New Jersey General Surgery

General | Colon | Endocrine | Reflux Disease [GERD]

Laparoscopic Appendectomy

The appendix is a small narrow segment of the large intestine that is generally found in the lower right side of the abdomen.  The appendix is prone to sudden infections. If this infection remains untreated, the appendix may burst, causing infection to spread throughout the abdomen.  Once the appendix is infected, an emergency surgery (appendectomy) must be performed before a hole develops in the appendix (ruptured appendicitis).  If surgery is not performed, ruptured appendicitis can spread the infection nearby (abscess) or throughout the abdomen (peritonitis). 

What are the symptoms of appendicitis?

• Abdominal pain:  Pain may begin around the belly button and then develop to sharp pain in the lower right side
• Fever and chills
• Nausea, vomiting or loss of appetite

If you have these symptoms, see a doctor immediately!

The laparoscopic (minimally invasive) surgical technique involves making 3 tiny cuts in the abdomen and inserting a miniature camera and surgical instruments. The surgeon then removes the appendix with the instruments, so there is usually no need to make a large incision in the abdomen

Most cases of acute appendicitis can be treated laparoscopically. The main advantages are:

• Less post-operative pain
• Faster recovery and return to normal activity
• Shorter hospital stay – most patients can be discharged within 24 hours
• Smaller incisions/scars

Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy, the removal of the gallbladder with very small incisions, is one of the most commonly performed surgical procedures in the United States.

The gallbladder is a small pear-shaped pouch situated under the liver in the upper right part of the abdomen. It stores bile, a liquid produced by the liver, and then releases it into the intestine to help digestion.

 

Gallstones are small, hard stones, which can sometimes develop in the gallbladder. They can result in a blockage of the flow of bile out of the gallbladder and symptoms that can include pain, jaundice (yellowed skin), and fever. The body can function well without a gallbladder and removing it is a common treatment for gallstones that are causing symptoms. 

Laparoscopic cholecystectomy uses approximately 4 small incisions to extract the gall bladder.  In most cases, the surgery is well tolerated and the patient is discharged home the day after surgery. Although there are many advantages to laparoscopy, the procedure may not be appropriate for some patients who have had previous upper abdominal surgery or who have some pre-existing medical conditions. A thorough medical evaluation by your personal physician, in consultation with a surgeon trained in laparoscopy, can determine if laparoscopic gallbladder removal is an appropriate procedure for you.


Laparoscopic Hernia Repair

A hernia describes a weakness of the inside layers of abdominal muscle, which creates a bulge or tear.  Similar to an inner tube which pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened abdominal wall to form a small balloon-like sac.  A loop of intestine or abdominal tissue can push into the sac, which could cause potentially serious problem requiring surgery.  A hernia may be present since birth, or may develop over time.  A hernia will not go away by itself; the only way to repair a hernia is with surgery.

The common areas where hernias occur are in the groin (inguinal), belly button (umbilical), and the site of a previous operation (incisional). It is usually easy to recognize a hernia. You may notice a bulge under the skin. You may feel pain when you lift heavy objects, cough, strain during urination or bowel movements, or during prolonged standing or sitting. Severe, continuous pain, redness, and tenderness are signs that the hernia may be entrapped or strangulated. These symptoms are cause for concern and immediate contact of your physician or surgeon.

Laparoscopic hernia repair is a technique to fix tears in the abdominal wall (muscle) using small incisions, telescopes and a patch (mesh). It may offer a quicker return to work and normal activities with decreased pain for some patients. The laparoscopic approach uses a laparoscope (a tiny telescope) connected to a special camera to view the hernia and surrounding tissue on a video screen.  Other cannulas are inserted which allow your surgeon to work "inside." Three or four quarter inch incisions are usually necessary. The hernia is repaired from behind the abdominal wall. A small piece of surgical mesh is placed over the hernia defect and held in place with small surgical staples.

Excerpted from Society of American Gastrointestinal Endoscopic Surgeons' Task Force on Patient Information