tween 1997 and 2000 but returned to music in 2000
with the albumInvincible Summer.
Impact By refusing to accept the pigeonholes that
often come with celebrity, K. D. Lang has made a last-
ing impact on the music world. Though she does not
consider being a lesbian the center of her public per-
sona, and feels frustrated when fans expect her to be
emblematic of all lesbians’ struggles, she also regu-
larly expresses support for GLBT causes. Her popu-
lar and mainstream success in the 1990’s came
alongside her coming out, and her fan base in-
creased dramatically throughout the decade.
Further Reading
Allen, Louise.The Lesbian Idol: Martina, kd, and the
Consumption of Lesbian Masculinity.Washington,
D.C.: Cassell, 1997.
Starr, Victoria.K. D. Lang: All You Get Is Me. New
York: St. Martin’s Press, 1994.
Jessie Bishop Powell
See also Country music; DeGeneres, Ellen; Ethe-
ridge, Melissa; Homosexuality and gay rights; Music.
Laparoscopic surgery
Identification Medical procedure
Date Introduced to wide use in 1990
Laparoscopic surger y provided a minimally invasive way
to perform a variety of medical procedures, allowing for
smaller incisions, less pain, and faster recover y time for the
patient.
Laparoscopic surgery, also known as keyhole, pin-
hole, band-aid, or minimally invasive surgery, is a
method of surgery used for many procedures. First
developed in the early part of the 1900’s for
gynecological procedures, laparoscopic surgery be-
came widespread as a medical procedure in 1990
with the development of a clip advancer that allowed
surgeons to easily clamp vessels without having to
pull out the clip applier, reload, and then reintro-
duce the applier into the patient’s body. This re-
duced the infection risks associated with laparo-
scopic surgery.
Uses Laparoscopic surgery is most commonly
used for cholecystectomies (removal of the gallblad-
der). This procedure is accomplished by introduc-
ing the surgeon’s tools through small incisions in
the abdomen. The surgeon uses a camera, scissors,
clip advancer, and graspers in four small incisions;
space for these instruments is created by pumping a
small amount of carbon dioxide into the body to in-
flate the surgical area. These primary instruments
are introduced through a hollow tube known as a
trocar, which is also sealed at one end to keep the
carbon dioxide from escaping the abdominal cavity.
Bile is suctioned from the gallbladder, and the organ
is removed through an incision in the navel. Appen-
dectomies are performed in a similar manner.
Laparoscopic surgery is also used for gynecologi-
cal procedures, the use for which the method was
originally devised. Laparoscopy is used to correct
intra-Fallopian tube pregnancies, thus preventing
serious damage to the patient’s reproductive system.
It has also been used as a fertility treatment, whereby
surgeons introduce both eggs and sperm into the
Fallopian tubes. This procedure has largely been
discontinued because of the successes with in vitro
fertilization, which can be accomplished in a
noninvasive fashion.
Laparoscopy is also used to remove parts of the
kidneys and colon, though larger incisions are re-
quired for these procedures because of the larger
size of the organs. This surgical method is also used
to correct hernias and for bariatric procedures in
obese patients.Benefits and Risks Laparoscopic surgery has sev-
eral benefits over more traditional surgical meth-
ods, including reduced bleeding, smaller incisions,
less pain, and shorter hospital stays. Laparoscopic
patients also do not require as much pain medica-
tion as traditional surgical patients, reducing the
risk of other pulmonary problems associated with
some narcotic usage; the reduced bleeding also re-
duces the possible need for a transfusion. Since
small incisions are used, the patient’s internal or-
gans are not as exposed to outside contaminants,
reducing the risk of infection. Many laparoscopic
procedures can now be performed as outpatient
surgeries, allowing patients with no complications to
go home the same day of the procedure.
Like all surgery, laparoscopic surgery has risks as-
sociated with it. Previous scar tissue can prevent sur-
geons from performing a successful procedure.
Some patients with previous pulmonary issues are
not able to tolerate the carbon dioxide inflation ofThe Nineties in America Laparoscopic surgery 499