Laparoscopic or “key hole” surgery was developed at the end of the 20th century as a new trend in surgical treatment, allowing patients to have a better recovery period after a surgery, with less pain, better cosmetic results and faster return to work and normal daily activities.
The technique was initially developed for small procedures, mainly diagnostic. Soon the procedures that were performed in this way started to increase both in complexity and type of surgery.
Over the past 10 years, the majority of the surgical procedures have been attempted and performed by laparoscopy successfully by experienced surgeons, in almost all areas of surgical expertise.
The most known procedures that can be performed by laparoscopy are gallbladder extraction (cholecystectomy), appendectomy, hernia surgery, gastroesophageal reflux disease, obesity procedures, ovarian surgery and tubaric ligation, kidney stone procedures, and minor thoracic surgeries both in adults and children.
As surgeons became more experienced, complex open surgeries like hepatic resection, large bowel and stomach cancer, spleen and kidney tumors started to be performed also by laparoscopy, raising the level of expectations of the medical and general population.
In these past 10 years, new laparoscopic surgery technologies have been appearing, with more or less consensus among surgeons and the general population:
1. Robotic Surgery – mainly used for prostatectomy, implies very high costs.
2. Natural Orifice Translumenal Endoscopic Surgery (NOTES) – Implies that the surgery to be performed will gain access to the abdomen through the wall of the stomach or vagina (efficiency not proven).
3. Single Port Technique – Single-Incision Laparoscopic Surgery (SILS) – all instruments are introduced in the abdomen through a single entry point of 3 to 4cm, typically the patient’s navel
4. Miniport Technique – Uses the same technique and incision locations applied in common laparoscopy, but uses miniature instruments that do not leave scars – micro laparoscopy or micro “keyhole” surgery.
This new micro laparoscopic technique basically uses all the common laparoscopic techniques which have been tested and are absolutely safe using bigger trocars and incisions, but in micro laparoscopy all the instruments are miniature. Three months after micro laparoscopic surgery, the incisions necessary to carry out this procedure as well as subsequent scars are almost invisible.
The HPA group has recently acquired this new technology that is available both in the Gambelas and Alvor hospitals.
This most recent technology is used for gallbladder removal, appendectomy, hernias (inguinal and incisional, in selected cases), gynecologic (tubarian ligation, ovarian cysts), varicocel treatment and also minor thoracic procedures, like symphathectomy and treatment of pneumothorax.
Anyone needing to be submitted to surgery and expecting better aesthetic results is advised to contact us and ask about this new innovative technique.
By Dr. Paulo Vieira de Sousa
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Dr. Paulo Sousa is a Surgeon and Medical Director at the Hospital Particular do Algarve Group
