Minimally Invasive Surgical Techniques

Minimally invasive surgery techniques allow operations to be done without large incisions to your body. Instead, the surgeon typically uses long, thin tools called laparoscopic devices. They're inserted through tiny incisions that need only a couple of stitches to seal. The tools are controlled remotely, with the surgeon able to see their location indirectly on a screen by using miniature cameras. The idea is to create less physical trauma for the patient. Many types of procedures can be performed using minimally invasive techniques.

Benefits

• Minimally invasive surgery with a laparoscopic system has several advantages over traditional "open" surgery: less hemorrhaging, smaller scars and less necessity for painkillers. Patients can generally go home sooner after surgery and get back to work and other regular activities more quickly. Some procedures are performed on an outpatient basis, while others require a hospital stay. By reducing or eliminating the number of days you spend in the hospital, minimally invasive surgical techniques may save money across the health care system.

Techniques

• In a minimally invasive procedure using a laparoscope, a fiber optic cable system is used to light up the area where the surgery is being performed. The abdomen is often blown up with carbon dioxide gas to make more space in which to work. With the laparoscope, the surgeon can control such tools as graspers and scissors. In recent years many technological advances to minimally invasive surgery have been introduced, including equipment to enlarge the surgeon's field of view and provide stabilization for shaky hands. The most complex of these tools is the surgical robot, which allows the surgeon to sit at a console across the room while guiding the robot's "hands" through the surgery.

Uses

• Among the procedures that can be performed with minimally invasive techniques are heart, colorectal, gastroenterological, gynecological, neurological, orthopedic, urological and vascular surgeries. One of the most common procedures is removal of the gallbladder. Very serious procedures such as heart valve surgery and removal of cancerous tumors can be performed as well. Because the techniques have some drawbacks such as difficulty in manipulating the instruments and restricted vision, they can be challenging to perform. Doctors in surgical residency training who want to focus on minimally invasive techniques typically spend a year or two in a specialized fellowship following the basic surgical training.

History

• Minimally invasive surgical techniques date at least to the early 1900s, when the laparoscopic approach was tried in canines by George Kelling, a surgeon from Dresden. In 1910, H.C. Jacobaeus of Sweden tried it in humans. Innovations such as the computer chip TV camera pushed the techniques along as decades passed. However, early endoscopes, designed to provide illumination inside the body for examination, date back at least to the 1770s.

  The early 1980s were an important time for laparoscopy, according to the Mount Sinai School of Medicine. Rules for performing laparoscopy were set up by surgical societies and hospitals in many locations.

Natural Orifice Surgery

• In the last few years the notion of performing surgery through the body's own orifices has gained attention. It is the least invasive of all minimally invasive surgical techniques, requiring no cuts at all. A doctor might, for example, snake tools into a patient's mouth and down the esophagus in order to remove the gall bladder. By 2007, doctors in India had already tried the technique in humans, removing the appendix. As doctors worldwide continue research to figure out the possibilities for natural-orifice surgery, medical device manufacturers are rushing to create tools suitable for the approach.