A guide to minimally invasive surgery
Surgery can remove, repair or replace damaged tissue all over the body. It can vastly improve your life, or even save it.
But cutting open the body carries risks. Complications from major surgery are not common, but they can include blood clots, infection or excessive bleeding.
In many cases, the potential hazards of surgery are due to the process of cutting the body open, not to the procedure itself.
But thanks to minimally invasive surgery, today some procedures can be done without open incisions. Instead, surgeons use 1 or more very small incisions or none at all.
According to the American Medical Association (AMA), minimally invasive surgery can mean fewer complications and a quicker return to a healthy, productive life.
A different perspective
Minimally invasive surgery is usually done using tubes called endoscopes that allow surgeons to see and operate inside the body.
Some endoscopes have built-in miniature cameras, and some include channels for other instruments. The surgeon views the area either directly through the endoscope or on a video screen.
In some surgeries endoscopes can be inserted through natural body openings, such as the mouth or anus. In these cases, the person may need only a local anesthetic or sedation. Otherwise, he or she may be put to sleep with a general anesthetic.
During surgery, the doctor makes an incision about 1/2 inch long for the endoscope. Additional small incisions may be made for other instruments, such as lasers and scissors.
The surgeon manipulates the instruments to accomplish the surgery, and then removes the instruments and endoscope.
It often takes only one stitch to close an incision.
Types of minimally invasive surgery
Minimally invasive surgery can be done in areas of the body that are large enough to allow movement of the instruments, such as the chest, abdomen, and large joints such as the knee and hip.
The AMA and other experts list these typical minimally invasive surgeries:
- Gallbladder removal.
- Repair of damaged cartilage in joints.
- Lung biopsy.
- Hernia repair.
Sometimes minimally invasive surgery is done without endoscopes. In minimally invasive direct coronary artery bypass (MIDCAB), the surgeon creates several small ports in the chest, and a small incision directly over the coronary artery to be bypassed. The surgeon then views and performs the operation directly. This surgery eliminates the need for a heart-lung machine and does not require the breastbone to be cut.
Benefits and risks
As its name implies, minimally invasive surgery can be easier on your body than open surgery. The American College of Physicians and other experts list these advantages:
- Scarring is reduced.
- Bleeding is minimal and recovery time is shorter.
- Wounds heal more quickly and are less likely to become infected.
Minimally invasive surgery can also be less painful than open surgery. But it does have risks:
- The small work area means slightly greater risk of damage to an organ or vessel.
- The need for open surgery could arise during the procedure.
- As with any surgery, there is a risk of an adverse reaction to a general anesthetic.
On the horizon
The future of minimally invasive surgery can sound like science fiction, but voice-controlled instruments and microprocessors that enhance surgeons' dexterity are already in use. And miniaturized instruments may soon allow for more procedures through natural body openings, requiring no surface incisions at all.
If you have an upcoming surgical procedure, ask your doctor if there is a minimally invasive procedure that would be appropriate for you.