procedure Laparoscopy

 Laparoscope’s, minimal access to the abdomen for diagnosis and later for therapy, was invented in 1910 by a Russian gynecologist.

The Operation

            Therapeutic application in areas other than gynecology began in 1987 when a French surgeon (Philippe Mouret) [performed the first laparoscopic cholecystectomy. Soon after, and with the advent of high-definition televideoscopy, a revolution began in abdominal and also in thoracic surgery (thoracoscopy) which is still  in progress.

Advantages:

1.  The large painful wound of open access is avoided.

2.  The instruments used for dissection are small and fine and so the tissue trauma of       surgical dissection is further reduced.

1. The operation is carried out inside the closed, confines of the body cavity which avoids cooling. Drying, excessive handling and extensive retraction of internal organs.
2. The overall disturbance to the patient, including pain and discomfort, is reduced.
3.  Recovery  to full activity is accelerate.
4. There is considerable reduction in all complications related to the wound; dehiscence and incisional hernia disappear 9although too large an incision to create a port may result in a later port site hernia).
5. There is reduced contact with the patient’s blood and a   consequent reduction in postoperative complications associated with recumbence and pain; e.g. chest problems (Ch.16), deep vein thrombosis Ch.29).
6. There is a reduction in postoperative  complications associated with recumbence and pain; e.g. chest problems (Ch.16), deep vein thrombosis Ch.29).
7. There is a possible reduction in postoperative peritoneal adhesions.

Disadvantages

        General organizational physiological and pathological constraints.

General and Organizational   Constraints

• Time. Procedures performed laparoscopically are generally slower, especially when setting-up time is included. This has important effects on scheduling and costs.
• Skills. Special technical expertise is necessary and it is only recently that training centers have been set up.

  Physiological and pathological constraints.

• A large pneumoperitoneum may compress the diaphragm and  lung bases and cause postoperative hypoxia.
• Previous adhesions may make a pneumoperitoneum impossible.
• There is a risk of gas embolism, although this is very small.
• Tactile feedback to the operating team is lost; this is important in some aspects of the evaluation of local disorder,
• Precise control of bleeding is undoubtedly more difficult to achieve through an endoscope because the bleeding point often retracts within surrounding tissues. Bleeding during minimally invasive surgery can considerably the field of vision.
• Organ extraction: in some instances use is made of natural pathways, such as the mediastinum for the esophagus or through the rectum for the colon. Other organs, such as the gall bladder or appendix are small enough to be removed through a port site after they have been put in a bag to stop the consequences of rupture and possible.
• Contamination. Yet others (spleen) can sometimes be broken up (morcellised), but for some circumstances the matter remains unresolved.

    Conversion from laparoscopy to open exposure

  

              Conversion from a laparoscopic to open procedure does not constitute a failure.

Part of the success of minimally invasive surgery rests on the ability of the surgeon to determine that the patient’s  interest are best served by converting a laparoscopic procedure to the same operation performed with open access.

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 (Key Hole surgery)

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Pin: 629 501.

Nghd; :04652-252253/251119)

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4.   24x24, 18x18 rJu msT gug;gsT nfhz;Ls;sJ.

5.   ,izg;Gfs; mw;w Rtiu nfhz;lJ.

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7.   midj;Jk; Computerized Monitor system %yk; ,aq;Fk;.

8.   n[h;kd; nlf;dhy[p mWit rpfpr;ir Nlgpis nfhz;Ls;sJ.

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