Wednesday, July 18, 2007

tying a knot laparoscopicly

I have heard of laparoscopy for several times. It’s minimally invasive and also known as a keyhole surgery. Patients don’t need to be hospitalized for a long time after operation. Improved cosmesis and reduced wound complications associated with large scars are also other major advantages. But not until this summer immersion did I have a chance to see a laparoscopy. Using one word to describe it from my own feeling, AWESOME.

The patient had a retroflex sigmoid colon. Because of gravity, the redundant colon constantly drags other part of colon and pushes rectum, which also brings pain to the patient. What the doctor will do is that he will use threads to knit a net to pull up the redundant colon. It sounds like a good idea.

At the beginning, the doctor made several small incisions on the abdomen and put come metal pipes through the abdominal wall as channels, so that a laparoscope and some other surgical devices could easily go in. Then CO2 was inflated and abdomen was blown up like a balloon to provide working and viewing place. The laparoscope captured real time movies and transmitted it to a high definition LCD. This is doctors’ “eyes” in the operation. Those long thin surgical devices are doctors’ “hands”.

Then we began a wild exploration. After identified several organs, the doctor thought that the position of uterus was hindering the operation so he delicately tacked the uterus onto the abdominal wall. He afterwards reassured me that considering the patient’s age, the chance for her to use her uterus was extremely low. That’s the reason he did so and it wasn’t a common procedure.

Finally, the retroflex colon was found. What happened next was I saw needles and threads going into the metal pipe. The long thin picker was so agile and efficient in such a small space. Within less than half an hour, some knots magically shown up on the monitor, and gradually assembled into a net. The redundant colon was fixed.

When the doctor was tying a knot, he tried to convince me that making a knot laparoscopicly is simple. I don’t believe him this time. Why? Just check out the underneath animation.

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