Minimal
Access Surgery: Surgery minus the trauma
Minimal Access
Surgery or laparoscopy as it is better known is the rage today and for innumerable
reasons too. Minimal Access Surgery brings with it a host of advantages:
It sometimes
offers even better visibility than open surgery. This occurs especially in
region like pelvis.
The requirement
of blood transfusion is very less in Minimal Access Surgery rather than in open
surgery. In open surgery, blood transfusion is always the norm than the
exception.
Smaller wounds
are associated with fewer wound complications, less scarring, and better
cosmesis.
Video imaging
allows surgical assistants, anaesthesiologists, and nurses to view what the
surgeon is doing and to actively participate in the procedure in their
respective roles.
Laparoscopy can
be performed in infants weighing less than 1.5 kg without significant mortality
or morbidity.
It comes with a
guarantee of better quality of life post operation.
It considerably
minimises the post-surgery trauma, thereby decreasing post-operative narcotic
use and the complications.
It brings with
it the prospect of smaller and fewer incisions, expediting the healing process.
It reduces
post-operative adhesions.
It facilitates
faster recovery.
It enables
quicker ambulation.
Patients are
able to return to their normal activities such as going to school, work, play,
faster.
A child’s quick
recovery allows parents to returns to work faster.
It reduces
post-operative complications.
Application Areas of Minimal Access Surgery:
Not only is
Minimal Access Surgery or laparoscopy highly beneficial, it also has a wide
range of applications. Here is a list of some of the applications:
Cholecystectomy
for gall bladder surgery. However, Many surgeons believed that laparoscopic
cases did not really apply to children, and the need for cholecystectomy was
relatively uncommon in children.
Gastroenterology
for hepatic biliary, the pancreas, the stomach and the colon.
Endoscopy for
haemorrhoids, varicose veins, chest surgeries etc.
Hernia:
Inguinal, umbilical, incisional and hiatus hernia.
Endocrine
Surgery: Adrenal gland, parathyroid gland surgery.
Oncosurgery for
cancer.
Others:
Gynaecology, urology, paediatric surgery etc.
Vanishing Myths about Minimal Access Surgery:
The general myth
shrouding all surgeries is the trauma factor. People always view operations as
a traumatic experience without exception. With the advent of Minimal Access
Surgery, or laparoscopy, came more apprehensions. The most common apprehensions
are:
Time: The surgeries were
thought to take too long to set up and to perform than open surgeries. However,
Minimal Access Surgery is the quicker option any day to set up and perform than
open surgeries.
Difficulty: Minimal Access
Surgery was believed to be too difficult to perform and too difficult to learn.
Contrarily, it is comparatively simpler than an open surgery.
Cost: It is true that
laparoscopy comes with a minimum addition in price, but it brings with it
numerous benefits that an open surgery can never offer.
Application: Contrary to
popular belief, laparoscopic surgery can be applied to oncology (cancer) cases
also.
Disadvantages of Minimal Access Surgery
Controlling
bleeding laparoscopically is difficult.
Operating time
is longer and the complication rate is higher during the learning curve of the
procedure.
With current
technology, the video camera can provide only a 2-dimensional image, although
3-dimensional views are becoming available.
Initial capital
cost is associated with laparoscopy because new equipment and training are
necessary.
Loss of tactile
sensation occurs, which is perhaps the major disadvantage of minimal access
surgery (MAS). Intra-operative ultrasonography is helping to overcome this
deficiency.
The number of
instruments and angles in which they can be applied are limited. Robotic
applications using wrist technology is improving this problem.
Bulky organs are
difficult to remove and hence, require open surgery.
Note: While every care is taken to provide medically accurate and up
to date information in this web site, it is to be noted that this
advice is not intended to replace the advice of your physician. Before
undertaking the advice contained in this web site, you should consult a
medical professional.
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