What is minimally invasive surgery?

Minimally invasive surgery is a set of techniques that allow surgical procedures to be performed through incisions of only a few centimeters, thus minimizing the trauma of the operation. Compared to traditional surgery, which involves an incision of several centimeters to expose the area to be treated, the minimally invasive technique allows access to the area to be operated on with instruments such as cameras, lights, and scalpels, which pass through holes of a few centimeters.

 

This procedure was developed from knowledge acquired in diagnostics applied mainly to gynecology. Minimally invasive surgery includes laparoscopy, endoscopy, and robotic surgery. Minimally invasive surgery now allows a whole series of interventions to be performed. In addition to observation and diagnosis, it is possible to remove anatomical parts and tumors, to restore cardiac and pulmonary functions, to insert prostheses (knee and hip), and to perform transplants (kidney).

 

Techniques in minimally invasive surgery

Laparoscopy

Laparoscopy is a minimally invasive diagnostic and surgical technique in which small incisions (two or three, approximately 0.5 to 1 cm) are made in the patient's abdominal region for the introduction of the laparoscope. The laparoscope is an instrument with an integrated miniaturized video camera that allows direct visualization of the peritoneal cavity. Other surgical instruments are used during laparoscopy. With these, maneuvers of manipulation, dissection, removal, and suturing of body tissues are performed. The ability to visualize and operate in the abdominal cavity using equipment inserted through small incisions constitutes a major advance for medicine, as it allows surgical and diagnostic procedures that were previously only possible with open or traditional surgery.

 

The main advantages of laparoscopy are:

• Reduced surgical trauma. Patients recover faster, have less scarring, and a low rate of postoperative complications.
• Safety.
• Reduced pain. Compared to traditional surgical techniques, we see a reduction in the need for analgesic medication.
• Reduced bleeding. Laparoscopy reduces the need for blood transfusions compared to traditional surgical techniques.
• Less contamination. With laparoscopy, there is less exposure of tissues to potential external contamination, reducing the risk of infection.
• With a minimally invasive technique such as laparoscopy, there is a reduction in hospital stay and considerable savings on the overall cost of treatment.

Endoscopy

Endoscopy is a medical procedure that allows visualization of the body's internal organs. Endoscopy involves the use of a rigid or flexible tube, called an endoscope, which records and transmits images to a screen using miniaturized cameras. This instrument is inserted directly into the area to be examined, allowing visualization of the inside of the patient's body.

 

Originally, endoscopy was used only for the esophagus, stomach, and colon. Today, physicians can use endoscopy to diagnose and treat diseases of the ear, nose, throat, heart, urinary tract, joints, and abdomen. When possible, endoscopes are inserted through natural orifices, such as the oral route. Sometimes, however, it is necessary to create an artificial access through an incision, as in the case of thoracoscopy or laparoscopy.

 

Endoscopy is widely used for diagnosis, but also for therapeutic procedures or as a support tool during surgery. Many types of endoscopic instruments have been developed to allow physicians to perform minimally invasive surgical procedures. Therapeutic endoscopic procedures can be used for the treatment of small prostate tumors, cauterization of a bleeding vessel by thermal coagulation or laser photocoagulation, dilation of membranes or strictures, reduction of volvulus or intussusception, excision of an intestinal polyp, or removal of a foreign body.

 

Robotic surgery

Robotic surgery is a type of operation performed using advanced technologies, involving the use of a sophisticated surgical platform capable of reproducing, in miniature, the movements of the human hand inside the body cavities, or in any case within the surgical field.

 

The advantages of robotic surgery concern both the surgeon and the patient. For the surgeon, robotic surgery:

• Increases comfort during surgery thanks to the ergonomics of the console, without reducing the precision of the operation.
• Eliminates the fulcrum effect, typical of laparoscopy, allowing the surgeon to perform more normal movements, typical of open surgery.
• Allows extremely easy access to "difficult" anatomies;
• Significantly increases the precision of demolition and reconstruction procedures.

On the other hand, from the patient's point of view, which also depends on the type of surgical intervention they undergo, robotic surgery:

• Allows minimal incisions with a considerable decrease in postoperative pain.
• Limits blood loss and therefore the need for transfusions.
• Reduces the likelihood of surgical site infections.
• Considerably reduces recovery time and therefore promotes a faster return to normal.
• Reduces hospital stay with considerable economic savings.

Why is minimally invasive surgery preferable?

When undergoing minimally invasive surgery, the first thing that catches the eye is the size of the incisions. The small holes have a diameter of approximately 1 to 2 cm, corresponding to the space needed to insert surgical instruments and an endoscopic probe. The preparation for minimally invasive surgery is no different from that required for traditional surgery. It is certain that hospitalization and rehabilitation times, compared to those of traditional surgery, although this depends heavily on the pathology treated and the patient's condition, are definitively reduced in those who undergo this type of intervention.

 

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