Open versus Closed Surgery. Laparotomy versus Laparoscopy.

This discussion focus on abdominal (tummy operations). ( refer to Abdomen on the glossary page). Laparotomy means to cut open. It originated from the ancient Greek words "laparo "( roughly equivalent to tummy ") and "tomea" ( to cut or cutting). Laparoscopy means to look and in the abdominally surgery context it means to look inside the abdomen. The term originated from the ancient Greek words "laparo" and "Skopein" (to view).

Open surgery refers to all operations done through a laparotomy and closed surgery refers to all operations done through a laparoscope.

Laparoscopies were initially only used for diagnostic purposes. The internal organs and peritoneal cavity (refer to peritoneal cavity were viewed and diseases like endometriosis diagnosed . Only a very small incision at the belly button was required.

With improved techniques and instrumentation it is now possible to do a wide range of operations with the help of a laparoscope. No large incisions are required, just a few very small incisions at different sites on the tummy. This is referred to as closed surgery.

LASER SURGERY

The word laser is an abbreviation of of "Light Ampiflication by Stimulated Emision of Radiation." In plain language it means that light is past through a special device and that the light that leaves the device, is an intense nearly nondivergent beam . Depending on the type of laser , an immense amount of energy can be focussed on a small spot.

Laser beams are used in surgery to cut tissue, vaporise abnormal tissue or control bleeding. The frequency of the laser bean can be changed and by changing it the temperature at the point of contact is changed.

SCOPES

As explain above the name scope is derived from ancient Greek and means to view. There are many different types of scopes in use today but only three types are of importance here. The three are cystoscopes, hysteroscopes and laparoscopes.

A cystoscope is used to examine the interior of the bladder.The instrument is passed through the bladder opening ( uretrha) into the bladder cavity.

A hysteroscope is used to examine the cavity inside the uterus and it's lining ( the endometrium) . It will be discussed in more detail later.

A laparoscope is used to view and examined the peritoneal cavity and the internal organs.It is also discussed in more detail later.

The following links will take you to a more detailed discussion of a specific type of operation.