Laparoscopic Surgery Center

Laparoscopic surgery is a minimally invasive procedure. It is an innovative technology that has been refined and developed over the years to enable surgeons to perform key-hole surgeries without a large incision as were the cases previously. Diagnostic and therapeutic procedures through laparoscopic surgeries have gained popularity and are an alternative way of treatments that enable the patient to return to normal activities with a better quality of life in a shortened time frame.

Laparoscopic surgeries help surgeons to visualize anatomic details of deep-seated and hard-to-reach internal organs with relative ease. Medical grade 4K video screen displays lifelike clear images for accurate, rapid diagnosis, and treatment.

Advantages of laparoscopic surgery

Smaller incision… The incision is substantially smaller compared to open surgery. The usual lengths of incisions are merely 0.5-1.0 cm.
Hurting less… The postoperative pain is much milder and lasts for a shorter period than traditional open surgeries enabling faster recuperation, expeditious return to work, and activities of daily living.

MedPark Hospital Laparoscopic surgery center offers the following services:

General Surgery Department

Surgery of the biliary tract and liver
Gastric and intestinal surgery
Surgery of the colon and rectum
Hernia surgery

Urology Department

Surgery for the kidneys and adrenal glands
Renal pelvis and ureteric surgery
Bladder and prostate surgery
Surgery for urinary tract stones

Obstetrics and Gynecology Department

Hysterectomy and ovarian surgery
Uterine cervix surgery

Orthopedic department

Spine surgery
Shoulder surgery
Knee and ligaments surgery

Preparation before and after laparoscopic surgery

Before undergoing surgery

It is necessary to abstain from food and water for at least 8 hours before surgery. In case it is necessary to eat, the food should be soft and easily digestible. If pregnant or suspected of being pregnant, notify your doctor first.
Inform the doctor about the current medications and supplements you are taking, especially anti-platelets and blood thinner medications.
The doctor will do a physical exam and order additional laboratory tests such as certain blood tests, take your blood pressure, pulse, respiration, lung and heart function, X-rays of related internal organs. An electrocardiogram may be performed to assess the underlying cardiac health of the person who will undergo surgery.

After surgery

Patients may feel tired and weak for 1-3 days, which is normal.
If you have pain or nausea after surgery, inform the nurse. The pain is more intense in the immediate postoperative period and can be relieved by painkiller medications. It will gradually fade away with time.
Patients can take a usual bath if waterproof wound dressing is used; if not, then be careful not to let the wound get wet until the follow-up appointment date.
Avoid lifting heavy objects and refrain from strenuous exercise for about 1-2 weeks after the surgery.
Avoid driving for at least 7 days after surgery.
Abstain from sexual intercourse for about 2 weeks after the surgery.

Why choose to have laparoscopic surgery at MedPark Laparoscopic Surgery Center?

At MedPark Hospital, our doctors closely work as a team. The surgeons specializing in laparoscopic surgery will work with a team of highly experienced anesthesiologists together with a professional O.R. nursing team that is keen to take good care of the patients and look out for the safety of the patient throughout the operation.
Surgeons of MedPark Hospital have undergone specialized training both locally and abroad. The following specialized laparoscopic surgical procedures are available at MedPark Hospital:

Sport Trauma or Sports Medicine

Knee (Arthroscopic With Ligament Reconstruction, ACL, PCL or meniscal repaired)
Shoulder (Arthroscopic With Rotator cuff repaired, Acromioplasty, Bankart repaired)

The arthroscopic surgery incurs a small incision of approximately 0.5 cm. It causes less irritation, less pain, and less complications. The patient could return home immediately after the recovery or admitting in the hospital for few days, allowing the patient to return to normal life and enabling to exercise or play sports faster.

Video – Assisted Thoracic Surgery (VATS)

This is a surgery using a rod-shaped video scope in conjunction with special long surgical instruments introduced through an intercostal space through a surgical port without needing to separating the ribs. This is different from traditional open thoracotomy that requires very long curving lateral chest incision with removal of a rib, or median sternotomy incision where a vertical cut through the entire breast bone must be made. Hence, the postoperative pain is much lesser, the wounds are small hidden under the lower border of the breast resulting in a better aesthetic outcome. Without having to cut through bones, the patient can return to work quicker. The hospital stay averages 1-3 days as compared with 5-7 days for open thoracotomy.

Laparoscopic gallbladder surgery(Laparoscopic Cholecystectomy)

The surgeon will insert the laparoscope and specialized surgical instruments into the abdominal cavity through key-hole incisions and proceed to dissect out the gallbladder from the undersurface of the liver and removing it out through the umbilical incision. The cystic artery is controlled with hemostatic clips in place of tying it with sutures before being divided. The small incisions, causing milder pain, are simply closed with a few suture stitches

Laparoscopic Appendectomy

The surgeon will insert a laparoscope and surgical instruments through small, key-hole incisions and the appendix will be excised. However, if a ruptured appendix resulting in extensive peritoneal contamination and inflammation is found, conversion to open surgery may be necessary. If the ruptured appendix is known or likely preoperatively, the choice of whether to perform a laparoscopic surgery or not depends on the severity and risks based on the health evaluation of each patient.

Laparoscopic Herniorrhaphy

Laparoscopic hernia surgery can be performed in 2 ways: through the abdominal wall tissue layers without entering the abdominal cavity, or by the intra-abdominal route. Three small incisions are required ranging from 0.5 – 1.5 cm. The surgeon will push the hernia sac back into the abdomen and place a synthetic mesh sheet over the internal ring where the hernia sac previously protruded and fixing it with metal staples. This is a surgical technique that minimizes tissue trauma and fibrosis. The procedure is nearly painless with a very low risk of complications and recurrence. It can also be used to repair all kinds of groin hernias in one operation. Some patients can go home immediately after they recover from anesthesia, or may need to stay in the hospital for merely 1-2 days. Most patients can return to normal activities of daily living within a week. If incisional pain is resolved within 2-4 weeks, you can do strenuous exercise or participate in full sports activities.

Laparoscopic Colectomy

Your doctor will remove a segment of the colon containing the tumor while looking at the image of the operative field on a monitor. When the colon segment containing the tumor is removed, the doctor will sew the two remaining ends of the colon back together. However, in the situation where the distal end is not suitable for anastomosis, the proximal end may be brought out through the abdominal wall as a colostomy, or sometimes distal small bowel is anastomosed to the distal colon or rectum if the entire proximal colon has to be removed with the tumor. The anastomotic option allowing a patient to have the best quality of life will be chosen.

Laparoscopic lysis of adhesion

Abdominal fibrosis is often caused by inflammation of the peritoneum. It may be a consequence of abdominal surgeries or other trauma to the abdominal organ and tissue. The fibrous tissue formed may be shaped like a band or sheet forming adhesion between the intestines and/or internal organs, such as the intestines to the abdominal wall, the attachment of the fallopian tube to the intestines, or the attachment of the liver to the diaphragm. These may cause blockage of the fallopian tubes or precipitate small bowel obstruction which necessitates surgical intervention. Laparoscopic lysis of adhesions is an alternative to open surgery with small incisions, less pain, and faster recovery.

Laparoscopic Gastrectomy

In the surgery for gastric cancer, gastric ulcer, or perforation, partial or total resection of the stomach may be carried out. For total gastrectomy, the esophagus will be directly connected to the small bowel to allow the patient to eat normally. The small incisions of laparoscopic surgery help to reduce complications, and speed up the recovery of the patient.

Laparoscopic Gynecologic Surgery

Gynecologic surgeries have evolved from difficult open surgeries with large wounds of the past into laparoscopic surgeries with small wounds of merely 0.5-1.0 cm. resulting in fewer complications despite increasing surgical repertoires being performed nowadays attended by less pain and faster recovery. Laparoscopic surgery is made possible by technological innovation and advances of the past 3 decades with continual refinement of laparoscopic surgical instruments and imaging systems. The surgery is performed by first inserting a hallowed surgical port, with a build-in one-way valve at its outer end, through a small umbilical key-hole incision into the abdomen. CO2 gas is then insufflated into the abdomen through a side channel in the port to increase space and lift the anterior abdominal wall. A videoscope is then inserted through the port into the abdomen to provide both lightings via fiberoptic cable and a camera system that enable the surgeon to see the operative field within the abdomen at 4K resolution on a video screen. Additional special long slender laparoscopic instruments can be inserted as needed via additional small ports safely placed under the direct laparoscopic vision to carry out the actual operation or for diagnosis of diseases of gynecologic pelvic organs such as the uterus, fallopian tubes, and ovaries.

Gynecological diseases treated by laparoscopic surgery include:

Ovarian cysts or tumors
Uterine fibroids
Endometriosis
Chronic pelvic pain without a known cause
Infertility
Fibrosis in the pelvis

GreenLight^TM Laser PVP (Photoselective Vaporization of the Prostate) Surgery

GreenLight^TM Laser PVP surgery is a more efficacious treatment of enlarged prostate than traditional prostate surgery as it causes less blood loss, pain and has a faster recovery. GreenLight^TM Laser PVP is an innovative, minimally invasive prostate surgery technique performed through natural body orifice without external wound or scarring. A long slender rigid scope consisting of both lighting and video camera system is inserted through the urethra like in endoscopic surgery. Instead of using an electrical scraper, a high-energy green light laser beam is swept over the obstructive tissue in the prostate causing it to gradually vaporized. As the laser light efficiently and simultaneously sealed blood vessels, less blood loss ensues. It is also a minimally traumatic procedure that causes less pain and has a short recovery period. You can return to light activities in 2-3 days. Besides, it has fewer complications and is especially suitable for elderly patients or patients with underlying cardiovascular diseases that cannot stop taking anti-platelets or anticoagulant drugs.

Before surgery, the spinal block will be administered by an anesthesiologist, and the patient placed in a supine position. A cystoscope that displays the operative field images on a video screen is first inserted into the urethra up to the level of the prostate gland after which a specially designed, dedicated green laser light guide is then inserted through a side channel in the cystoscope, the doctor will then mark the enlarged prostate tissue with a 120 – 180 watts laser beam emitting from the side near the end of the scope. Tiny bubbles will be formed in the area of obstructing prostate tissue being vaporized by the laser without blood loss, the remaining tissue bed will turn into yellowish-white soft tissue and widening up the narrowed, previously obstructed urethra.

State-of-the-art Hybrid Operating Room

MedPark Hospital’s spacious hybrid operating room is equipped with state-of-the-art ARTIS Icono Biplane Angiography System capable of delivering clear, sharp 2D, 3D, and 4D medical images with less use of contrast agents and X-ray for full-body endovascular treatment of difficult, complex diseases. The room meets cleanroom standards to minimize infection and space is extra-large specially designed to accommodate modern, sophisticated, multidisciplinary operating teams of surgeons, neurologists, cardiologists, radiologists, anesthesiologists, O.R. nurses, and radiology technicians working collaboratively to treat difficult and complicated diseases through full-body endovascular intervention. Examples are TAVI, transcatheter aortic valve implantation; clip repair of the mitral valve, closure of the intracardiac septal defect, endovascular abdominal aortic aneurysm repair, cerebral artery aneurysm obliteration, electrophysiology procedures, etc.

The sophisticated angiography system is designed to provide smooth, rapid work-flow, motorized parts move effortlessly without interfering with the surgical and anesthesiology team. Flexmove technology, capable of 360-degree X-ray imaging, allows doctors to perform a complex procedure more conveniently and efficiently. The synchronized O.R. bed can be adjusted in multiple axes, helping to make surgical treatment more versatile and cutting down the operating time.

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Dr Mingmuang Worawattanakul

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