ADVANTAGES OF LAPAROSCOPIC SURGERY
In comparison to open surgery, laparoscopic surgery may result in:

- less trauma to the tissues
- less pain after the operation
- less use of painkillers after surgery
- less time in hospital
- faster return to work and normal activities
- faster return to exercise
- less scarring, therefore it is cosmetically better

DISADVANTAGES OF LAPAROSCOPIC SURGERY
- dangerous in inexperienced hands
- not all operations are suitable
- may take longer if surgeon inexperienced in the technique

WHO SHOULD DO LAPAROSCOPIC SURGERY?
A surgeon trained in the technique of laparoscopic surgery at a dedicated laparoscopic surgical teaching unit

OPERATIONS SUITABLE FOR LAPAROSCOPIC SURGERY:

· gallstone/gall bladder surgery
· hiatus hernia repair/anti-reflux surgery
· hernia surgery (i.e. groin, abdominal hernia)
· appendicitis surgery
· spleen surgery
· bowel surgery (small bowel, large bowel/colon, and rectum)
· gynaecological surgery

COMPLICATIONS OF LAPAROSCOPIC SURGERY
No operation can be performed with zero risk of complication. Some complications are minor and some are major, and even, occasionally, fatal. Some occur rarely, and others more frequently.
It is usually the duty of the surgeon performing the operation to ensure the patient understands the potential risk of complications before the decision to undergo surgery is made.

The following is a list of potential complications that may occur in any operation, either open or laparoscopic:

· Bleeding: All operations result in some bleeding. This usually stops or is stopped by the end of the procedure. Occasionally a major vessel (i.e. artery or vein) is inadvertently injured leading to excessive, even life threatening bleeding.

· Infection: is always a risk when surgery is performed. When contaminated (e.g. bowel) or infected (e.g. appendicitis) areas are operated on, the risk of infection is increased. Careful surgical technique with the help of antibiotics reduces this risk.

- Pain: Postoperative pain is controlled with analgesics (painkillers), either in injectable or tablet form. Pain after laparoscopic operation should be less than that experienced after open surgery.

Deep Vein Thrombosis (DVT) and Pulmonary embolism
There is a slight risk of DVT (clot in the deep veins of the leg) after laparoscopic surgery. This may result in a pulmonary embolism. Prophylactic Heparin may be used to thin the blood and therefore diminish the risk of developing this problem.

Anaesthetic Complications
Any anaesthetic is associated with a small risk to the patient, including risk of complications involving the lungs or heart. All the above risks are minimized by a skilled, experienced surgeon, anaesthetist, and theatre staff. A well-equipped, modern hospital would also minimize these risks.

HIATUS HERNIA, ANTI-REFLUX SURGERY

Potential complications :
1. difficulty swallowing
Some patients feel food getting stuck as it goes down past the new valve. This should be temporary and will improve with time until swallowing is back to normal.
2. "gas bloat"
T this is the feeling of gas trapped in the upper abdomen after a meal.Usually occurs only with overeating or eating too fast early on after the operation. This symptom should improve with time.
3. flatulence

BOWEL SURGERY
Any area of bowel (i.e. stomach, small intestine, large intestine, rectum) can be successfully operated on using laparoscopic surgery. The surgeon needs to be skilled in this technique in order to avoid unnecessary risks.
click here for a diagram of the abdomen

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