The decision to use laparoscopic surgery versus an open procedure, however, is based on the judgment of the physician. Open surgery is sometimes required if the small incisions will not provide enough access to the tissues that need to be repaired or removed.

At Midland Surgical Associates, our surgeons have extensive experience with laparoscopic surgery. Below are the laparoscopic procedures that we perform:

Laparoscopic Appendectomy

This procedure is typically done to remove the appendix. While most appendicitis cases are emergency situations, some patients plan to have the procedure done if the appendix has not burst but is causing discomfort.

An endoscope and a few surgical instruments are used in this procedure through small incisions. The endoscope has a TV monitor on the end of it, which allows the surgeon to see inside without the need of large incisions. The appendix is removed through the small incisions, and the patient experiences less pain and recovery time than with open surgery.

Laparoscopic Cholecystectomy

The most common of all laparoscopic procedures performed is for the removal of the gallbladder. This occurs when the gallbladder develops gallstones or chemical imbalances that impede its function. The gallbladder is removed through one of the small incisions, and the patient can usually return home quickly with less pain and scarring than with open surgery.

Colon Resection

A colon resection is a procedure used to remove part of the colon or, in severe cases, the entire colon. The surgery treats the following conditions:

During the procedure, the diseased part of the colon is removed, and the healthy ends are connected to one another. In some cases, a colostomy bag is used temporarily to allow the colon to have more time to heal before it must perform digestive functions on its own.

Like all other laparoscopic procedures, the colon resection usually has faster recovery time and less post-operative pain for patients than open surgery.

Hernia Repair

Some hernias can be treated and fixed laparoscopically as well. These include inguinal hernia, hiatal hernia, and incisional hernia.

• Inguinal Hernia: An inguinal hernia is a bulge in the groin from a small part of the bowel that has bulged out from a weakened place in the abdominal muscles. Repair involves reinforcing the weak part of the muscles with mesh.

• Hiatal Hernia: In a hiatal hernia, the stomach moves up toward the chest and sometimes causes digestive discomfort, including heartburn and acid reflux. Surgery is usually performed if there is a risk that the stomach will become strangulated, causing its blood supply to be cut off. The surgery prevents the stomach from sliding above the diaphragm.

• Incisional Hernia: An incisional hernia results from an incision from previous abdominal surgery when the fascia has not healed properly and begins to protrude through the abdominal muscles. Simple repairs involve re-suturing the area, while more severe cases may require the use of mesh and reconstruction of the abdominal wall.

Laparoscopic Spleen Removal

This procedure is used if the spleen is not functioning properly due to certain conditions, such as thrombocytopenia purpura, hemolytic anemia, or certain types of cancer. If the spleen is not too large, the surgeon may be able to remove it laparoscopically. In some instances, plugging the artery to the spleen before surgery can allow for a laparoscopic procedure so that the patient experiences less pain and recovery time after the spleen has been removed.

Nissen Fundoplication

This surgical procedure is used to treat gastroesophageal reflux disease and hiatal hernia. The stomach is wrapped or plicated around the lower end of the esophagus and stitched in place. The esophageal hiatus is also narrowed by sutures to treat concurrent hiatal hernia.

This procedure is routinely performed laparoscopically and even robotically with the Da Vinci Surgical System. The procedure is intended to relieve symptoms of GERD and should have faster recovery time than open surgery techniques.