Hiatal Hernia Repair Laparoscopic surgery is performed with long, narrow instruments inserted through incisions that are smaller than those required for traditional, open surgical techniques. Its minimally invasive nature enables patients to experience less bodily trauma and blood loss, less pain, and shorter recovery periods than traditional procedures. Laparoscopic surgery is also known as keyhole surgery and band aid surgery. Minimally invasive surgical technology has made tremendous progress in recent years, thanks to the advent of telerobotic equipment that greatly enhances visualization of the internal anatomy and adds a high degree of precision that was unachievable prior to its use. The Division of General Laparoscopic Surgery, part of The Department of Surgery at Hackensack University Medical Center, has been at the forefront of this revolutionary technology since it introduced one of the earliest forms of telerobotic equipment in 1996. The medical center continues to expand its robotic surgery program. With The da Vinci™ Surgical System, a surgeon sits at a control console that has a three-dimensional viewing system. The console allows the surgeon to position three robotic arms and precisely maneuver endoscopic instruments and an endoscope, and a variety of articulating EndoWrist™ Instruments. The medical center is an approved da Vinci™ training facility for the east coast. Hackensack University Medical Center was recently the first hospital in the nation to utilize the da Vinci™ fourth arm, the latest wave of this groundbreaking technology and now has three da Vinci™ systems on campus. The Division of General Laparoscopic Surgery offers a variety of laparoscopic procedures, including: Anti-reflux surgery (Laparoscopic Nissen Fundoplication) - The surgical repair of hiatal hernia, acid reflux, or heartburn. During the procedure, a new "valve" is constructed at the upper portion of the stomach (fundus) and is wrapped around the lower end of the esophagus. The wrap is intended to support the muscle so that it will open only when it is supposed to and not allow stomach acid to push its way up into the esophagus. If a patient also has a hiatal hernia (which occurs in 40 percent of patients) the hernia is repaired before the wrap procedure is performed. Reflux symptoms disappear immediately after surgery, and the patient no longer needs medications. As with other minimally-invasive operations, there is little pain following the procedure because of the small incision. Patients usually come to the medical center on the morning of the operation and go home the next day. Some elderly patients stay 2 or 3 days, but typically, it is a short stay procedure. Sometimes the surgery is performed on an ambulatory basis. Patients can return to work or normal activities in approximately two weeks. Colectomy (bowel resection) - Laparoscopic surgery can be used to treat a wide range of colorectal diseases. It achieves the same results as traditional surgery, but patients recover faster and experience less pain. Colon conditions that are commonly treated laparoscopically include diverticulitis, Crohn's disease (occurring in the small intestine as well as the colon), chronic ulcerative colitis, constipation, sigmoid volvulus, and endometriosis. Laparoscopy may also be used to repair rectal prolapse, remove non-cancerous polyps, and treat some types of colon cancer. Gallbladder surgery – In the past, gallbladder removal, or cholecystectomy, required a six- to nine-inch incision and a week-long stay in the hospital, followed by four to six weeks of recovery at home. Healing of the surgical incision could entail considerable pain. Today, gallbladder surgery can be performed laparoscopically. Patients usually return home on the morning following surgery, and they can resume their normal routine within a week. In addition, they lose less blood during surgery and experience far less pain. During the minimally invasive procedure, the common bile duct and artery at the base of the gallbladder are severed from the liver using electronic instruments, then sealed. The surgeon empties the gallbladder of its contents, drawn out through one of the incisions. The incisions are then closed with surgical tape or stitches. Hernia repair - Laparoscopic surgery can be used to repair most common types of hernias. During a laparoscopic hernia repair procedure, the surgeon first pulls the hernial sac back into the abdominal cavity, exposing the defect in the abdominal wall. This weakened portion is then covered with a mesh patch. Laparoscopy allows the surgeon to place and anchor the patch on the inside of the abdominal wall, taking advantage of the natural outward pressure of the abdomen to secure the repair and promote healing. (In contrast, the patch must be placed on the outside of the abdominal wall in the traditional open operation). Ventral (incisional) hernia repair – The surgical repair of hernias that bulge through muscles at a location where an incision was made during previous abdominal surgery. During the laparoscopic technique, the affected area is reinforced with a mesh patch that is stitched to the back of the abdominal wall, around the hernia. The laparoscopic technique is considerably more successful than the traditional method of attempting to put stitches directly over the opening in the abdominal wall, which often leads to complications.