Dr. N Bharwani – Medicine Hat

General Surgeon, Freelance Writer, Photographer at Noorali Bharwani Professional Corporation, Medicine Hat, Alberta, Canada.

Noorali’s weekly column (What’s up doc?) has appeared in the Medicine Hat News since 1998. His articles have appeared in The Medical Post. He has made several infomercials (Medical Moments) for CHAT TV as part of his on going commitment to educate the public on health matters.

Dr. Noorali Bharwani is a general surgeon and a former Regional Chief of Staff for the Palliser Health Region in southeastern Alberta. He is also a freelance writer and contributes columns on health, wellness and travel to newspapers in Canada.

Minimally invasive surgery has revolutionized surgical procedures. – July 2018

In minimally invasive surgery, doctors use a variety of techniques to operate with less damage to the body than with open surgery. Minimally invasive surgery is associated with less pain, a shorter hospital stay and fewer complications.

This advantage is achieved by using a technique called laparoscopy where surgery is done through one or more small incisions, using small tubes and tiny cameras and surgical instruments.

Laparoscopic technique was one of the first types of minimally invasive surgery. Another type of minimally invasive surgery is robotic surgery. It provides a magnified, 3-D view of the surgical site and helps the surgeon operate with precision, flexibility and control.

It was in 1902, Georg Kelling from Dresden in Germany performed laparoscopic surgery using dogs. In 1910, Hans Christian Jacobaeus from Sweden used the approach to operate on a human. Over the next couple of decades, the procedure was refined and popularized by a number of people.

Laparoscopic gallbladder surgery (cholecystectomy) was introduced about 25 years ago. In 2011, cholecystectomy was the 8th most common operating room procedure performed in hospitals in North America.

Now laparoscopy has become the approach of choice for cholecystectomy. Other laparoscopic surgical procedures are appendectomy, nephrectomy, hysterectomy and other gynecological procedures. Just like anything else in life, these procedures are not without complications – during or after surgery.

If the laparoscopic surgery is difficult to perform and if the surgeon feels this may cause harm to the patient then the procedure is converted into an open one. Patient has to understand this and give consent to the surgeon to do whatever is safe for the patient.

To make sure that the surgical procedures are carried out safely, the operating room follows a protocol, which takes into account the following:

  • Perform a surgical pause (time out) to confirm the procedure with the team prior to initiating surgery.
  • Verify that the correct materials or equipment was available and functional prior to use.
  • Consider potential harm from misuse of surgical equipment.

Possible intra-operative injuries include damage to the bowel, blood vessels, ureter, reproductive organs, or nerves. The complication rate during surgery increase if the patient is obese and there are adhesions from previous surgeries.

How quickly you can return to normal activities after a cholecystectomy depends on which procedure your surgeon uses and your overall health. People undergoing a laparoscopic cholecystectomy may be able to go back to work in a matter of days. Those undergoing an open cholecystectomy may need a week or more to recover enough to return to work.

In 95 per cent of people undergoing cholecystectomy as treatment for simple biliary colic, removing the gallbladder completely resolves their symptoms. Up to 10 per cent of people who undergo cholecystectomy develop a condition called post-cholecystectomy syndrome. That means patient has symptoms typically similar to the pain and discomfort of biliary colic. Small number of patients may get chronic diarrhea after surgery. This can be controlled with medication like cholesteramine.

Overall, it is a very safe procedure.

2018-07-10T14:26:45+00:00