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A laparoscopic surgeon is a specialist surgeon who focuses on managing surgical conditions by performing minimally invasive procedures. This article will discuss the training of these surgeons, the conditions they manage and their daily schedules.

A laparoscopic surgeon manages elective surgical conditions by performing minimally invasive surgeries, also known as keyhole or bandaid surgeries. Laparoscopy is a relatively modern surgical technique, when looking at the history of surgical procedures, in which these procedures are performed from more distal areas from the location of the pathology, through small incisions (1-2cm) done on another area of the body.

When compared to open surgery, there are numerous advantages to the patient by performing a laparoscopic procedure. These include the following:

  • Smaller incisions are needed resulting in less post-operative scarring.
  • Less haemorrhaging (bleeding).
  • Less pain which results in less pain medication, such as narcotics, being needed.
  • The hospital stay is less that leads to a faster return to everyday activities.
  • There's a reduced risk of acquiring infections due to exposure of internal organs to possible contaminants.
  • A faster recovery time as compare to open surgeries.

Instrumentation used in laparoscopic procedures

Laparoscopic procedures are performed by using a long, fibre-optic cable system which allows viewing of the pathology by maneuvering the cable from a more distant and easily accessible location. Two types of laparoscopes exist and they are a digital laparoscope, and a telescopic system that's connected to a video camera.

The scope is then attached to a fibre-optic cable system that is connected to a Xenon or Halogen light source. Once the scope is inserted into the area distal to the pathology, the abdomen is then expanded with carbon dioxide (CO2). A working and viewing space is then produced since the abdominal wall is lifted away from the intra-abdominal organs. The reason why CO2 is used is because it's non-flammable, non-toxic in the abdomen, it occurs commonly in the body, it can be absorbed by human tissue and is removed by the respiratory system. 

Laparoscopic surgery is performed within the abdominal or pelvic cavities, depending on the patient's pathology, and a minimally invasive procedure performed on the chest or thoracic cavity is called thoracoscopic surgery. 

Training

A laparoscopic surgeon needs to complete the following training programmes before they become specialist surgeons in the field of laparoscopic procedures.

  • A 5-6 year medical and surgical undergraduate programme to become a qualified medical doctor.
  • A 1-2 year internship training period where the doctor becomes exposed to the various surgical and medical disciplines.
  • A 5 year residency programme in general surgery to become a qualified surgeon.
  • A 1-2 year fellowship training programme in laparoscopic procedures.

Advanced technologies in laparoscopic medicine - Robot laparoscopic surgery

Electronic tools have been developed to assist surgeons. An example of this impressive technology is a system that is remotely controlled by a surgeon and it has the following features:

  • It performs a reduced number of incisions, in fact just one at the navel.
  • The device makes use of a large viewing screen which improves visibility and visual magnification.
  • It contains simulators which offers a virtual reality training tool for surgeons in order to improve their proficiency in surgery. 
  • There's electromechanical damping of vibrations that can be caused by shaky hands or due to machinery mechanics, and this offers improved stabilization.
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