The Age Of Minimally Invasive Surgery

For hundreds of years, physicians have been seeking ways to spare their patients the trauma and risks of open surgery. Finally, the time has come.

Minimally invasive surgery is the long sought after alternative to traditional open surgery. Until very recently, surgery has always involved a sizeable incision through flesh and muscle (and sometimes bone) to reach the organ requiring repair or removal. Drawbacks to this method have led physicians to seek out other approaches.

The first minimally invasive surgeries were performed in the early 1800s for the urological problem of bladder stones, a very painful condition common to the era. The procedure called for breaking up or crushing a stone in the bladder and drawing out the pieces. Refinement of the tools and acceptance of the procedure took time, but by the end of the century, this technique had become the preferred method for removing bladder stones.

Today, a method of breaking up stones called shock wave lithotripsy is perhaps the most minimally invasive surgery possible, requiring no incision or entrance into the body at all.

Used predominantly for kidney stones, the technology (based on equipment originally designed to test supersonic aircraft parts) was introduced in the 1980s. The procedure uses x-rays or ultrasound to locate the stones. Then, precisely targeted, high-energy shock waves are generated outside the body and directed to fragment the stones into particles that are small enough to pass on their own. The entire procedure generally takes between 45 minutes and an hour and most people go home the same day.

A wide range of technologies At Premier Medical Group, we utilize a wide range of technologies that allow us to provide minimally invasive procedures for almost all of our patients’ needs. These techniques decrease the trauma of surgery, minimize blood loss and infection, and speed recovery time.

Endoscopic surgery, using small fiberoptic telescopes, allows access to the entire urinary tract—all the way up to the kidneys—by way of the urethra. Small ports in these ureteroscopes permit use of miniaturized instruments and laser fibers that can fragment kidney stones or destroy tumors.

Laparascopy is probably the best known type of minimally invasive surgery, replacing the large incisions of open surgery with “keyhole incisions”, each about 1/4 to 1/2 inch. A partial kidney removal, for example, uses 4 small incisions in the front of the abdomen while an open surgery would use a 10-inch incision on the patient’s side or flank. One “keyhole” is used for a light source and video camera, while surgical instruments are manipulated through the other “keyholes.”

Robotic surgery is the next generation of minimally invasive surgery that we use in some kidney procedures. This technology, in the capable hands of Dr. Rahman,is providing excellent results for those patients requiring prostate removal.

As Dr. Pietrow points out, minimally invasive surgery isn’t just a minor procedure, it’s still surgery, and requires a period of recovery. But, as patients attest, the healing happens more quickly.