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1. What is MIS? |
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| Laparoscopic surgery, also known as keyhole surgery, is a method of carrying out an operation without having to make a large incision (as is the case with conventional or ‘open’ surgery). Surgical scars are between 3mm and 15 mm in length. |
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| Many types of operations can be performed using MIS. These include surgery for appendicitis, inguinal/ ventral hernia repair, gallbladder disease, hyperhidrosis (sweaty palms), adrenal mass, benign and malignant colorectal diseases, gastroesophageal reflux disease and removal of spleen and kidneys. |
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2. What are the advantages of MIS over ‘open’ surgery? |
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| Compared to ‘open’ surgery, patients who have undergone laparoscopic surgery tend to recover earlier, experience fewer side effects, feel less post-operative pain and have smaller scars. The duration of hospitalization is also reduced. |
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| A common side effect of ‘open’ surgery is the formation of adhesions, a condition whereby internal organs stick together and form bands of scar tissue. Adhesions can be painful and cause bowel obstruction. The risk of adhesions is reduced in laparoscopic surgery. |
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3. Are there any risks or side effects of laparoscopic surgery? |
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| All operations, including MIS, carry a small risk of infection and bleeding. Anaesthesia used in surgery also carries a risk of complications and may result in side effects. These include nausea, vomiting, sorethroat, headache, dizziness and shoulder pain. These are usually short-lived and do not require any specialized care. Remote injuries may involve the bowels and vessels which will require ‘open’ surgery. |
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4. Are there alternatives to MIS? |
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| All operations carried out via MIS can be carried out using the ‘open’ method. However, ‘open’ surgery has its own disadvantages as listed previously. |
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5. Is everyone suitable for MIS? |
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| Most patients would be suitable candidates for MIS. However, some may not be able to proceed with MIS due to reasons such as late pregnancy or unexpected intraoperative findings where ‘open’ surgery is needed. Your doctor will be able to advise you on the surgical options that are more suitable for your condition.
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6. How is MIS carried out? |
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| Small incisions are made in the abdomen after which a harmless gas is pumped in to create space for the surgeon to operate. Viewing equipment (comprising of a camera connected to a TV monitor) and surgical instruments are then inserted through the incisions into the newly formed space. With a clear image of the operating field projected onto the monitor, the surgeon then carries out the operation. |
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7. How can I prepare for surgery? |
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| Pre and post-operative care required for ‘open’ surgery and MIS are the same. |
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| Prior to hospital admission for surgery, you will receive a letter listing the things you need to do/note to prepare for surgery (e.g. not eating and drinking for a length of time before surgery). It is important to follow all the instructions to ensure that your surgery can proceed as scheduled. |
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| Your surgeon will explain the procedure and also answer any questions that you may have. You will also need to sign a consent form for surgery. The anaesthetist will also discuss the anaesthesia options with you. If you have any medical condition (such as drug allergies), please inform the doctor. |
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8. What can I expect after the operation? |
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| After surgery, you will be taken to the recovery room to allow the effects of anaesthesia to wear off. Thereafter, you will be warded for post-operative care. |
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| If required, you can request for pain relief options such as: |
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Oral/ intravenous medication |
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Nurse or patient-controlled analgesia (NCA or PCA). The amount of pain relief needed can be adjusted by either the nurse or the patient. |
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| After surgery, you may not be able to eat or drink for a few hours and will be put on an intravenous drip. |
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9. What are the things that I need to note after discharge? |
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| After discharge, you may need some medication for pain relief. Usually,
Paracetamol will suffice but, if required, your doctor can prescribe you stronger pain relief medication. These prescribed medicines can be obtained from the hospital pharmacy. Please inform your doctor of any allergies. |
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| Try to rest as much as possible and refrain from vigorous activities to allow your body to recover. |
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| Most patients feel well enough to resume their normal activities and return to work, a week after the operation. Your doctor will advise when you can take up more vigorous activities and sports. |
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IMPORTANT: |
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| You will need to return for a review by your doctor in about 4 - 6 weeks after the operation. |
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| Please see your doctor if you have any of the following symptoms: |
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Intense pain (which medication does not seem to relieve) |
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Wound sites that are red, inflamed and feel warmer than the surrounding skin |
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Oozing from the wound sites |
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| Please consult your doctor if you require more information about the operation.
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