Karim Sarhane

An Overview of Laparoscopic Surgery

Karim SERHAN
Dr. Karim SERHAN

Laparoscopic surgery is a revolutionary surgical technique that utilizes innovative methods to deliver improved surgical outcomes. Through the insertion of short, narrow tubes known as trochars into the abdomen via small incisions, this procedure paves the way for transformative medical possibilities. Surgeons skillfully employ long and narrow instruments within these trochars to manipulate, cut, and suture tissue, granting them great precision. In stark contrast to traditional open abdominal surgery, which necessitates substantial incisions ranging from 6 to 12 inches, laparoscopic surgery embraces a more precise approach. With a mere two to four small incisions measuring half an inch or less, the benefits can be substantial. This technique allows for enhanced visualization and optimal surgical maneuvers. These incisions serve distinct purposes: one acts as an entry point for a camera, while the others accommodate the surgical instruments. A vast array of common surgeries can now be accomplished through laparoscopy, heralding a new era of medical advancement. The procedure entails using a laparoscope, a slender tube equipped with high-intensity light, and a high-resolution camera at its forefront, granting doctors a clear view of the abdominal organs. Guided by these live images projected onto a video monitor, physicians gain invaluable information without resorting to extensive incisions. Moreover, they can extract biopsy samples and perform surgical interventions, all during the same procedure. Eligibility for laparoscopic surgery hinges upon the complexity of an individual’s condition. This technique is rapidly emerging as the preferred choice for an expanding range of common operations, driven by its cost-effective nature and improved patient outcomes. Doctors now recommend laparoscopy to examine various organs, including the liver, appendix, stomach, gallbladder, pancreas, spleen, small and large intestines, and reproductive organs. Exceptional advantages associated with laparoscopic surgery include reduced bleeding, accelerated healing, and diminished pain and scarring. Unlike standard open surgery, recovery time after laparoscopic surgery can be remarkably reduced from several weeks to a few days. A vital aspect contributing to these favorable outcomes is the minimal manipulation of abdominal contents during laparoscopic procedures. Before undergoing most laparoscopic surgeries, patients typically receive general anesthesia. Adequate preparation is vital, and doctors typically advise patients to abstain from eating or drinking for approximately eight hours before the procedure to minimize the risk of anesthesia-induced nausea. In addition, it’s essential to arrange for a reliable means of transportation home considering the potential disorientation resulting from the anesthesia’s effects. Specific instructions regarding medications may also be provided by the attending physician. While laparoscopy generally carries a low-risk profile, it is important to remain vigilant for any potential complications. Although rare, instances of bleeding, infection, or organ damage may occur. If symptoms such as fevers or chills, escalating abdominal pain, redness or discoloration, bleeding, and shortness of breath persist, consult the doctor. Other signs that might warrant a doctor’s attention include swelling, bleeding, continuous nausea or vomiting, inability to urinate, or lightheadedness. There is a minor threat of organ injury during a laparoscopy, which might result in the leakage of blood or other fluids into the body if an organ is accidentally pierced. In such circumstances, additional surgical intervention is required to repair the damage and restore function. Less prevalent risks of laparoscopic surgery include issues from general anesthesia, inflammation of the abdominal wall, and the formation of blood clots that could spread to the pelvis, legs, or lungs. While these dangers are rare, it is critical to be aware of them and get proper medical assistance if any of these symptoms occur.

Karim SERHAN, MD

Karim SERHAN

Differences between a Panniculectomy and a Tummy Tuck

Karim SERHAN
Dr. Karim SERHAN

Weight loss helps address health issues like the risk of congenital conditions and can boost self-esteem due to body contouring. The loss, however, can result in loose and sagging skin that does not respond to exercise, and may require removal through surgery to enhance the contouring further. Two primary surgical options exist – panniculectomy and tummy tuck. The choice between the two may be confusing. Though the end goal remains the same, there are differences in the process, candidates, cost, and risks. A panniculectomy involves removing the panniculus, the excess loose skin that forms a flap below the waistline and over the thighs. The panniculus does not emanate from pregnancy, excess weight, or regular weight loss. It emanates from losing excess body weight, typically over 100 pounds, mostly from extensive weight loss procedures like gastric bypass. The extent of a panniculectomy, considered a medical procedure, depends on how much skin is removed. A tummy tuck, on the other hand, is considered a cosmetic procedure that involves removing excess stomach skin and tightening the abdominal muscles. Sometimes surgeons add an abdominal mesh to reinforce muscle repair. This woven mesh surgically temporarily or permanently supports organs after surgery or damaged tissue during healing. The second difference between a panniculectomy and a tummy tuck is eligibility. The former is best for patients with life-impacting sagging skin, which follows heavy weight loss, especially gastric bypass. Other candidates include individuals experiencing hygiene issues under the skin such as ulcers and infections, especially below the pubic region. The excess skin flap can also affect the individual’s mobility. On the other hand, a tummy tuck addresses sagging skin that does not affect the individual’s health and is mainly for cosmetic purposes, especially contouring the body for a more hourglass shape. Other good fits include individuals with sagging skin following a pregnancy who cannot get rid of the excess skin despite exercise and diet changes. In conjunction with liposuction, a tummy tuck can help resolve body-related self-esteem issues and those seeking to get rid of more skin after a panniculectomy. The third difference is the recovery time after each procedure. Recovery from any mild to major surgery involves surgical drains, skin glue, steri-strips, and the dressing. The surgeon provides instructions on how to care for each over the recovery period. A panniculectomy typically takes eight weeks to heal. However, the time may vary depending on the surgery’s extent and the patient’s attendance to the wound after the surgery, especially daily tasks and nutrition. Even weeks after the healing has taken place, however, the patient should refrain from strenuous activities like heavy lifting. Tummy tucks take less time to recover from due to less surgery complexity – usually four to six weeks. With proper care, especially hygiene of the surgical area, the patient should resume regular activity, including strenuous tasks, in the first few weeks following the procedure. Due to the extent of the surgery, panniculectomies are more costly than tummy tucks. A procedure typically costs between $8,000 and $15,000, plus additional fees like anesthesia, compared to an average of $6,000 for a tummy tuck. However, as a medical procedure, insurance companies may cover part or all of a panniculectomy. There is also the cost of taking time off work, especially for self-employed individuals – patients should set aside a minimum of eight weeks for recovery, compared to four to six weeks for a tummy tuck. Finally, the risks and side effects differ. Although both procedures cause discomfort and pain, the side effects tend to be more severe for panniculectomy. These can include pain post-surgery, fluid retention, and numbness. Other effects, though rare, include chest pain, heart palpitations, shortness of breath, and infections. Conversely, tummy tuck patients may experience bruising, numbness, deep vein thrombosis, and bleeding around the surgical area.

Karim SERHAN, MD

karim SERHAN