New op goes in

2009-07-20 00:00

A PRETORIA specialist this week became the first surgeon in South Africa to remove an appendix laparoscopically through a single incision in a patient’s belly-button.

Dr Johan van Beljon, a specialist surgeon, performed the procedure on a 24-year-old woman in the Netcare-Montana Hospital.

South African surgeons are old hands at procedures like removing gall bladders laparoscopically, but usually about four incisions are made in the upper body for ports through which to introduce all the devices into the body.

New equipment now makes it possible to introduce four devices into the body through only one port in the belly-button.

“Patients experience considerably less post-operative pain, they are up and about sooner, and it is cosmetically much more acceptable,” Van Beljon explained.

Whereas patients usually stay in hospital for about two days after an appendix operation, a laparascopic operation usually allows them to go home on the same day.

Van Beljon says he selects his patients very carefully for this procedure and prefers to focus on less complicated cases.

In the procedure like this week’s one, he makes an incision of between one and two centimetres in the woman’s navel and a port with four openings is then put in place.

A small tube is inserted through one of the holes.

Then carbon dioxide is pumped through the tube to inflate the abdomen.

A camera with a five millimetre lens makes a video recording at a 30º angle.

It is pushed through the second hole, and Van Beljon’s instruments through the last two.

The camera provides a clear view of the woman’s organs, like her ovaries, liver and uterus.

Van Beljon said the advantage is that one can use the camera for diagnostic purposes during the laparoscopic procedure.

“If I see any reason for referring her [because of another problem], I can refer her to the relevant specialist together with a video recording of what was seen inside.”

After Van Beljon cuts the appendix loose and ties it off with titan staples and thread, the whole port is removed with appendix and all.

The patient will be discharged with only a tiny scar in her belly-button.

 

Laparoscopic surgery, also referred to as “minimally invasive surgery”, describes the performance of surgical procedures with the assistance of a video camera and several thin instruments. During the surgical procedure, small incisions of up to two centimetres are made and plastic tubes called ports are placed through these incisions. The camera and the instruments are then introduced through the ports which allow access to the inside of the patient.

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