What are Laparoscopic-Assisted
Endoscopic Procedures?
Laparoscopic- assisted endoscopic procedures are performed
to assess parts of the gastrointestinal tract which have
been excluded or bypassed from previous surgery for obesity,
ulcer disease or cancer. The most commonly excluded portion
is the distal stomach and the first stage of the small
bowel which drains the bile ducts. Patients may develop
bleeding ulcers or bile duct stones which cannot be accessed
by routine upper endoscopy. The goal of laparoscopic assisted
endoscopy is to allow the endoscope to pass through a
small incision in the skin into the excluded portion of
bowel.
How are Laparoscopic-Assisted
Endoscopic procedures performed?
Laparoscopic surgery uses a thin, telescope-like instrument
called a laparoscope which is inserted through a small
incision in the umbilicus. The laparoscope is connected
to a tiny video camera which projects a video image of
the operative site onto video monitors in the operating
room. An endoscope is also a telescope like instrument
that is flexible and is used to examine the gastrointestinal
tract. The abdomen is inflated with carbon dioxide, a
gas, to allow your surgeon a better view of the operative
area. A total of four incisions will be made with an umbilical
incision, two incisions in the left upper quadrant of
the abdomen and one incision in the right upper abdominal
quadrant. The stomach or first stage of the small bowel
are dissected free of scar tissue.
Stitches are placed in the bowel and used to elevate
it to the anterior abdominal wall. The bowel is then entered
using a needle with an outer sheath. Progressively larger
sheaths are placed into the bowel to dilate the hole in
the bowel until it is the same diameter as the endoscope.
The endoscope is then passed into the intestine at which
time therapeutic maneuvers such as common bile duct stone
extraction can be performed. After completion of these
procedures the hole in the bowel is sutured closed.
Why Laparoscopic?
- ___Four tiny scars instead
of one large abdominal scar.
- ___Shorter hospital stay.
- __
Reduced post-operative pain.
- ___Shorter recovery time
and quicker return to daily activities, including work.
What can I expect after surgery?
It is important to follow your doctor’s instructions after
surgery. You will be started on a liquid diet the day
after surgery. If you are able to tolerate liquids, you
should be discharged the day after surgery.
To make
an appointment with Dr. Rosser, please call 212-420-4337.
