Minimally Invasive Surgery

It’s natural to feel uneasy when your doctor recommends surgery for your condition. However, technology has made it possible in recent years for doctors to perform minimally invasive procedures (also known as laparoscopy and keyhole surgery), which may make surgeries safer and easier for patients to recover quickly.

What Is Minimally Invasive Surgery?

In minimally invasive surgery, doctors make small incisions in the skin, called ports, or no cuts at all, rather than larger cuts often needed to perform traditional or open surgery. Doctors use these ports to insert thin tubes, such as an endoscope or laparoscope, with a light source and a camera to guide the surgery. Tiny surgical instruments pass through these openings as well to do the surgery.

Conditions that can be treated with minimally invasive surgery include those relating to vascular diseases and conditions affecting the spinal cord or discs, neurological disease, such as tumors around the brain or skull and treatment for injuries to the brain and spine.

What Are Types of Minimally Invasive Surgery?

Many types of minimally invasive surgery are used to diagnose and treat a range of conditions. They usually fall into these categories:

• Endoscopy – a type of surgical procedure that allows surgeons to use the endoscope itself to perform the procedure through the body’s natural openings, such as the mouth and nostrils, without the surgeon making any incisions.
• Laparoscopy – a type of surgical procedure that allows surgeons to use small incisions (sometimes called “keyhole” cuts or incisions) to guide the scope and special surgical tools into the body.
• Robot-assisted surgery (robotic surgery) – a type of surgical procedure that enables surgeons to operate by making several small incisions to guide the scope and robotic tools into the body. Surgeons can perform the procedure using robotic controls at a nearby computer console. Doctors use robotic-assisted techniques to treat problems dealing with the lungs, heart, urologic system, gynecology system, digestive system and other general areas, such as gastric bypass for obesity, gallbladder infection or stones, pancreatic cancer and gastroesophageal reflux disease (GERD).

Who Are Candidates for Minimally Invasive Surgery?

In some situations, not all procedures can be performed through minimally invasive methods and may not be as safe or effective as traditional open surgery. Many conditions cannot be treated with minimally invasive surgery. A doctor can tell which type of surgery is best for your condition. Be sure to ask about the possible risks and benefits before any procedure.

How Is Minimally Invasive Surgery Performed?

Patients undergoing minimally invasive surgery will be given anesthesia to help them sleep throughout the procedure. The surgeon then inserts a scope through the body’s natural openings like the nostrils or mouth or tiny cuts in the body.

Some scopes have tiny surgical tools on the end, while others are flexible or stiff. The kind of scope used depends on the procedure. Examples of scopes include a colonoscope for procedures done inside the colon (colonoscopy), a laparoscope for surgeries inside the stomach (laparoscopic surgery) and a thoracoscope for procedures in the chest (thoracoscopic surgery).

The scope provides images of the inside structures of the body through monitors in the operating room to give surgeons a clear and magnified view of the surgical area. Depending on the procedure, the surgeon will insert special surgical tools and instruments through other small incisions to explore, remove or repair a problem inside the body.

During minimally invasive surgery, the surgeon might have to switch to open surgery if the problem differs from what the surgeon expected and may have to explore or operate directly on the surgical site.

What Are the Benefits and Risks of Minimally Invasive Surgery?

The benefits of minimally invasive surgery over traditional open surgery that can benefit patients include:

• Shorter hospital stays and quicker recovery times. Other minimally invasive procedures can be performed on an outpatient basis.
• Less pain and bleeding after the operation.
• Smaller scars due to reduced trauma on muscles and other tissue.
• Fewer complications.

As with any surgical procedure, minimally invasive surgery also has potential risks. In a laparoscopic procedure, doctors send carbon dioxide gas into the abdomen to expand the area for a better view and room to operate on the surgical site. They release the gas at the end of the procedure. Sometimes, small pockets of gas form and remain, which can irritate the diaphragm and cause shoulder pain that usually does not last more than one day.

Additionally, minimally invasive surgery, particularly robotic surgery, can be more complex than traditional open surgery and may take longer because the doctor needs direct access to the surgical site. Asking the following questions can help point you in the right direction:

• Is surgery a better option for me than medication or antibiotics?
• Is it a better option than open surgery for me?
• How long will I spend recovering from the surgery?
• How much pain will I feel after?
• Is it any more risky than open surgery for me?
• Is it a better solution or treatment for my condition?

Talk to your doctor to see if minimally invasive surgery is the best option for you. We’re here for you, always.