Operative laparoscopic technique in surgery was first reported in the early 1980's. At this time it was utilized primarily for gynecological surgery, such as tubal ligations and appendectomy. Soon, the operation was dubbed "bandaid surgery" due to the small incisions and the fact that many of the diagnostic laparoscopy procedures could be done in overnight stay facilities rather than in a traditional hospital setting.

Dr. McKernan had experience as a 'primary care' general surgeon in that he was called on to perform gynecological surgeries in a small rural setting, as well as having to develop diagnostic skills in endoscopy, including colons and the stomach. This led to what seemed a logical progression for him towards questioning why the laparoscope couldn't be used in his specialty for additional general surgery procedures.

What is Laparoscopy?
Lap-aro-scopic: A surgical method in which the abdominal cavity is accessed through several small incisions, and surgery performed using a projected image from the ½" diameter scope placed within the abdomen , aided by other ¼" entry ports which allow instrument insertion. The abdomen wall is gently lifted by inflation using a non-toxic gas.

Open Surgery: A surgical method developed in the 1880's in which the abdomen is cut with a knife in a manner that allows the surgeon, and assistants, visual access to the abdominal cavity. Open surgery employs the use of retractors to spread the incision, and surgeons put their hands inside the body through this cut.

Benefits of Laparoscopic Surgery vs. Open Surgical Methods

Laparoscopic Surgery Open Surgery methods Abdominal muscle split to accommodate ½" incision at umbilicus, multiple ¼" incisions (usually 3 -5) for miniaturized instruments. Abdominal muscle cut. Incision made as large as required by surgeon for best use of retractors, hands and instruments. Reduction in post-operative problems with adhesions. Exposure to talc/latex in surgical gloves can cause adhesions to form during recovery. If done in an Outpatient facilitiy, shorter patient exposure overall, and thus, less chance for nosocomial infection. Multiple opportunities during hospital stay to acquire an infection. Post-op period usually requires narcotic pain relief for only first 12-36 hours. If performed Outpatient, stay is up to 23 hours if needed, and it is usually much less. Post-op period difficult due to the cutting, stretching, and pulling of large wounds. Hospital stay varies from 3 - 7 days. Walking soon after surgery, and back to normal activities in a few days to two weeks. Lengthy period before return to normal activities.