Minimally access/invasive surgery is a means of performing major surgeries via small incisions(cuts) as compared to larger incision(cut) needed in traditional laparotomy(open surgery), often using specially designed instruments and miniaturized(small), high-tech imaging systems, to minimize the trauma of surgical exposure.
Minimal access does not refer to magnitude of invasiveness as absolute criteria, but invasiveness or accessibility is compared with the conventional open surgery. With the introduction of minimal access surgery, the importance of open surgery is decreasing. Now-a-days, almost all general surgical operations can be performed using minimal access including procedures in the chest and abdomen.
What Are the Types of Minimally Invasive Surgery?
Minimally invasive surgery usually falls into these categories:
Endoscopy: The surgeon uses the endoscope itself to do the procedure. The endoscope goes in through the body’s natural openings, without the surgeon making any cuts. (Upper Gastrointestinal scopy, Colonoscopy, cystoscopy, bronchoscopy, NOTES etc)
Laparoscopy: Using small cuts (sometimes called “keyhole” cuts or incisions), the surgeon guides the endoscope and special surgery tools into the body. (Thoracoscopy, Mediastinoscopy, Retroperitoneoscopy)
LASER surgery: Laser surgery is a type of surgery that uses special light beams instead of instruments for surgical procedures. LASER stands for “Light Amplification by the Stimulated Emission of Radiation.”
Robot-assisted surgery (robotic surgery): The surgeon makes several small cuts to guide the endoscope and robotic tools into the body. From there, the surgeon controls the surgery while sitting at a nearby computer console.
What Are the Benefits of Minimally Invasive Surgery?
Small incisions and minimal scar tissue formation
Less damage to surrounding muscle and soft tissues
Decreased blood loss
Decreased pain and reduced need for pain medication
Quicker recovery and faster return to regular activities
Shorter hospital stays
Many procedures can be performed as outpatient surgery
Decreased risk of postoperative infection
What Happens During Minimally Invasive Surgery?
Someone having minimally invasive surgery will get anesthesia to “sleep” through the procedure. Then, the surgeon inserts the endoscope. Surgeons can put an endoscope into the body through:
the body’s natural openings (like the mouth or anus) or
tiny cuts in the body
Images from the endoscope are shown on monitors in the operating room so surgeons can get a clear (and magnified) view of the surgical area.
In some minimally invasive procedures, special surgical tools or instruments are inserted through other small incisions. The surgeon uses these to explore, remove, or repair a problem inside the body.
There are many different types of endoscopes. Some have tiny surgery tools on the end. Some are flexible, while others are stiff.
The kind of endoscope used depends on the surgery, and might have a different name. For example:
colonoscope — for procedures done inside the colon (such as a colonoscopy)
laparoscope — for surgeries inside the belly (laparoscopic surgery)
thoracoscope — for procedures in the chest (thoracoscopic surgery)
Sometimes during minimally invasive surgery, the surgeon might have to switch to a traditional surgery after looking inside the body. This can happen if the problem is different from what the surgeon expected.
Are There Any Side Effects From Minimally Invasive Surgery?
In laparoscopy, surgeon insufflate the inside of the belly. This means they add carbon dioxide gas to create space in the abdomen, giving them a better view of the surgical area. They release the gas at the end of the procedure. Sometimes, small pockets of gas remain and can irritate the diaphragm, causing shoulder pain. This pain usually doesn’t last more than a day.
Even though laparoscopy is a minimally invasive surgery, it still necessitates tiny incisions as opposed to endoscopy, which does not necessitate any incisions. An endoscope is an instrument used in endoscopy, while a laparoscope is a device used in laparoscopy.
The majority of surgical operations can be done in a less invasive manner. The esophagus, stomach, gall bladder, liver, spleen, pancreas, small and large intestine, appendix, adrenal glands, kidneys, bladder, and male and female genitourinary organs can all be removed or reconstructed by minimally invasive surgery
Compared to traditional open surgery, the advantages of minimally invasive surgery include less postoperative pain, faster recovery and restoration, and fewer incisional problems. Surgeons benefit from the less intrusive method because of the enhanced lighting and magnification provided by the cameras. Because each person operating can see the region of interest equally, this approach can be safer than open surgery.