What’s the Scope About Surgery? Understanding Minimally Invasive Surgery

By Richard Daniels, MD, FACS
Vascular Surgery, General Surgery and
Thoracic Surgery
Evergreen Surgical, Eau Claire

My doctor said that surgery can be done with a scope. What does that mean?

Minimally invasive surgery crosses most traditional disciplines of surgery and involves such subspecialties as general surgery, neurosurgery, orthopedics and urology. It’s a philosophy about surgery that has changed our way of thinking and operating over the years. The concept of minimally invasive surgery means performing major operations through small incisions. High-tech imaging systems are used to minimize the trauma of surgery. The advantages are a marked decrease in the disruption of normal tissues resulting in less post-operative pain and a quicker return to normal activities.

The term minimally invasive surgery is relatively new. However, the concept of using a “scope” or a camera to assist surgery is much older. The first laparoscopy (using a camera to look inside the abdominal cavity) was performed in 1901. In the 1970’s, new technology enabled more specialties to apply minimally invasive techniques to various procedures such as hysterectomies, hernia repair, kidney removal, knee ligament repair, etc. Some terms to describe minimally invasive techniques include:

LAPAROSCOPY: use of a scope to aid abdominal surgery
THORACOSCOPY: use of a scope to aid chest surgery
ARTHROSCOPY: use of a scope to aid joint surgery
ENDOSCOPY: use of a scope to aid internal organ evaluation

With minimally invasive surgery, the traditional large incision is replaced by several smaller incisions. A camera is then placed through one of the incisions to gain visual access to the desired area. For example, the traditional incision for gallbladder removal is a 10 inch long incision below the right rib cage. This results in a large portion of the abdominal wall muscles being cut. Today, four small 1/2 inch incisions are used to remove the gallbladder. A camera is placed through one of the 1/2 inch incisions near the umbilicus (belly button). Then, three more 1/2 inch incisions are made and instruments are inserted to assist in removing the gallbladder. The four small incisions result in much less post-operative pain.

In the specialty of general surgery, some basic laparoscopic procedures are quite common. These include laparoscopic removal of the gallbladder and treatment of heartburn. Some advanced laparoscopic techniques have been developed for treatment of many other problems in the abdomen and chest. Minimally invasive surgery is the more desirable technique in many situations. The patient definitely benefits from a reduced amount of pain and time spent in the hospital and a quicker return to their normal activity level.

On the other hand, there are times when small incisions may not be the best option. A traditional large incision allows the surgeon to adequately expose the area of interest. The larger incision may also be needed for safety reasons when bleeding needs to be controlled.

For more information, or to schedule an appointment with Dr. Richard Daniels » 715.832.1044, Evergreen Surgical or visit www.evergreensurgical.com