Laparascopic (Keyhole) Surgery and its Advantages

In order to gain access to the internal pelvic organs, gynaecologists make use of two distinct methods: open surgery (laparotomy) and keyhole surgery (laparoscopy). During open surgery, a very large incision (cut) around 120mm in length is made to the abdomen and the cut made is then physically pulled open to form a large hole through which surgery is performed. The diagram below shows the two incisions, one of which is made during open surgery:

In contrast, during keyhole surgery, three extremely small 0.5cm – 1.2 cm incisions are made in the abdominal wall:

Through these holes are inserted i) long narrow instruments which are used to perform the surgery and ii) a laparoscope (video camera) which is used to guide the surgeon:

Due to the much smaller incisions made during keyhole surgery when compared to open surgery it has a vast number of advantages:

• Less post-operative pain
• Shorter length of hospital stay (1-2 nights for keyhole versus 5-7 with open) and quicker recovery
• Less wound complications:
– Infection
– Haematoma (blood collection in the wound)
– Dehiscence (wound gaping)
– Hernia (weak wound resulting in protrusion of abdominal content)
• Less disruption to bowel and bladder function
• Lower risk of infection of the operation site (since the operation site is not exposed to external environment)
• Lower risk of chest infection
• Lower risk of Deep Vein Thrombosis (DVT – clot formation in the leg veins)
• Less adhesion (sticking of the organ) and scar formation (since the operation is performed under magnification the surgery is more precise)
• Better cosmetic results (open surgery leaves a large scar on the abdomen which may never completely heal)
• Shorter convalescent time and so less disruption to family life and early return to work
• Less restriction to type of work one can do post-operatively

Perhaps the only disadvantage of keyhole surgery is that it is more technically demanding for the surgeon and requires more training. Mr. Trehan is a keyhole surgery specialist with over 20 years experience of keyhole surgery and has performed several thousand procedures via keyhole surgery, and patients can therefore rest assured that their operation will be completed by keyhole surgery and will not be converted to open surgery. Mr. Trehan’s conversion to open surgery rates and complication rates are amongst the lowest reported in the literature.

Mr. Trehan performs almost 100% of procedures via keyhole means with very rare exceptions.

It is important to note that no operation is complication/risk free. Although extremely rare for Mr. Trehan, risks of surgery include: injury to internal organ, such as bowel, bladder (urine bag), ureter (tube carrying urine), blood vessels; infection; haemorrhage (blood loss); blood clots leading to Pulmonary Embolism etc. The only assurance Mr. Trehan can provide you is that he has an excellent past record, and his complication rates are among the lowest reported in the literature.