Gastrointestinal MIS Procedures Laparoscopic surgery, the MIS procedure in the abdominal cavity, is the most common form of MIS performed and is used for many gastrointestinal conditions. The surgery is done while viewing the video screen. This allows for the same result as open surgery but with the least possible damage to the body structures. Gastrointestinal minimally invasive surgeries include :
Laparoscopic Anti-Reflux Procedures
The standard treatment for Gastroesophageal Reflux Disease (GERD) and hiatus hernias (herniation of the stomach into the chest) is laparoscopic fundoplication. In this procedure, the fundus (upper part) of the stomach is wrapped around the lower portion of the oesophagus and stitched in place. This surgery prevents stomach acid from flowing back into the oesophagus, preventing GERD.
This removal of the appendix is performed for acute appendicitis. Laparoscopic appendicectomy is a good alternative for patients with acute appendicitis, especially for young women of childbearing age, as the laparoscopic procedure has a diagnostic advantage for uncertain diagnosis. Other advantages include better cosmetic results, less pain and quicker recovery.
Bariatric (Weight Loss) Surgery
Surgical intervention for obesity, also referred to as bariatric surgery, has consistently been shown to be more effective than medical, dietary and lifestyle treatments alone. Bariatric surgical procedures cause weight loss by modifying parts of the gastrointestinal system. Four types of minimally invasive bariatric procedures are available at KIMS :
A silicone balloon is placed in the stomach by endoscopy and filled with a saline solution to give patients a sense of fullness, thereby reducing food intake. Although it is an effective method of weight loss, the balloon must be removed after 6 months because of breakdown by gastric acid.
Laparoscopic Adjustable Gastric Banding (LAGB)
LAGB is used for morbid obesity. An adjustable silicone band is placed around the upper part of the stomach to decrease the size of the stomach so that a person feels full faster, thus eating less and ultimately losing weight. The band is deemed adjustable because a port implanted under the skin allows for fine adjustments.
Laparoscopic Sleeve Gastrectomy (LSG)
In this procedure, the stomach is made into a tube with the excess part up to 85% removed. Although this is a relatively new procedure, early results show that weight loss after LSG is comparable to LAGB.
Laparoscopic Roux-en-Y Gastric Bypass (LRYGB)
This is the most complex bariatric surgical procedure performed at SGH. By reducing the size of the stomach and bypassing part of the small intestine, food intake is not only reduced, the process also limits the body’s ability to absorb calories. This has a great effect on the functioning of the gastrointestinal system and can be remarkably effective in correcting metabolic disorders such as Type II Diabetes Mellitus and hyperlipidaemia.
To achieve the best results, our bariatric surgeons work closely with endocrinologists, dietitians and physiotherapists for a multidisciplinary approach to prepare patients for the best intervention suited to their needs.
Laparoscopic Gallbladder Surgery
Laparoscopic cholecystectomy or removal of the gallbladder, is the most common MIS procedure performed daily. The gallbladder is removed to treat gallstone disease which causes symptoms such as pain or complications arising from the gallstones. For bile duct stones or associated abnormalities, exploration of the common bile duct can also be performed laparoscopically together with the cholecystectomy.
Laparoscopic Hernia Repair
Hernias in the groin (inguinal), umbilical and other parts of the body occur when the abdominal wall is weakened and this may result in some abdominal contents such as the intestines bulging out. In laparoscopic surgery, the hernia is repaired from behind the abdominal wall. A small piece of surgical mesh is placed over the hernia defect and held in place with surgical staples.
Laparoscopic Liver Surgery
The laparoscopic segmental hepatectomy (removal of a small part of the liver) may be performed for liver cancers and tumours. For larger tumours or tumours less suitable for a complete laparoscopic technique, the laparoscopic-assisted hepatectomy is performed instead, in which case most of the surgery is performed with the laparoscopic technique. This technique still gives a much smaller incision than the usual open surgery incision.
Others include :
Using small abdominal incisions for access, surgeons use a laparoscope to remove an adrenal gland.
Laparoscopic Colon Resection
Laparoscopic approaches to colon and rectal disease are performed routinely by our surgeons for patients with colon cancer, colon polyps that can not be removed by a colonoscope, diverticulitis, ulcerative colitis and Crohn's disease. Removing the abnormal section of colon with laparoscopic techniques results in less pain, a smaller incision, and a shorter stay in the hospital.
Laparoscopic Gallstone Removal
Using the navel and small abdominal incisions for access, surgeons use a laparoscope to view the gallbladder, detach it, deflate it and remove it through the navel.
Laparoscopic Myotomy for Achalasia
Using small abdominal incisions for access, surgeons use a laparoscope to view the esophagus and repair the muscle of the lower esophagus.
Laparoscopic Removal of Stomach Tumors
Using small abdominal incisions for access, surgeons use a laparoscope to view and remove a tumor.
Laparoscopic Spleen Removal
Using small abdominal incisions for access, surgeons use a laparoscope to view the spleen, detach it, place it in a surgical bag and remove it through an incision.
Laparoscopic Ventral Hernia Repair
Using small abdominal incisions for access, surgeons use a laparoscope to view internal organs, remove existing scar tissue and place a surgical mesh under the hernia defect and attach it to the strong tissues of the abdominal wall.