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
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
It facilitates faster
It enables quicker
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
Application Areas of Minimal Access
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
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
Vanishing Myths about Minimal Access
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
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
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
Bulky organs are difficult to remove and
hence, require open surgery.