Laparoscopic surgery generally refers to a minimally invasive surgical technique where surgeons perform surgery through several small incisions using a camera to view the procedure on a TV monitor. Because of advances in surgical instrumentation and imaging devices, the incisions are considerably smaller than with traditional or open surgical techniques.
Advanced laparoscopic surgery requires more complex skill set and more extensive training. Certain operations require proficiency in laparoscopic suturing techniques, safe tissue retraction and handling and an in-depth knowledge of the various energy devices, cutting and stapling apparatus available today. The breadth of general surgery training is insufficient to provide trainees with a sufficient number of cases to attain proficiency in advanced laparoscopy, therefore young surgeons need to complete additional years in fellowship training where they deal with nothing but such complex surgical problems managed with these techniques. Selection of prospective candidates to these training programs is managed through the Fellowship Council via a matching program and these are very competitive training opportunities.
Minimally invasive surgery is performed with the aid of a telescope-like instrument called an endoscope, which is placed into the body through keyhole-sized surgical incisions. The telescope, connected to a video camera, provides the surgeon with a more detailed view of the operative site which allows for more precise work. The video camera projects a view of the operative site onto video monitors located in the operating room. Additional small incisions are made to allow the surgeon to use tiny specialized surgical instruments to perform the procedure.