The Daily Schedule Of A Laparoscopic Surgeon

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.

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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.

The Daily Schedule Of A Laparoscopic Surgeon 

A laparoscopic surgeon performs elective surgeries since minimally invasive procedures aren't ideal at this time for performing emergency procedures. The latter is still being researched for gastrointestinal surgeries. 

The specialist will consult with their post-operative patients on a daily basis and they tend to be discharged home relatively quickly due to the benefits of laparoscopic procedures. 

The office of the laparoscopic surgeon is situated in the hospital so that they can attend to any patients in the casualty department or hospital ward. These specialists will also provide on call services for the hospital during after hours and on weekends as part of the call roster for general surgeons. This means that they will also consult with emergency cases during this time period, but they will be more specialised to perform minimally invasive procedures in cases that aren't too emergent.

Monday 

This is usually an administrative day where tasks such as confirming and attending hospital meetings with staff and management occurs. The specialist will also confirm their surgical lists for the week and attend to other clinical and non-clinical administrative issues before they start consulting with patients.

The laparoscopic surgeon will consult with patients for the rest of the day and some may be managed conservatively before surgery is offered as a treatment option, and other patients will be sent for further investigations which will be followed up and feedback will be given to them. The specialist may decide to admit a patient for further management or schedule them for an elective procedure at a later date.

Tuesday

The laparoscopic surgeon will spend this day in theatre operating on patients. The most common laparoscopic procedure performed by these surgeons is a laparoscopic cholecystectomy, and they can perform 8-12 of these procedures every week. Other common laparoscopic procedures include a laparoscopic appendectomy and colectomy. 

Any emergency conditions of the gallbladder, appendix and colon needing surgical intervention would need to be done via a laparotomy since performing these procedures laparoscopically will put the patient in danger.

Wednesday

The surgeon will continue consulting with patients in the morning and performing laparoscopic procedures in the afternoon in the operating room.

The afternoon would also be used to perform other tasks such as filling in chronic prescriptions for patients, filling in motivation letters to medical aid companies to get authorization for certain procedures to be done (these insurance companies are notorious for not authorizing laparoscopic procedures when they can be done via open surgeries) and doing further research for the surgeons own academic requirements.

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Thursday

The surgeon will spend the morning operating on patients and the afternoon will be used for training of undergraduate medical students and postgraduate surgical residents.

Friday

The surgeon will attend to patients in their office for the morning and will reserve the afternoon for resolving any unfinished administrative duties. This will include confirming the surgical list for the following week.

Once the specialist has dealt with all these aspects, they can then finish up their work week.