Minimal Access Surgery
Minimal Access Surgery
In just the past ten years, the field of minimal access, minimally-invasive, or laparoscopic (lap-rah-sca’-pick) surgery has grown tremendously. Today, laparoscopic surgery is the standard of care, or operation of choice, for procedures such as cholecystectomy (gallbladder removal) or Nissen fundoplication (wrapping the stomach around the esophagus to correct GERD, or gastroesophageal reflux disease).
What is Minimal Access Surgery?
Minimal access surgery is completed with one or more small incisions instead of a large incision. The surgeon passes a telescope with video camera through a small incision (usually only 1/4″ long) into a body cavity. The surgeon then views the surgery on a TV monitor. Surgical instruments are then passed through other similar little incisions. The surgeon examines and operates on the area in question by viewing magnified images on a television. When the telescope is used to operate on the abdomen, the procedure is called laparoscopy. When used in the chest, the procedure is called thoracoscopy, and when used in a joint, it is called arthroscopy.
The Benefits of Laparoscopic Procedures
- Less postoperative pain.
- Less pain medication is required
- Faster healing for a quicker return home.
- Smaller, less noticeable scars after healing.
MINIMAL ACCESS SURGERY/ ENDOSCOPY
The laparoscope, a fiber-optic telescope, is inserted through one port and attached to a camera. It sends images from the abdominal cavity to television monitors placed for easy viewing by all the operating room personnel. Thus, the surgeon and his or her assistants can view the abdominal cavity and its contents. Through the remaining ports, long-handled instruments are used to perform various procedures.
Endoscopy is a minimally invasive diagnostic tool, used to view the inside of organs, inspect for abnormalities and take biopsies. A small camera and light source are mounted onto a flexible tube which can be inserted into the mouth (to inspect the esophagus, stomach and duodenum) or the anus (to inspect the large bowel).
Upper endoscopy is usually performed to evaluate symptoms of persistent upper abdominal pain, nausea, vomiting, or difficulty swallowing. It is also the best test for finding the cause of bleeding from the upper gastrointestinal tract.
Upper endoscopy is more accurate than x-ray films for detecting inflammation, ulcers, or tumors of the esophagus, stomach and duodenum. Upper endoscopy can detect early cancer and can distinguish between benign and malignant conditions when biopsies of suspicious areas are obtained. Biopsies are taken for many reasons and do not necessarily mean that cancer is suspected.
Upper endoscopy is also used to treat conditions present in the upper gastrointestinal tract. A variety of instruments can be passed through the endoscope that allow many abnormalities to be treated directly with little or no discomfort, for example, stretching narrowed areas, removing polyps (usually benign growths) or swallowed objects, or treating upper gastrointestinal bleeding. Safe and effective endoscopic control of bleeding has reduced the need for transfusions and surgery in many patients.
Endoscopy for urology has a lot of advances at the last 10 years. Endourology is the branch of urology that deals with the closed manipulation of the urinary tract. Cystoscopy is the endoscopy for the urinary bladder. Ureteroscopy is the endoscopy for the ureter. Urethroscopy is the endoscopy for the urethra. Nephroscopy is the endoscopy for the kidney. Each one of these procedure may be for diagnostic or therapeutic purposes or combined.
Percutaneous nephrolithotomy is the endoscopic procedure for fragmentation and removal of kidney stones.
Ureteroscopy with laser is the endoscopic procedure for fragmentation and extraction of ureteric stones and also for incision and dilatation of ureteric stricture.
Ureteroscopy and laser for biopsy and ablation of ureteric tumours. Endoscopic insertion of ureteric stent for ureteric stricture. Transurethral resection and biopsy of bladder tumours. Transurethral resection of the prostate for prostatic enlargement.