Laparoscopic Oncosurgery
Advancement of laparoscopic procedures have changed the fate of medical science in the past couple of years. Further, in the past three decades it has worked as a revolution in the field with surgeries like laparoscopic cholecystectomy becoming the gold standard worldwide.
The Advantages of laparoscopic surgery are widely well known, some of which include dramatically reduced hospital stay, better patient comfort, less pain, faster recovery, lesser incisions, lesser scars, no risk of excessive bleeding or infection as compared to open surgery. Further, it offers better visualization and magnification to internal organs especially in areas like the pelvis and the thorax which are often difficult to access in an open surgery. Furthering, Systemic immune competence has shown to be better preserved and has a better efficacy in laparoscopic surgery.
The role of laparoscopy in case of cancer has expanded to include better diagnosis, staging, precise treatment, monitoring, and palliating many different types of malignancies. Also, Laparoscopic guided biopsy allows the confirmation of malignancy by providing tissue specimens, especially where other means of biopsy are not feasible enough.
Laparoscopic staging can also help in identification of unresectable disease, which often dramatically alters therapy. Also, with increased accuracy in staging, many patients are able to avoid pain and prolonged hospital stay in case of non therapeutic laparotomy.
Colorectal cancer is one of the prime examples of malignancies in which extensive research has been done in comparing open versus laparoscopic resection (cost trial, classic trial, color trial) and it has shown that there is no compromise in oncologic outcomes with laparoscopic surgery. Further, other cancers which are amenable to laparoscopic resection may include cancers of the esophagus, stomach, small intestine, kidney, adrenal, spleen (hematologic), pancreatic tail, some liver tumors, and gynecological cancers.
The role of laparoscopy has changed the way of diagnosis and treatment. In many cases it helps the patients with incurable cancers need palliation of their malignancy. In cases where the gastric outlet is obstructed by a tumor in such cases incurable gastric or pancreatic cancer, a laparoscopic stapled gastrojejunostomy can be performed quickly in order to provide pain relief and allow resumption of eating.