Laparoscopic surgery, also called minimally invasive surgery (MIS) / band aid surgery / keyhole surgery is a modern surgical technique in which operations in the abdomen are performed through small incisions (usually 0.5-1.5 cm) as compared to the larger incisions needed in laparotomy.

The key element in laparoscopic surgery is the use of a laparoscope. This is a long thin instrument with a light source at its tip, to light up the inside of the abdomen or pelvis. Fibreoptic fibers carry images from a lens, also at the tip of the instrument, to a video monitor, which the surgeon and other theatre staff can view in real time. The laparoscope can be moved around within the abdominal or pelvic cavity to give several different views.

Three or more small (5-10 mm) incisions are made in the abdomen to allow access ports to be inserted. The laparoscope and surgical instruments are inserted through these ports.

The abdomen is usually insufflated, or essentially blown up like a balloon, with carbon dioxide gas. This elevates the abdominal wall above the internal organs like a dome to create a working and viewing space. CO2 is used because it is common to the human body and can be absorbed by tissue and removed by the respiratory system. It is also non-flammable, which is important because electrosurgical devices are commonly used in laparoscopic procedures.

The surgeon then uses the laparoscope, which transmits a picture of the abdominal organs on a video monitor, allowing the operation to be performed.

Traditional intestinal surgery requires a long incision down the center of the abdomen and a lengthy recovery period. The word “laparoscopy” means to look inside the abdominal cavity with a special camera or “scope”. Laparoscopy, also known as “keyhole” surgery, has been used for many years to diagnose medical conditions inside the abdominal cavity. The intestinal laparoscopic surgery uses this same technique to remove diseased sections of the intestinal organs for selected patients.

Laparoscopic intestinal surgery eliminates the need for this large incision. As a result, the patient may experience less pain and scarring after surgery, more rapid recovery and less risk of infection.

Most of the procedures can be done as day care surgery but some might require more than 24 hours stay.

The advantages of the minimally invasive laparoscopic technique are:

• Small incisions and little blood loss.
• Less post-operative pain and need for pain medication.
• Earlier discharge from the hospital.
• Shorter post-operative disability at home.

Infection is the most common complication of any surgical procedure. In laparoscopic surgery, rate of infection is lesser than open surgery but many statistical studies show that infection is still the most common complication after laparoscopic surgery. This complication is not related to the laparoscopic technique itself but depends on the sterilisation and theatre environment of the hospital. In case of infection and other mild complications, a short course of appropriate antibiotic is sufficient to overcome the problem. The injury to the bowel is the second most common cause of morbidity and mortality after laparoscopic surgery. The injury to bowel and blood vessels is specially related to the technique of laparoscopic surgery. If the complication is severe, an additional operation may be required with a larger incision to either stop bleeding or repair an injury that cannot be fixed by laparoscopy. In experienced hands, complications may occur but are not frequent.