Overview

The human body's abdominal cavity contains both hollow and solid organs, all of which play important roles in digestion and other functions. The liver, spleen, kidneys, adrenal glands, and pancreas are examples of solid organs.

There are numerous surgeries that can be performed on solid organs, including resection (removal). Most surgeries, with a few exceptions, can be performed laparoscopically or robotically, which is generally more comfortable than open surgery.

Solid organs of the body:-

Liver - The liver is the largest internal organ of the body, located directly beneath the diaphragm, and is made up of two lobes, lobules, and bile ducts:

• lobe to the left
• Right lobe
• Lobules – a liver-supporting framework that is primarily concerned with blood flow and other liver functions.
• Bile ducts – transport bile from the liver to the gallbladder.

Primary functions of liver include:-

• Break down and remove old red blood cells, as well as recycle iron from haemoglobin.
• Toxins that enter the body are detoxified. Iron and vitamins are stored.
• Develop plasma proteins
• Aid in the digestion of all foods (carbohydrates, fats and proteins)
• Its bile ducts secrete bile.

In the small intestine, bile is essential for fat digestion and absorption. Many waste products are excreted from the body through bile secretion and subsequent elimination in feces

Spleen - The spleen is a small oval organ located above the left kidney and behind the lower part of the stomach. The organ's size varies and can enlarge and atrophy, particularly in old age.

What are the functions of the Spleen?

The functions of the spleen include:

• removing and destroying microorganisms from the blood
  • Repair of tissues
  • Red blood cells and platelets that are faulty or old are destroyed.
  • Acting as a blood reservoir, releasing extra blood to the body when required

Because the spleen contains a large volume of blood, especially at rest, an injury or rupture of the spleen can result in extensive internal bleeding and death.

Kidney - The kidneys are bean-shaped organs about the size of a fist that are located beneath the rib cage, one on each side of the spine.

The kidneys are responsible for filtering and removing waste from the blood.

Adrenal Glands - The adrenal glands fit over the top of the kidneys like a cap. They are divided into two sections:

Adrenal cortex – outer portion

Adrenal medulla – inner portion

The adrenal glands secrete various types of corticosteroids, each with its own function. They also secrete hormones.

Aldosterone aids kidney function and maintains sodium (salt) homeostasis in the blood by adjusting sodium, potassium, and pH levels. Epinephrine, norepinephrine, and glucocorticoids all have an effect on the autonomic nervous system as a response to stressful and inflammatory conditions, among other things. Sexual hormones are also secreted by the adrenal glands.

Pancreas:

The pancreas is a small, banana-sized organ in the upper abdomen near the spine and partially behind the stomach.

The pancreas secretes pancreatic juice, which contains digestive enzymes. The pancreas also performs important endocrine functions, which include the production and secretion of pancreatic hormones such as insulin and glucagon, which regulate blood sugar levels in the body.

What are the types of Solid Organ Surgery?

Liver Surgery - The surgical removal of the liver is known as a "hepactectomy." For liver transplantation, partial hepatectomies are performed. The extent of surgery is determined by the patient's condition as well as the liver's function. A portion of the liver or an entire lobe may be removed by the surgeon. In a partial hepatectomy, however, the surgeon leaves a margin of healthy liver tissue. Only in a few cases is a liver transplant required.

Laparoscopic hepactectomy:

• Two to three tiny incisions are made in the abdomen by the surgeon to insert tube-like surgical instruments.
• To aid the surgeon's view of the abdominal cavity, the abdomen is filled with gas, usually carbon dioxide.
• The surgeon then inserts the laparoscope and instruments through these incisions and removes the affected portion of the liver, which is placed inside a bag inside the body.

Spleen removal surgery ( Splenectomy) -

A splenectomy is the surgical removal of the spleen. A partial splenectomy is when part of the spleen is removed, and a total splenectomy is when the entire spleen is removed.

Splenectomy is a surgical procedure used to treat diseases, symptoms, and conditions affecting the spleen, such as:

• The most common reason for splenectomy is a ruptured spleen, which usually occurs as a result of a severe abdominal injury or an enlarged spleen (splenomegaly)
• Infection with a splenic abscess that is resistant to other treatments
• Blood disorders that are resistant to other treatments, such as idiopathic thrombocytopenic purpura, polycythemia vera, sickle cell disease, and thalassemia
• Cancers such as chronic lymphocytic leukaemia, Hodgkin's lymphoma, non-lymphoma, Hodgkin's and hairy cell leukaemia are examples of blood cancers.
• A noncancerous cyst or tumour within the spleen that cannot be removed.
• Spleen enlargement resulting in pain and a feeling of fullness
• Hereditary spherocystosis (HS)
• Aneurysm of the splenic artery
• Laparoscopic Splenectomy –
• The procedure is carried out under general anaesthesia.
• A cannula is inserted into the abdomen, causing it to inflate with carbon dioxide gas to create a working space.
• A laparoscope is inserted through one of the cannulas, and a video image of the internal organs and spleen is projected on a television monitor.
• Several cannulas are placed in various locations on the abdomen to allow the surgeon to insert instruments into your stomach to remove your spleen.
• After the spleen has been severed from everything to which it is attached, it is placed inside a special bag. The bag containing the spleen is inserted into one of your abdomen's smallest but largest incisions.

Surgery for Kidney ( Nephroctomy)  - The term "nephrectomy" refers to a surgical procedure that removes all or part of the kidney. It is also used to remove a healthy kidney from a donor in preparation for transplantation.

For a diseased kidney, there are two types of nephrectomy:

Complete nephrectomy: This procedure involves removing the entire kidney.

Partial nephrectomy: A partial nephrectomy removes only the diseased or injured portion of the kidney.

Laparoscopic nephrectomy- 

• The procedure is carried out under general anaesthesia.
• It is carried out through a few small punctures or incisions in the abdomen.
• Through these keyhole incisions, a laparoscope and instruments are inserted into the abdomen, allowing the surgeon to dissect the kidney.
• The kidney is then placed in a plastic bag and removed via an extension of pre-existing incision sites.

Adrenalectomy ( Removal of Adrenal glands) - An adrenalectomy is a surgical procedure that removes one or both of the adrenal glands via minimally invasive laparoscopic surgery, traditional open surgery, or cryoablation.

Adrenalectomy is a surgical procedure used to treat diseases, symptoms, and conditions affecting one or both adrenal glands, such as:

• Adrenal tumours, benign or cancerous – most common indication; one or both adrenal glands may be removed; most adrenal tumours are benign (noncancerous)
• Excess hormone production, usually as a result of a tumour
• Greater than two-inch increase in gland size

Laparoscopic Adrenalectomy –

• The procedure is carried out under complete general anaesthesia.
• A few small punctures are made in the abdominal cavity, either in the upper abdomen or on the flank, just below the ribs.
• A camera-equipped laparoscope is inserted through the cannula.
• Other cannulas are inserted as well, allowing the surgeon to carefully separate the adrenal gland from its attachments. After the adrenal gland has been dissected, it is placed in a small bag and removed through one of the incisions.
• The small incisions are closed after the adrenal gland is removed.

Pancreatectomy( part of complete removal of Pancreas) –

A pancreatectomy is the surgical removal of all or part of the pancreas. A distal pancreatomy is a surgery that removes the pancreas's body and tail, as well as the spleen. The lower part is referred to as distal.

A distal pancreatectomy is typically performed to remove benign or malignant pancreatic tumours found in the body or tail of the pancreas. Chronic pancreatitis and pancreatic injuries are also indications for a distal pancreatectomy.

A pancreatectomy is used to treat a wide range of diseases and conditions involving the pancreas, including:

• Cancer of the pancreas
• Islet cell tumours, ampullary cancer, lymphoma, and papillary cystic neoplasms are examples of benign and malignant tumours.
• Cancer of the bile duct's distal (lower) portion
• Cancer of the duodenum
• Inflammation
• Pancreatitis necrotizing
• Chronic pancreatitis that is severe
• Hypoglycemia with severe hyperinsulinemic hypoglycemia
• Trauma

Laparaoscopic  Pancreatectomy-

• A few punctures/incisions are made by the surgeon to insert tube-like surgical trochars.
• To aid the surgeon's view of the abdominal cavity, the abdomen is filled with gas, usually carbon dioxide.
• Through incisions, a laparoscope and instruments are inserted.
• A camera is inserted into one of the tubes and images are displayed on a monitor in the operating room.
• If a partial pancreatectomy is performed, the blood vessels are clamped and cut, and the pancreas is stapled and divided for removal. The spleen is also removed if the disease affects the splenic artery or vein.
• When performing a total pancreatectomy, the surgeon removes the entire pancreas as well as any attached organs.

Book an appointment at Aakash Healthcare if you have a condition affecting one of the solid organs. We can diagnose your condition and advise you on the most effective and tolerable treatment options for your specific situation. We are considered one of the best centers/hospitals for laparoscopic surgery in Dwarka Delhi. The department has best team of laparoscopic surgeons.