Tiny tools and minimal incisions are giving the operating room an extreme makeover.
Appendectomies in the 19th century were the type of operation that would make a grown man faint: large incision, exposed muscles and tissue, blood-staunching nurses. Post-op wasn’t much better, as a patient would spend weeks in recovery, fighting infection.
Thankfully, this is no longer the case. Through minimally invasive surgery (MIS), surgeons can repair and remove everything from an inflamed appendix to a cancerous tumor. Undergo a minimally invasive procedure, and chances are good that you'll be walking the hospital corridors within hours and going home the next day.
Rapidly evolving advances in biotechnology, diagnostic methods and specialized instruments like the da Vinci robotic system have helped speed this astounding medical transformation. According to Beaufort Memorial surgeon Gregory Miller, MD, these advances are significantly improving patient outcomes.
“Over my career, I've seen two major surgical shifts—the first from open surgery to laparoscopic, and the second from laparoscopic to robotics,” Miller says. “As technology evolves, more and more people are thinking about new ways to make surgery better for patients. And now, the robot affords us a better modality for a lot of different surgeries.”
So what's minimally invasive surgery all about? Here's the lowdown.
|The daVinci robot in action|
The beauty of minimally invasive surgery is, of course, the minimally invasive, small incisions—most measure less than a half-inch. Because there's less cutting and blood loss, infection risks are lower and recovery times are faster.
MIS can be performed almost anywhere in the body, from the brain to the foot. Gallbladder removal and appendectomies are two of the most popular procedures. Prostate and uterus removal is also common. Heart disorders, diverticulitis, uterine fibroids, joint problems, obstructions and herniated disks are just some of the other conditions for which MIS may be suitable.
The Brain behind the Bot
During robot-assisted MIS, a physician sits at a console and maneuvers “arms” that seamlessly replicate hand movements to manipulate miniature instruments. A high-definition camera that has been inserted through a small incision streams 3-D images to a monitor.
Miller says this combination of increased visibility and flexibility in approaching the repair allows for greater precision and accuracy. “When I'm talking to patients, I tell them to imagine the difference between standard TV and high definition,” he says. “That's what robotic surgery is like—your ability to see things is magnified tenfold.
Your dexterity is also so much better. As doctors, we can put our hands in spots we couldn't otherwise reach.”
The Latest Breakthroughs
Single-site surgery, also known as single-port surgery, is a newer form of MIS. The physician uses a soft and flexible instrument equipped with three distinct openings that allow for the simultaneous use of three surgical devices—all accessed through one small incision, usually in the navel. It’s increasingly being used for gallbladder, urologic and gynecologic procedures.
Another new frontier is known as “scarless surgery,”—or NOTES, for natural orifice translumenal endoscopic surgery--which uses the body’s existing openings, such as the mouth and the vagina, to access organs with an endoscope and surgical tools. “We're seeing a lot of change in our field,” says Miller. “It's exciting to be at a place like Beaufort Memorial that continues to embrace new technology and techniques.”
To learn more about the benefits of Beaufort Memorial's da Vinci surgical system, click here.