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.