Minimally Invasive Surgery
This involves procedures performed by entering the skin via small incisions or by a body cavity with two aims:
- Produce the least possible damage to structures
- Whilst at the same time achieving the same result as if performed by open or more invasive surgery
It requires specialist equipment including fibreoptics, camera and equipment with handles.
 By using a long, thin surgical instrument with a tiny video camera attached to it, the surgeon is able to enter the body through a series of tiny incisions (5 to 10 millimeters) to view and explore the body and perform the operation. The video camera is attached to a monitor with magnification up to 20X so the surgeon can maneuver the instrument with exacting precision. Because minimally invasive surgical procedures cause minimal tissue, skin and muscle damage, recovery time is reduced and the patient can return to normal activity more quickly.
Background
The use of light containing probes to view internal cavities has a long history. Philipp Bozzini (1771-1809) was the earliest deviser of such equipment which was called the "Lichtleiter" and was primarily used to examine the vaginal cavity. This was then modified by John D. Fisher (1798 - 1850) and used for urological purposes. In 1929 Heinz Kalk a German gastroenterologist used laparoscopy to diagnose hepatobiliary disease. 30 years later the automatic insufflator was invented and used to perform an appendectomy as part of a gynaecological procedure. However, it was not until the early 1980's that laparoscopic procedures began to be performed on a regular basis.
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Here the ports are placed appropriately to remove the gallbladder
through key hole incisions |
Disadvantages and Advantages of Minimally Invasive Surgery
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| Advantages |
Disadvantages |
- Less expensive
- Shorter duration of hospital stay
- Less trauma to patient
- Less pain
- Less blood loss
- Smaller skin scars
- Becoming more common for major surgical procedures e.g. cardiac surgery
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- Requires special equipment
- Specialist training required
- Equipment is more expensive
- Some procedures, especially latest ones, may take longer
- Some complications can be masked e.g. biliary peritonitis
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Patient Suitability
Not all patients will be suitable for minimally invasive procedures. For example, raised body mass index, previous abdominal surgery leading to adhesions or other underlying medical conditions may affect the decision whether to proceed towards more invasive surgery.
We routinely perform key hole surgery for the following organs/diseases :
- Appendix (Appendicitis)
- Gallbladder (Cholecystitis, Gallbladder infection)
- Liver (Benign and malignant tumours)
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