Vincent Mazzarella, MD

First popularized in France for general surgical procedures, laparoscopic surgery has been popular in the United States since about 1991.

Despite laparoscopy having been in continuous use for almost 20 years, many older surgeons have not been trained in this procedure. The older "open" method of operating, used 20 years ago (and rarely required today for many operations), involves widely cutting and separating muscles, which can take several weeks to heal and can be quite painful during the recovery phase. Laparoscopy avoids this for many simple operations such as removing a gallbladder or appendix. The elevated risks of pain, infection, and subsequent hernia that are associated with the older open procedures are therefore avoided.

While it is not always possible to perform an operation laparoscopically, there are a great many operations that can be done without the need to cut muscles.

The technology involves making very small holes through which hollow tubes (the size of hard plastic straws) are placed. Through these tubes (known as "ports") long thin operating instruments are passed, visualized by a camera placed through another of the tubes. Currently available ports actually stretch the holes, which can then return to their minimal size when the ports are removed at the end of the operation. Because of the minimal size of these holes, hernia risk is almost zero afterwards, and normal activities can be resumed almost immediately (in most cases).

Laparoscopy specifically refers to the usage of the camera in the abdomen. In order to be able to see, the abdomen is temporarily inflated with benign CO2 gas (the same gas we exhale) to "lift and separate" the intra-abdominal contents gently. At the end of the procedure, this CO2 gas (carbon dioxide) is vacuumed and/or pushed out of the abdomen.

The CO2 gas is irritating while inside the abdomen, so general anesthesia is required. Nevertheless, it is an inert gas and has no ill-effects.

Operations routinely performed by Dr. Mazzarella laparoscopically (since 1994):

* Removal of gallbladder
* Removal of appendix
* Repair of (ventral) abdominal hernia (using a plastic patch)
* Resection of intestinal tumors or abnormalities, such as intestinal lymphoma, intestinal duplication (such as Meckel's diverticulum)
* Liver biopsies for cirrhosis or other conditions
* Drainage of abscesses, hematomas, or other intrabdominal fluid
* Placement of CAPD dialysis catheters for chronic ambulatory dialysis
* Lysis (division) of adhesions (scar tissue) from prior operations or other conditions
* Resolution of small bowel obstructions
* Tubal ligations
* Evaluation of chronic pain (pelvic and abdominal) for which causes have not been identified on imaging studies (CT scans, for example)
* Evaluation of intestinal irregularities (diverticulitis, Crohn's disease, missed appendicitis, partial small bowel obstruction) which are not able to be clearly distinguished on imaging studies (CT scans or ultrasound, for example) and for which the diagnosis is in question