Laparoscopic Surgery

What is Minimal Invasive Surgery (MIS)?

 

Minimal Invasive Surgery is a surgical approach to a problem which traditionally involves using a small cut or incision to correct the problem. An endoscope is a long, thin tube with a miniature camera attached at the end is passed through the incision. The images captured by the endoscope allow the surgeons to get a magnified view of the surgical area. The surgeon also passes special instruments through other openings that enable surgeons to perform the surgery. Due to small incisions, the patients experience less discomfort than with conventional surgery and the recovery time is much faster.

What are the advantages of MIS?

  • Magnified view during surgery and hence more accurate dissection and repair possible
  • Minimal postoperative pain
  • Early recovery
  • Early discharge
  • Minimal scarring
  • Less postoperative adhesions and long term complications

 

How safe is MIS in small babies and children?

MIS in children is done regularly worldwide in major pediatric surgical centers and also in a few centers in our country. The safety and success of MIS has been proven by many evidence based studies in multicenter trials and has become the prescribed standard of care for many conditions. However the success and safety always depends on the experience of the pediatric surgeon and the expertise of the pediatric anesthetist.

What are the common MIS procedures?

 

Laparoscopic

  • Appendicectomy (including complicated appendicitis)
  • Cholecystectomy -Intussusception reduction
  • Herniotomy – Orchiopexy
  • Pull through procedure – Fundoplication
  • Choledochal cyst excision – Meckel’s diverticulectomy
  • Splenectomy – Nephrectomy
  • Pyeloplasty – Pyelolithotomy
  • Ureteric reimplantation – Pyloromyotomy for IHPS
  • Ovarian cystectomy (including neonates)
  • Mesenteric cyst excision
  • Diagnostic procedures and biopsies

Thoracoscopic

  • Decortication -Bronchogenic cyst excision
  • Mediastinal mass excision -lung biopsies
  • Diaphragmatic hernia repairs
  • Diaphragmatic eventration repair

Bronchoscopy

  • Diagnostic bronchoscopy
  • Foreign body removal
  • Endobronchial biopsies

Endourology

  • Fulguration of posterior urethral valves (PUV) including neonatal fulguration
  • Visual internal urethrotomy for urethral strictures
  • Cystoscopic deroofing of ureteroceles
  • Cystoscopic injection of Deflux for non operative management of vesicoureteral reflux (VUR)
  • DJ stenting for upper tract obstructions with infection
  • Cystoscopic biopsies.

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