Minimal Access Surgery: What You Need To Know

What is minimal access surgery?

Minimal access surgery (MAS), also called laparoscopic surgery, is one that is done through one or more small incisions in the body cavity instead of a large incision. Surgeons pass special instruments fitted with camera (known as laparoscope) that allow them to access and view the area in question better than a traditional surgery. Other surgical instruments inserted through various other incisions enable the surgeon to perform the surgery while viewing the area on a monitor. MAS techniques were originally developed as diagnostic procedures, and are still widely used to scan and determine various medical conditions and their severity. Minimal access surgery is a method of choice in specialities like gynaecology, orthopaedics and urology. MAS is the first line of technique used for many pelvic surgical procedures. Recent advances in MAS procedures include the advent of laparoscopic procedures that allow surgeries to be completed through small ports of entry in the abdominal wall.

Why should you opt for minimal access surgery?

A minimal access surgery offers various advantages over the traditional open surgery. These include:

1. Through advanced viewing and magnification techniques, MAS surgery offers more precision with minimal damage to surrounding healthy tissues.
2. The increased accuracy of MAS provides faster recovery and minimal post-operative complications. Patients experience less pain due to minimal tissue damage and smaller operative scars as compared to a large scar from a conventional open surgery. Patients are able to resume normal activities in a week's time.
3. The hospitalization time for patients is reduced in a minimal access surgery. Most patients are released on the same day or after one day of surgery.

Which specialist should be consulted for minimal access surgery?

This procedure is used in all fields that deal with organs within the abdomen, and is popularly employed in fields like gastroenterology, oncosurgery (surgery of cancer), gynaecology, urology, and orthopaedics and paediatric surgery. Depending on the patient's ailment and present condition, the corresponding specialist doctor will assess and outline the right treatment plan.

What is the procedure for minimal access surgery?

Most laparoscopic surgeries are performed under general anaesthesia, though some can be conducted under local anaesthesia. The procedure begins with small incision near the area of interest which the insertion of laparoscope. Other small incisions are made to allow the insertion of additional laparoscopic instrumentation. A device in one of the incisions inflates the body cavity with gas, creating working space for the surgeon to manoeuvre instruments. The laparoscope is fitted with a camera that transmits real-time images on to a monitor. This enables the surgeon to view the internal region for diagnosis, extent of affliction, and guide the instruments accurately for the procedure. Once the diagnosis and surgical procedure is complete, all instruments are removed and the incisions are sutured and bandaged. Robotic arms are also available to assist a laparoscopic surgery. Attached to the operating table, a robotic arm may be employed to hold and position the laparoscope, allowing steady camera movements. The surgeon controls the robotic arm through a foot pedal with voice command or a hand-held control panel.

What are the known complications of the surgery?

Like any operative procedure, minimal access or laparoscopic surgery carries some risk factors. These include:

1. Bleeding
2. Infection
3. Injury to internal organs and blood vessels
4. Blood clotting
5. Complications in anaesthesia

 What precautions or steps are necessary to stay healthy and happy before and after minimal access surgery?

Most laparoscopic surgeries are carried out on an outpatient basis but the patient is required to take several pre-operative steps immediately before the surgery. These include eating light one day before the surgery and fasting 12 hours prior to the surgery. The doctors will question the patient's medical history, any known allergies, and current medication. Following laparoscopy, patients may feel light-headed under the aftereffects of anaesthesia and may be either released from the hospital on the same day or the next day. Patients will be given instructions regarding medication, activity levels and dietary regulations for the initial few days after the surgery. Sources:"Laparoscopy," Encyclopaedia of Surgery, https://www.surgeryencyclopedia.com/Fi-La/Laparoscopy.html#b"Minimal Access Surgery, Medscape," Marc A Levitt, MD, 29 November, 2012, https://emedicine.medscape.com/article/938198-overview"Minimal Access Surgery," Primus Hospital, https://www.primushospital.com/index.php/departments/minimal-access-surgeryIntroduction to minimal access surgery," StratOG, Royal College of Obstetricians and Gynaecologists (RCOG), https://www.rcog.org.uk/stratog/page/introduction-minimal-access-surgery"Surgical procedures and innovations - Minimal Access," Colombia Surgery, https://columbiasurgery.org/general/minimal.htmlImage source: asianhhm