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The 1990s in America

Laparoscopic surgery

by Emily Carroll Shearer

Identification Medical procedure

Date Introduced to wide use in 1990

Laparoscopic surgery provided a minimally invasive way to perform a variety of medical procedures, allowing for smaller incisions, less pain, and faster recovery time for the patient.

Laparoscopic surgery, also known as keyhole, pinhole, band-aid, or minimally invasive surgery, is a method of surgery used for many procedures. First developed in the early part of the 1900’s for gynecological procedures, laparoscopic surgery became widespread as a medical procedure in 1990 with the development of a clip advancer that allowed surgeons to easily clamp vessels without having to pull out the clip applier, reload, and then reintroduce the applier into the patient’s body. This reduced the infection risks associated with laparoscopic surgery.

Uses

Laparoscopic surgery is most commonly used for cholecystectomies (removal of the gallbladder). This procedure is accomplished by introducing the surgeon’s tools through small incisions in the abdomen. The surgeon uses a camera, scissors, clip advancer, and graspers in four small incisions; space for these instruments is created by pumping a small amount of carbon dioxide into the body to inflate the surgical area. These primary instruments are introduced through a hollow tube known as a trocar, which is also sealed at one end to keep the carbon dioxide from escaping the abdominal cavity. Bile is suctioned from the gallbladder, and the organ is removed through an incision in the navel. Appendectomies are performed in a similar manner.

Laparoscopic surgery is also used for gynecological procedures, the use for which the method was originally devised. Laparoscopy is used to correct intra-Fallopian tube pregnancies, thus preventing serious damage to the patient’s reproductive system. It has also been used as a fertility treatment, whereby surgeons introduce both eggs and sperm into the Fallopian tubes. This procedure has largely been discontinued because of the successes with in vitro fertilization, which can be accomplished in a noninvasive fashion.

Laparoscopy is also used to remove parts of the kidneys and colon, though larger incisions are required for these procedures because of the larger size of the organs. This surgical method is also used to correct hernias and for bariatric procedures in obese patients.

Benefits and Risks

Laparoscopic surgery has several benefits over more traditional surgical methods, including reduced bleeding, smaller incisions, less pain, and shorter hospital stays. Laparoscopic patients also do not require as much pain medication as traditional surgical patients, reducing the risk of other pulmonary problems associated with some narcotic usage; the reduced bleeding also reduces the possible need for a transfusion. Since small incisions are used, the patient’s internal organs are not as exposed to outside contaminants, reducing the risk of infection. Many laparoscopic procedures can now be performed as outpatient surgeries, allowing patients with no complications to go home the same day of the procedure.

Like all surgery, laparoscopic surgery has risks associated with it. Previous scar tissue can prevent surgeons from performing a successful procedure. Some patients with previous pulmonary issues are not able to tolerate the carbon dioxide inflation of the abdominal cavity, forcing surgeons to transition from a laparoscopic procedure to a more traditional procedure. Damage to blood vessels is the most common risk in laparoscopic surgery.

Patient Recovery

Patients who receive laparoscopic surgery are generally able to return home on the same day as the procedure. They can experience some pain, both from the actual incisions and manipulation of internal organs as well as from the carbon dioxide remaining in the abdominal cavity. Both sources of pain dissipate after a few days.

Patients may also experience difficulty walking and transitioning from a supine to upright position after the surgery. This also eases after a few days. Full recovery from the procedure can be expected within two to three weeks.

Impact

Now a common surgical technique, laparoscopy has changed the field of surgery for both surgeons and patients. Surgeons are able to perform surgeries more quickly and with less risk. Patients experience less pain and recover faster; since laparoscopy is typically an outpatient surgery, this medical development has made many procedures routine and allowed patients to feel more comfortable when faced with the prospect of surgery.

Subsequent Events

In 2007, surgeons at Drexel University used a newly developed form of laparoscopic surgery to remove a patient’s gallbladder. This method used only one incision, rather than the multiple incisions typically needed. Referred to as single port access surgery, this method is accomplished through an incision in the naval with high-dexterity surgical implements, resulting in a lack of scarring on the torso. Studies indicate that this method may also result in less pain than more traditional laparoscopic surgeries and reduce recovery time even more.

Further Reading

1 

Adler, Robert E. Medical Firsts: From Hippocrates to the Human Genome. Hoboken, N.J.: John Wiley & Sons, 2004. Offers a look at the genesis of laparoscopy in the gynecological field.

2 

Kennedy, Michael. A Brief History of Disease, Science, and Medicine: From the Ice Age to the Genome Project. Cranston, R.I.: The Writers’ Collective, 2004. Like Porter’s history, Kennedy’s book offers an overview of medical history but adds more detail to developing technologies.

3 

Porter, Roy. Blood and Guts: A Short History of Medicine. New York: W. W. Norton, 2004. Porter’s short history offers an overview of medical history, including a section devoted to evolving surgical technology that addresses laparoscopic surgery.

4 

Ruggieri, Paul. The Surgery Handbook. Omaha, Nebr.: Addicus Books, 1999. Designed for patients approaching surgery, Ruggieri’s book offers an overview of different types of surgery and the benefits and drawbacks of each procedure.

5 

Singer, Sanford S. “Laparoscopy.” In Magill’s Medical Guide. 4th rev. ed. Pasadena, Calif.: Salem Press, 2008. A four-column introductory article on the procedure, noting is uses, complications, and a brief history.

Citation Types

Type
Format
MLA 9th
Shearer, Emily Carroll. "Laparoscopic Surgery." The 1990s in America, edited by Milton Berman, Salem Press, 2009. Salem Online, online.salempress.com/articleDetails.do?articleName=1990_1318.
APA 7th
Shearer, E. C. (2009). Laparoscopic surgery. In M. Berman (Ed.), The 1990s in America. Salem Press. online.salempress.com.
CMOS 17th
Shearer, Emily Carroll. "Laparoscopic Surgery." Edited by Milton Berman. The 1990s in America. Hackensack: Salem Press, 2009. Accessed October 22, 2025. online.salempress.com.