What is Endoscopic Surgery?

Endoscopic Surgical Guide to far
Less-Invasive Endoscopic Surgery Techniques

Endoscopy means looking inside or in the interior and when related to health refers to looking inside the human body for medical reasons. Endoscopic surgery is a technique that involves the use of an endoscope instrument, which allows a surgeon to visually examine the interior of a bodily canal or a hollow organ such as the colon, bladder, or stomach through a very small incisions.

Most chronic sinusitis conditions that need surgery to relieve the chronic sinusitis condition are performed using endoscopic surgery, a new way of operating without making incisions on your face. The endoscopic surgery usually takes 1-3 hours and it can take several weeks for a full recovery.

Endoscopic surgery has been performed for decades in gallbladder removal, tubal ligation, and knee surgery. However, in the world of plastic surgery, endoscopic instruments have recently been introduced. Plastic surgeons believe the technique holds great promise, but further study is needed to establish its effectiveness, especially over the long-term. As important research continues, endoscopy is being used on a limited basis for both cosmetic and reconstructive procedures.

The goal for using endoscopes for surgery is to reduce the tissue trauma and body's response to the injury of traditional (or open) surgery. As compared to minimally invasive surgery, traditional surgery requires much longer incisions and the stretching of incisions with retractors. Minimally invasive surgery usually uses several very small openings, thus reducing the surgical insult. Controlled studies in patients and laboratory animals have found decreased stress response in patient operating endoscopically as compared to traditional surgery.

Endoscopy is more critical in exotic and zoo animals as even a physical examination or obtaining a blood sample frequently requires sedation or general anesthesia. In these animals, it is common to perform all diagnostic procedures during one anaesthetic episode such that blood sampling, focused physical examinations, radiography, ultrasonography, and endoscopy are performed at the same time. Endoscopy may be with rigid or flexible scopes depending on the nature of the problem. Rigid endoscopy can provide diagnostic information and may even provide the means to treatment.

Endoscopic surgery is used to remove gallstones. Surgery to remove the gallbladder is the most common way to treat symptomatic gallstones. (Asymptomatic gallstones usually do not need treatment.) Each year more than 500,000 Americans have gallbladder surgery. The surgery is called cholecystectomy.

The most common operation is called laparoscopic cholecystectomy. For this operation, the surgeon makes several tiny incisions in the abdomen and inserts surgical instruments and a miniature video camera into the abdomen. The camera sends a magnified image from inside the body to a video monitor, giving the surgeon a close-up view of the organs and tissues. While watching the monitor, the surgeon uses the instruments to carefully separate the gallbladder from the liver, ducts, and other structures. Then the cystic duct is cut and the gallbladder removed through one of the small incisions.

Because the abdominal muscles are not cut during laparoscopic surgery, patients have less pain and fewer complications than they would have had after surgery using a large incision across the abdomen. Recovery usually involves only one night in the hospital, followed by several days of restricted activity at home.

If the surgeon discovers any obstacles to the laparoscopic procedure, such as infection or scarring from other operations, the operating team may have to switch to open surgery. In some cases the obstacles are known before surgery, and an open surgery is planned. It is called "open" surgery because the surgeon has to make a 5- to 8-inch incision in the abdomen to remove the gallbladder. This is a major surgery and may require about a 2- to 7-day stay in the hospital and several more weeks at home to recover. Open surgery is required in about 5 percent of gallbladder operations.

The most common complication in gallbladder surgery is injury to the bile ducts. An injured common bile duct can leak bile and cause a painful and potentially dangerous infection. Mild injuries can sometimes be treated non surgically. Major injury, however, is more serious and requires additional surgery. Click-here for Health Tip-of-the-Day.

If gallstones are in the bile ducts, the physician (usually a gastroenterologist) may use endoscopic retrograde cholangiopancreatography (ERCP) to locate and remove them before or during the gallbladder surgery. In ERCP, the patient swallows an endoscope which is a long, flexible, lighted tube connected to a computer and TV monitor. The doctor guides the endoscope through the stomach and into the small intestine. The doctor then injects a special dye that temporarily stains the ducts in the biliary system. Then the affected bile-duct is located and an instrument on the endoscope is used to cut the duct. The stone is captured in a tiny basket and removed via the endoscope.

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Occasionally, a patient who has had a cholecystectomy is diagnosed with a gallstone in the bile ducts weeks, months or even years after a successful surgery. The 2-step ERCP procedure is usually successful in removing the stone.


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