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Apr 29

Minimally Invasive Procedures

2nd opinion on surgery

 

For many people, the term “surgery” conjures up images of large incisions, open body cavities, significant disruption to internal organs and tissues, and major scars afterwards. And, traditionally, these conditions used to be standard aspects of many surgeries. In recent years, however, advancements in medical technology and surgical procedures have greatly reduced the invasiveness and trauma associated with surgeries of all types. These surgical techniques go by the name of minimally invasive procedures and they have revolutionized the treatment of many types of medical disorders.

 

What Is a Minimally Invasive Procedure?

In basic terms, a minimally invasive procedure is one that requires less breakage of the skin and minimal contact with the internal body cavity than traditional open surgery for the same operation. It also implies that there will be less trauma to the tissues at the point of incision. Dr. John Wickham first used the term in a 1987 article for the British Medical Journal. Most minimally invasive procedures involve one of two specific techniques: arthroscopy and laparoscopy, depending upon the nature of the condition to be treated.

 

Arthroscopy

Arthroscopy, or arthroscopic surgery, is a minimally invasive procedure used to evaluate and repair damage to joints. To evaluate the damage, a surgeon uses a tool called an arthroscope that features a long, flexible tube containing fiber optic wire, a light source to illuminate the interior of the joint, and an imaging device to see the interior structures. By looking through an eyepiece at one end of the endoscope, the surgeon can assess the nature and extent of the damage and use this information to plan surgery. The surgeon needs only to make a small incision to insert the arthroscope and another small incision for the surgical instruments to be used to repair the joint. The surgeon views the surgical field through the arthroscope itself or on a video screen that displays the image provided by the arthroscope.

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Arthroscopy is most frequently used to treat injuries to the knee, hip, elbow, shoulder, ankle, foot, and wrist. The procedure gained widespread exposure as a result of its use in treating sports injuries, particularly a form of shoulder surgery for baseball pitchers known as “Tommy John surgery” after the first high-profile player to have the procedure performed. Today, arthroscopy is one of the most common forms of joint surgery due to the minimal trauma and reduced recovery time compared to traditional open surgery. Another advantage of arthroscopic surgery is that it can be performed under local anesthesia in the doctor’s office. Traditional open joint surgery requires the use of general anesthesia and is performed in a hospital operating theater.

Laparoscopy

Like arthroscopy, laparoscopy uses a fiber optic imaging tool to view the interior of the body in order to evaluate and repair damage. Laparoscopy, however, is used to assess medical issues with or perform surgical procedures on structures in the abdomen or pelvis.

There are two distinct formats or systems of laparoscopic surgery. The da Vinci system requires multiple incisions for various tools such as a camera, vacuum pump, and laser scalpels. The surgeon does not manipulate the tools directly, but uses two grip devices that transfer the movement of the surgeon’s hands to the surgical tools. The Bonati system, meanwhile, uses a single incision and all the tools are activated when the laser cutter is used. The da Vinci system is used for a wide variety of laparoscopic techniques, whereas the Bonati system was designed specifically for spinal surgery.

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The advantages of laparoscopy are similar to those of arthroscopy. These include smaller incisions, reduced postoperative pain, less chance of hemorrhage during surgery, and, since the internal organs are much less exposed, a reduced risk of infection. Unlike arthroscopy, laparoscopy requires the patient to undergo general anesthesia and must be performed in a hospital setting. In addition, laparoscopy seems to be less beneficial in younger individuals, and many surgeons restrict the procedure to adult patients.

Both of these techniques have revolutionized surgical procedure and enhanced the surgeon’s ability to diagnose and treat medical conditions quickly and effectively. If you are considering surgery, it pays to speak to your physician about the benefits of arthroscopic or laparoscopic surgery and whether either of these techniques is appropriate for you. Minimally invasive procedures can make surgery less intimidating, less painful, and quicker to recover from than traditional open surgery.

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