Your questions answered

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Keyhole stomach repair

As a tiny camera took Surgery Live viewers on the most incredible journey inside patient Susan Hyde's abdomen, questions poured in for operating surgeon Richard Hardwick. During the programme, #slive became the third most popular trending topic on Twitter. Here is a selection of questions that were answered on the night.

Surgeon Richard Hardwick also kindly answered more of your questions especially for this website.

Is keyhole surgery more difficult than normal surgery? Is the view better or more restricted? (via Twitter)

'I think, like all surgery, once you get good at it, it's no more difficult, laparoscopically than open.

'The difficulty is the learning curve, the time it takes to learn how to do these things is longer than it is in an operation, and the answer to the second question - we often get a much better view with this high-technology camera than we would at open surgery, peering into dark holes with inadequate light, so it can be a major advantage.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital (while operating)

Is the yellow stuff fat? Sorry for not using technical terms. (via Twitter)

'Yes. That was easy.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital (while operating)

Why does there appear to be so much space in there? Why is everything so separated? (via Twitter)

'By pumping carbon dioxide gas into the abdomen.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital (while operating)

Would the use of 3D technology help advance this technique due to the fact of being able to judge depth? (via Twitter)

'Yeah, they've played around with that, and there's some interesting work, it helps people who are novices, but people who are experienced laparoscopic surgeons don't seem to get a lot of benefit from it, but we're always keen to play with new technology.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital (while operating)

How are the holes repaired after surgery? (via Twitter)

'We'll put some little dissolvable stitches in the bigger ones, and in the very small ones, we hardly need to do anything to them at all, just a skin stitch.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital (while operating)

Presumably you need steady hands to do this kind of surgery, so I was interested if the surgeon has to do anything special to prepare, like avoiding caffeine before the surgery. (by the audience)

'As you become more experienced with an operation, I think your hands do become steadier, but one of the things with laparoscopic or keyhole surgery is you almost have to not think what your hands are doing, you've got to concentrate on what's happening at the end of the instruments, so you do need steady hands, but no more probably than an average person.

'It's very important to concentrate on what you're doing here and not thinking about which way your hands are moving, you've got to think about what's happening at the end of the instrument.'

Simon Dwerryhouse, consultant surgeon, Addenbrooke's Hospital

The surgeon on Monday night sounded critical of keyhole surgery. Is this an entirely different skill-set? (via Twitter)

'No, I think we all apply different techniques to different things. Keyhole surgery is not appropriate for everything, and I think, it's just a tool, it's just a way of doing something. It's less painful for the patients and it gets them out of hospital quicker, but it should never be to just be clever, it has to be better.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital (while operating)

Can keyhole surgery be performed while awake or will the patient be in too much pain? (via Twitter)

'No, the patient needs to go under a general anaesthetic - they must be asleep and on a ventilator to relax the muscles and provide the right conditions for surgery.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital

Do the patients experience bloating after this operation?

'Yes, they can do, particularly if they swallow too much air, as their ability to belch is reduced soon after surgery.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital

Will there be any side effects of inflating the abdomen with air? (via Twitter)

'We use carbon dioxide, not air, and we release it before closing the holes. Any carbon dioxide left is absorbed very quickly with no ill effects.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital

Why is the inside of the body not full of fluid? (via Twitter)

'In health, there is only a very small amount of liquid inside the abdominal cavity, which allows the loops of intestine to glide over each other.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital

How long will it be before most keyhole surgery is done by a robot? (via Twitter)

'We will probably never leave operations to robots unmanned by surgeons as procedures are too unpredictable. But we may increasingly use robots to help us - currently it is very expensive so we're looking at 10-20 years ahead.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital

What would be the procedure if there was a problem during 'keyhole' surgery? Would you move directly to open surgery, or carry on? (via Twitter)

'Usually we can deal with any unexpected problems using keyhole surgery and it is rare that we need to convert to an open operation but all our patients know that if necessary we would do that.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital

You appear to be cutting tissue, which I presume have vessels in? Yet there appears to be so little blood? (via Twitter)

'This is because we use an instrument called the harmonic scalpel which both cuts and seals blood vessels simultaneously, and has made keyhole surgery much quicker and simpler.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital

Is the keyhole surgery a common surgery? (via Twitter)

'Yes, for certain procedures like removing the gall bladder and increasingly for repairing hernias. Keyhole surgery is effective for these procedures because you're working in a small area of the body. But applications for keyhole surgery are increasing all the time as the techniques develop.'

Richard Hardwick, upper gastrointestinal surgeon, Addenbrooke's Hospital