| Many terms have been used to describe laparoscopic surgery including endoscopic surgery, keyhole surgery and minimally invasive surgery. A common misconception is that this is "laser surgery". However, no lasers are involved.
Laparoscopic surgery is abdominal surgery performed using only ½ inch or less incisions. Instead of having his or her hands in the belly, the surgeon operates using long hand held instruments that slide in and out of sheaths (trochars) going through the abdominal wall.
To begin, the abdomen is inflated to a constant pressure with CO2 gas. This makes room for visualization of the abdominal cavity using a rigid scope which transmits the image to monitors in the operating room. Specialized tools such as scissors, dissectors, graspers, ultrasonic shears and endoscopic staplers facilitate the surgeon's ability to perform complex intraabdominal surgery.
We among others have been able to master advanced laparoscopic techniques such as major vessel division, suturing and tying and intracorporal anastomosis (reconnecting the bowel without bringing it out of the abdomen). 
Using scopes to view inside body cavities started approximately in 1805 using candle power. In 1879 Nitze designed a rigid scope incorporating electric light filaments and a series of lenses, first used to see inside the bladder. Rigid scopes were used to inspect the peritoneal cavity as early as 1910.
However, technological advancements starting in the 1950s fueled the laparoscopic movement. These included improved optics of the scopes, fiberoptic light cords and the automatic insufflator. Early surgeons and gynecologists had to peer through the scope one at a time. However, in 1985 the mini video camera was connected to the scope and used to transmit images to video screens in the operating room. This allowed the entire team to view the field, facilitating two handed operating by both the surgeon and assistant.
The first human laparoscopic cholecystectomy (gallbladder removal) was performed in France in 1987. The laparoscopic movement quickly spread to America and has progressed at an exponential rate. 
Laparoscopic abdominal surgery can be used in place of almost all open operations with equal or better results, giving patients less pain and a shorter recovery. There are also smaller scars and less wound complications. In experienced hands, there are few disadvantages, although laparoscopic cases may take longer. However, not all general surgeons do complex laparoscopic surgery.
We were trained in advanced laparoscopic surgery and have made this type of surgery a primary focus of our practice. We were one of the first groups on the North Shore to perform difficult laparoscopic cases such as colectomy, splenectomy and ventral hernia repair. Our accumulated volume and experience rivals that of downtown medical centers, thus our patients can get state of the art care close to home, both at Highland Park Hospital and Lake Forest Hospitals.
This includes common procedures such as removal of the gallbladder or appendix as well as rare cases like splenectomy, small bowel resection and mesenteric lymph node biopsy. We have done hundreds of laparoscopic ventral and inguinal hernia repairs and will suggest this when we feel it is the best for the patient.
For laparoscopic colon resection, the incisions keep getting smaller, and the hospital stay shorter. Using intracorporal anastomosis for both right and left colectomy, we are able to keep the largest incision under two inches. Most surgeons cannot say this. Laparoscopic colectomy is now the standard for both benign disease like polyps or recurrent diverticulitis, and malignant tumors.
Foregut surgery is a major part of our practice, with the rise of bariatric surgery. Dr. Haggerty does laparoscopic Roux-en-Y gastric bypass and Lap Band placement. We also do other stomach surgery, such as removal of stomach tumors and stomach wrapping for reflux disease, known as Nissen fundoplication. In addition, we are comfortable managing large hiatal hernias using bio-absorbable mesh, which has been shown to decrease recurrence rates.
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