This week: laparoscopy

My mother (45) has been diagnosed to have stones in her gall bladder. Doctors have advised its removal. We have decided to go for a laparoscopic surgery, but my relatives are against it. They say that it’s not a foolproof procedure, as in many cases stones or parts of the gall bladder are left behind, leading to further complications. They are in favour of an ayurvedic medicine which can dissolve the stone. I am confused. Which of the treatments should we opt for? My wife (38) has been diagnosed to have stones in the bile duct as well as the gall bladder. What should we do? My wife (37) has been suffering from an ovarian cyst. Can it be removed laparoscopically? Can she conceive after this surgery? My father (62) has an appendix problem. A doctor has suggested that it be removed laparoscopically? Is there any advantage if we go for this procedure? I (35) have been diagnosed to have hernia in my groin. I’m very worried. Can it be removed laparoscopically? Is it a very expensive treatment?

By Doctor's Desk Dr Om Tantia is the medical director, Institute of Laparoscopic Surgery Speciality Centre
  • Published 22.08.05
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gall bladder stone

My mother (45) has been diagnosed to have stones in her gall bladder. Doctors have advised its removal. We have decided to go for a laparoscopic surgery, but my relatives are against it. They say that it’s not a foolproof procedure, as in many cases stones or parts of the gall bladder are left behind, leading to further complications. They are in favour of an ayurvedic medicine which can dissolve the stone. I am confused. Which of the treatments should we opt for?

There is no medicine which can dissolve the stones. It has to be surgically removed. The removal of the gall bladder can be done both by open and laparoscopic surgeries. In the former, a surgeon has to make a 6-8 inch cut on the stomach, and she will have to stay in the hospital for five to seven days. In this procedure she will have to endure a lot of pain, agony and other associated problems. The surgery will also leave a scar on her stomach. Gallstones can also be removed using a laparoscope; in this technique the surgeon makes four small holes on the stomach and views the inside of the abdomen through a high-resolution telescope under magnification. Then the surgery is performed. There is practically no blood loss, very little pain and the patient can go home 24 hours after the operation. He or she can also resume normal jobs within a week. In this procedure the entire gall bladder, along with the stones, are removed.

bile duct stone

My wife (38) has been diagnosed to have stones in the bile duct as well as the gall bladder. What should we do?

Ideally, the bile duct stone should be removed by ERCP (Endoscopic Retrograde Cholangiopancreatography) in which an endoscope is inserted through the mouth to clear up stones in the duct. This is basically an out-patient procedure with minimum risk. After the stones are cleared by ERCP your wife can go for a laparoscopic removal of the gall bladder. If facilities for ERCP not available, open surgery should be done. However, in some centres laparoscopic removal of stones from the bile duct is also done with equally good results.

ovarian cyst

My wife (37) has been suffering from an ovarian cyst. Can it be removed laparoscopically? Can she conceive after this surgery?

A normal ovarian cyst can be removed laparoscopically with the same kind of result as in an open surgery. In the former, three tiny punctures are made and the cyst is removed through them. The ovary is kept intact and there is no harmful effect on conception. The results, at times, are even better than in an open surgery, as there are less adhesions (the intestine or other organs sticking to the ovary) in a laparoscopic surgery.

appendicitis

My father (62) has an appendix problem. A doctor has suggested that it be removed laparoscopically? Is there any advantage if we go for this procedure?

The appendix can be removed laparoscopically quite easily. The advantage is that concomitant diseases are identified and a correct diagnosis is achieved. Sometimes the appendix is situated in an abnormal position and this calls for large cuts in an open surgery. Such unusual cuts can lead to more pain and complications, compared to those of a laparoscopic method.

hernia

I (35) have been diagnosed to have hernia in my groin. I’m very worried. Can it be removed laparoscopically? Is it a very expensive treatment?

Laparoscopic repair of groin hernias are done with good results. In this method a large mesh (or prosthesis) is placed from behind the hernial defect into the groin. The cost of the treatment is at par with that in open surgery, considering the fact that the patient is back home within 24 hours of the operation and resumes normal work within seven days of surgery. An open surgery requires 5-7 days of hospitalisation and 3-4 weeks’ leave from office.


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