Nature and Scope of Endoscopic Surgery

Abstract

Conventional open surgery requires that the surgeon gets to the organ which is the site of the disease. In order to achieve this objective and carry out the procedure, resective or otherwise, the relevant body cavity (chest, peritoneal cavity, pelvis) has to be laid open. Adequate exposure, which is essential for the safe and expeditious conduct of the procedure, is assisted by the use of metal retractors held by the assistants or by mechanical holders. On completion of the procedure, the body cavity concerned is repaired. Although timehonoured in our profession, this open conventional approach has certain intrinsic disadvantages which, to a large measure, influence the immediate postoperative course and delay recovery of the patient from the operative ordeal:

• 1. In the first instance, open exposure incurs additional trauma and therefore aggravates the postoperative catabolic response, which is accompanied by established and well-researched physical and bio-chemical changes, and neuropsychological sequelae which are poorly understood but which often persist for several weeks to months. These include asthenia, lethargy and mental debility.