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Inflammatory Bowel Disease Inflammatory Bowel Disease Treatment

The Future of Intestinal Surgery: Laparoscopy

Although it sounds futuristic, laparoscopy, which is a surgery performed with the help of a tiny camera that is temporary placed inside the body, has been a part of medical practice for decades. It was first used when performing tubal ligations, to prevent pregnancy, and to diagnosis abdominal conditions. It was later adapted to remove the gallbladder and the appendix. Because it allows surgeons to make smaller incisions than what is required in the traditional open surgery, patient recovery time is considerably easier and shorter.

Today, laparoscopic surgery is an increasingly popular option for people with intestinal conditions, who may need sections of the bowel repaired or removed. While recovery from open surgery for intestinal disease, which usually involves one large incision, takes an average of six weeks, people who have undergone laparoscopic surgery tend to feel back to normal in just three weeks. Below, Conor Delaney, MD, PhD, a staff surgeon in the department of colorectal surgery at the Cleveland Clinic Foundation, discusses these and other benefits of this minimally invasive surgery.

What kinds of intestinal conditions require surgery?
The common conditions that end up requiring surgery within the abdomen, particularly relating to the large and small bowel, are colon and rectal cancer, diverticulitis, and inflammatory bowel disease, such as Crohn's disease and ulcerative colitis.

What is the difference between open surgery and laparoscopic surgery?
Traditionally, abdominal surgery has been performed in an open manner, and what that means is the patient has a reasonably large incision, which varies in size between four and 10 inches long. It's usually in the midline of the abdomen, so it runs from the pubis at the lower midline of the abdomen up to the navel. The length depends on the extent of surgery and the extent of bowel that one has to free up or take out. When the surgery's performed laparoscopically, we put in three or four access ports, which are little plastic tubes that go into the abdomen that are positioned through incisions less than half-an-inch long. Then through these access ports we put in a camera, which is less than a half-inch in diameter, which is used to see what's going on inside the abdominal cavity. Through the other access ports we put in very fine little surgical instruments, about 5 millimeters in diameter. We use those instruments to free up the bowel and then we make an incision of four to six centimeters in size (around two inches) to remove the bowel.

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