Keyhole Surgery offers new hope. DNA healthline, May27, 2007,DNA healthline,May 27, 2007

Keyhole surgery offers new hope

Even complex procedures are now possible due to the advances in laparoscopy technology and equipment

For two years after he was born, Rahul Singh's parents did not realise their son had been born with a defect. One of the boy's testicles had not descended, and the family was told that only surgery would correct the problem. "He was very small and it was a scary thought, so we put off surgery till later," says Rahul's father, Ramesh. After several surgeons told him it might already be too late, Ramesh came across one who suggested laparoscopy.

Four months after surgery, Rahul, now 3, has only a two-millimetre scar as a reminder that he had a problem. "In Rahul's case, open surgery wasn't an option. It would have been too dangerous after the age of two," says Dr Arbinder Singal, paediatric surgeon at MGM hospital, Vashi. "Thanks to laparoscopy it is now possible for surgeons to carry out even complicated paediatric procedures."

Since it was introduced in the 1980s, laparoscopy or key-hole surgery has become immensely popular and used for a wide spectrum of surgeries. A surgeon inserts a telescope and other surgical instruments through small incisions in the abdomen, and then performs the procedure by watching the images on a computer screen. Only a qualified laparoscopic surgeon can perform the procedure as it needs a lot of precision and hand-eye coordination.

"Almost 80 per cent of all abdominal surgeries are performed laparoscopically," says Dr Deepraj Bhandarkar, senior laparoscopic surgeon at PD Hinduja National Hospital. "The remaining 20 per cent are open surgeries only because the patient is an accident victim or has cancer or very large tumours," he adds. Advances in optical instruments, cameras and surgical instruments have also made the procedure more precise.

For instance, surgeons now use ultrasonic shears that immediately seal blood vessels along the incision. This means that patients who could haemorrhage during an open surgery can undergo laparoscopy, and reduce the risk involved. "Laser technology causes minimal damage to tissues and blood vessels even during the procedure," says Dr Bhandarkar.

There are a lot of reasons for the increasing popularity of laparoscopic surgery. "It is minimally invasive, which speeds up the healing process," says Dr Singal. Patients usually need to spend only a few days in the hospital, and because the incision is small, the wound heals much faster and leaves no scars. "The surgery is also more precise because the doctor gets a magnified view of the organ he is operating on," he adds.

A laparoscopy costs about Rs2,000-3,000 more than open surgery. "The cost has come down because Indian manufacturers make good equipment now and we don't need to import them anymore," says Dr Bhandarkar.

For Puriben Rathod, 95, laparoscopy proved to be a life-saver. She had stones in her kidney as well as her gall bladder. "The pain was terrible," she says. Doctors didn't want to risk open surgery on Rathod because of her age, so she underwent a laparoscopy. "We did not know too much about laparoscopy, but we are grateful now," says Deepak, her grandson. "She was ready to go home a day after the surgery. A week later, she was all set to go shopping for vegetables."