Minimally invasive surgery clinics and centers

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2023-12-16 20:44

Medical technology does not stand still; their development significantly expands the possibilities - both diagnostic and at the treatment stage.

In particular, due to the active development of endoscopic techniques, minimally invasive surgery has become quite widespread. Consider what it is in this article.

Why minimally invasive surgery is needed

All the subtleties of this technique are aimed at minimizing the traumatic effects on the patient's body, which are inevitable during any surgical intervention.

Endoscopy and laparoscopic surgery are examples of techniques.

The combination of laparoscopy with alternative methods of access to internal organs can also be attributed to minimally invasive surgery.

The popularity of the method is easily explained.

This technique meets both the interests of patients (the consequences of these operations are minimal) and socio-economic interests (due to the use of minimally invasive surgery, it becomes possible to significantly reduce the time the patient stays in a medical institution.

Laparoscopy has found wide application in pediatric abdominal surgery:In children, most abdominal operations are performed by laparotomy. Laparoscopic surgery is possible in children of almost any age. Moreover, to work with young patients of different ages, sets of instruments for laparoscopy with different diameters are provided.

Laparoscopic surgery is very limited for pregnant women.

Benefits

• Damage to the patient's body during surgery performed in accordance with minimally invasive surgical methods is significantly lower than with conventional surgical access.
• Long bed rest after minimally invasive surgery is not necessary. Such manipulations can be carried out in special clinics for minimally invasive surgery (the so-called one-day clinics).
• Low-traumatic surgery is well tolerated by patients.
• The level of traumatization of body tissues during such manipulations is significantly lower due to a reduction in the intervention time; and a low level of traumatization allows to increase the therapeutic and cosmetic effects.

Examples from history: how it all began

The very first laparoscopic operation was performed in France in the 80s of the 20th century. A few years later, this method was already introduced into mass use.

After the start of systematic use, this technique has been rapidly developed and in a fairly short period of time has become verypopular.

Cons of minimally invasive interventions

• Surgical interventions performed using endoscopic techniques do not allow tissue palpation.
• The need to install high-tech equipment in a medical institution or create special centers for minimally invasive surgery; the high cost of such equipment.
• The need for medical staff to acquire skills in working with high-tech equipment.

Laparoscopy

This type of minimally invasive surgery can be applied in the following situations:

• Female infertility.
• Treatment of endometriosis.
• Ovarian cysts.
• Uterine fibroids.
• Ectopic pregnancy.
• Removal of the gallbladder.
• Removal of small neoplasms of internal organs.
• Removal of lymph nodes.
• Treatment of some vascular pathologies.

Surgical intervention begins with the fact that three or four punctures are made in the anterior abdominal wall. Subsequently, through them, carbon dioxide is introduced into the body, which is necessary to increase the volume of the cavity and create sufficient space for the operation. Then a camera is inserted through one of the punctures, which displays on the monitor the operating field, internal organs and instruments introduced to perform manipulations through the remaining punctures.

Mini laparotomy (mini access)

In essence, this is a normal surgical operation, but through a much smaller incision, made possible by the use of a special set of instruments. Many abdominal surgeries can be performed in this way.

Endoscopy

This technique is used to examine internal organs that have a hollow structure, and is carried out using special instruments - endoscopes.

Endoscopic minimally invasive surgery, unlike laparoscopy, does not use punctures or incisions; medical instruments are inserted into hollow organs through natural openings. Accordingly, recovery after such a manipulation is much easier.

Thus, in the clinics of endoscopic and minimally invasive surgery and endoscopic departments of hospital complexes, the following organs are examined:

• esophagus;
• stomach;
• intestine;
• larynx;
• trachea;
• bronchi;
• bladder.

In addition to examination, endoscopy also provides opportunities for medical procedures, for example, stopping gastric bleeding, removing small tumors of the stomach and intestines. Such manipulations are performed both in conventional medical institutions and in specialized clinics (for example, the clinic of coloproctology and minimally invasive surgery).

Rehabilitation period

Due to the low leveltraumatization of tissues and organs during operations performed in accordance with the principles of minimally invasive surgery, the rehabilitation period after such interventions has a minimum duration and is well tolerated by patients.

There is no need to prescribe prolonged bed rest when using low-traumatic surgery methods.

Pain syndrome during minor operations is much less pronounced, this circumstance makes it possible to avoid the use of drugs belonging to the group of analgesics, and, consequently, their side effects.

When minimally invasive surgery doesn't work

Despite all the benefits, minimally invasive surgery can not be applied in all cases. Some surgical interventions cannot be transferred to the category of low-traumatic ones.

1. The presence of adhesions in the abdominal cavity. This circumstance is an obstacle for some part of such operations. A particularly serious problem is when the patient has a history of several surgical interventions that led to the formation of adhesions. However, in some cases, when the patient is denied laparoscopic surgery on the abdominal organs due to the presence of adhesions, surgery can be performed from the so-called mini-access. There is no single-valued algorithm; the decision is made on a case-by-case basis.
2. Diseases of the cardiovascular system and lungs in the stage of decompensation. This is due to the fact that in order tolaparoscopy requires the introduction of carbon dioxide into the abdominal cavity; and this, in turn, will lead to an increase in intra-abdominal pressure and the creation of additional pressure on the diaphragm and, as a result, on the organs of the chest cavity. In patients with cardiopulmonary insufficiency, such exposure leads to a deterioration in the condition.
3. Dramatically increased patient weight. Obesity of the third and fourth degree may also be a contraindication for laparoscopic surgery due to the fact that the length of the instruments may not be enough to access the internal organs in these cases. In addition, due to the high mass of the anterior abdominal wall in such patients, in some cases it is not possible to create a pneumoperitoneum.
4. Ophthalmohypertension, particularly in glaucoma. Pneumoperitoneum can cause an increase in intraocular pressure, worsening the course of this serious disease and the development of complications (for example, retinal detachment).
5. High degree of myopia - above six diopters (for the same reasons - to avoid retinal detachment). However, there may be exceptions in some cases, such as short-term exposure or low-gas laparoscopy, when intra-abdominal pressure increases slightly.
6. Diseases of the blood system, characterized by a violation of its ability to coagulate. Such conditions are fraught with increased bleeding, which is unacceptable.

In old age, a whole range of circumstances are more often recorded that are contraindications to laparoscopicsurgical intervention. In such cases, patients undergo surgery using the mini-access technique, which has practically no general contraindications.